Acne Vulgaris (AV)
Acne Vulgaris (AV): Causes, Symptoms, Diagnosis, and Treatment
Acne Vulgaris (AV) is the most common form of acne, characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and cysts due to the obstruction and inflammationInflammation (IFM) of pilosebaceous units (hair follicles and sebaceous glands). It primarily affects the face and upper trunk, with a significant impact on adolescents and young adults. Below is a detailed overview of its causes, symptoms, diagnosis, and treatment options.
Causes of Acne Vulgaris
Primary Factors:
- Excess Sebum Production: Stimulated by hormonal changes, particularly during puberty.
- Follicular Plugging: With sebum and keratinocytes, leading to comedone formation.
- Bacterial Colonization: Cutibacterium acnes (formerly Propionibacterium acnes) contributes to inflammation.
- Inflammation: Release of inflammatory mediators exacerbates acne severity.
Secondary Triggers:
- Hormonal Fluctuations: Pregnancy, menstruation, or polycystic ovary syndrome (PCOS).
- Medications: Corticosteroids, lithium, and certain anticonvulsants can exacerbate acne.
- Lifestyle Factors: Occlusive cosmetics, high humidity, and certain dietary factors (e.g., high-glycemic diets).
Symptoms of Acne Vulgaris
- Comedones: Whiteheads (closed comedones) and blackheads (open comedones).
- Inflammatory Lesions: Papules, pustules, nodules, and cysts, which may be painful and lead to scarring.
- Post-inflammatory Hyperpigmentation: Dark spots remaining after lesions resolve.
Diagnosis
Diagnosis is primarily clinical, based on visual examination of skin lesions. No specific tests are required for routine cases, but in complex or resistant cases, further evaluation may include:
- Hormonal Testing: To rule out underlying hormonal imbalances.
- Skin Scraping or Biopsy: Rarely needed to differentiate from other skin conditions.
Treatment Options
Topical Therapies:
- Retinoids: Normalize keratinization and prevent comedone formation.
- Benzoyl Peroxide: Reduces bacterial counts and inflammation.
- Topical Antibiotics: Used in combination with benzoyl peroxide for mild to moderate inflammatory acne.
Systemic Therapies:
- Oral Antibiotics: For moderate to severe acne, often used in combination with topical treatments.
- Isotretinoin: Reserved for severe acne due to its potential side effects.
- Skin Care: Gentle cleansing and avoiding occlusive products.
- Dietary Changes: Reducing intake of high-glycemic foods and dairy products may help some individuals.
Complications
- Scarring: Permanent marks left by severe inflammatory lesions.
- Psychological Impact: Acne can cause significant emotional distress and social withdrawal.
Conclusion
Acne vulgaris is a common skin condition that can have significant physical and emotional impacts. Early treatment is crucial to prevent scarring and reduce psychological distress. A combination of topical and systemic therapies, along with lifestyle modifications, can effectively manage acne and improve quality of life.
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