Acne

What are the symp­toms of acne?

  • Acne skin lesions are char­ac­ter­ized by seb­or­rhea, scaly skin lesions
  • Come­domes, con­sist­ing of black and white heads that are the direct cause of seba­ceous glands get­ting clogged with sebum which is a nat­u­ral­ly occur­ring oil in the skin
  • Papules or ​“zits” that apply to small red lesions
  • Pus­tules lesions with white heads
  • Nod­ule or cys­tic acne con­sist of large, red raised lesions

Pedi­atric acne applies to pre­sen­ta­tion of the dis­ease before age 11 and ado­les­cent acne refers to acne pre­sen­ta­tion from age 12 through adult.

Neona­tal acne – con­sist of red papule or papu­lo­pus­tu­lar lesions on the face (cheeks, chin, eye­lids, and fore­head). This is a self lim­it­ing prob­lem that resolves in 1 – 3 months occa­sion­al­ly up to 12 months.

Infan­tile acne – is more com­mon in boys than girls and is less com­mon than neona­tal acne. It usu­al­ly starts between 3 – 6 months of age and most­ly involves face and cheeks and is more like reg­u­lar acne with come­domes and occa­sion­al nod­ules and cysts.

Mild child­hood acne - In gen­er­al, this form of acne is rare and presents in chil­dren 1 – 6 years of age and it may indi­cate high andro­gen lev­els. There­fore, adren­al gland dis­or­ders should be ruled out.

Pread­o­les­cent acne – This is when acne presents between age 7 – 11 and may be the first sign of puber­tal mat­u­ra­tion. The lesions are usu­al­ly come­domes in the T‑zone of the face (across the fore­head, on and near the nose, and on the chin).

Ado­les­cent acne – is the most com­mon skin prob­lem, affect­ing 15% of indi­vid­u­als of all ages and 85% of ado­les­cents. This usu­al­ly con­tin­ues into adult­hood, but decreas­es in inten­si­ty or disappears.

Severe acne that caus­es large nod­ules, also called cys­tic acne, can cause scar­ring and pig­men­ta­tion. The psy­cho­log­i­cal impact of acne on indi­vid­u­als, espe­cial­ly ado­les­cents can lead to reduced self esteem and at times depres­sion. There­fore ear­ly and aggres­sive treat­ment can decrease the over­all long term impact.

Con­tribut­ing factors:

  • Genet­ics – it tends to have a famil­ial predisposition
  • Hor­mon­al – increased hor­mone activ­i­ty dur­ing puber­ty, men­stru­al cycle and use of ana­bol­ic steroids can aggra­vate or cause acne
  • Infec­tious agents p. acne and staph epi­der­mi­tis have been fre­quent­ly dis­cov­ered in acne lesions, but not yet cer­tain to be the sole cause of acne
  • Diet high in sug­ar and excess con­sump­tion of milk is believed to wors­en acne, but choco­late and salt are not sup­port­ed by evidence.

Treat­ment – There are many dif­fer­ent treat­ments for acne that are all based on nor­mal­iz­ing the shed­ding of the top lay­er of the skin and pre­vent­ing the block­age including:

  1. Anti­se­b­or­rhe­ic medications
  2. Antibi­otics and retinoids
  3. Antian­dro­genic medications
  4. Ker­a­tolyt­ic soaps

Your physi­cian will be able to diag­nose the type of acne and pro­vide you with the appro­pri­ate treatment.