Table of content
Acne Vulgaris 3
Factors in development of acne 4
Medical and treatments 6
Acne vulgaris is a common, chronic disease of the sebaceous follicle that primarily affects the face, chest and back. Acne vulgaris can be characterized by areas of seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), nodules (large papules), pimples, and possibly scarring. The populations prone to be affected by acne vulgaris are adolescents and others predisposed to acne. Acne vulgaris has a lifetime prevalence of 85%. Actually, almost every teenager can expect to experience acne to some degree during the adolescent years. Acne tends to occur in adolescence, when hormones are in a state of flux. However, teenage females may continue to experience acne into the adult years, sometimes well beyond into their thirties and forties. Thus, attention should be paid to the risk and factors that influences the development of acne vulgaris in order to cure the disease.
Factors in development of acne
Acne vulgaris is a multi factorial disease. Hormonal, diet, psychological, infectious and environmental factors have been implicated in the development of acne vulgaris.
Hormonal activity, such as menstrual cycles and puberty, may contribute to the formation of acne. Acne tends to occur in adolescence, when hormones are in a state of flux and may flare up when they are premenstrual. An increase in sex hormones called androgens during puberty may cause the follicular glands to grow larger and make more sebum. A similar increase in androgens occurs during pregnancy, also leading to increased sebum production. Several hormones have been linked to acne such as the androgens testosterone, dihydrotestosterone (DHT) and dehydroepiandrosterone sulfate (DHEAS) as well as insulin-like growth factor 1 (IGF-I).
Development of acne vulgaris in later years is uncommon, although the incidence of rosacea, which may have a similar presentation, is increased in older age groups. in adult women, acne vulgaris may be a feature of an underlying condition such as pregnancy, or disorders such as polycystic ovary syndrome, hirsutism, or Cushing's syndrome. Besides that, menopause-associated acne such as acne climacterica may occur as production of the natural anti-acne ovarian hormones estradiol and progesterone fail, permitting the acnegenic hormone testosterone to exert its effects unopposed.
As with the disease whose course is prolonged and capricious, the importance of psychological factors in treatment of breakout has been repeatedly stressed and should be seriously taken into account when using treatments. While the connection between acne and stress has been debated, scientific research indicates that "increased acne severity" is "associated with increased stress levels. Most patients with acne who seek medical care are concerned with the effects on their appearance, but some patients seek care because of painful nodules or scarring caused by the disease. Consequently, acne vulgaris can cause severe psychological problems, undermining self-assurance and self-esteem at a vulnerable time in life. Thus, attention should be paid to psychosomatic aspects especially if depressive-anxious disorders are suspected, particularly with evidence of suicidal tendencies.
Environmental factors also play a major role in determining the severity and extent of acne and affect topical treatments. In most cases the manifestations are worse in winter and improves during the summer, suggesting a salutary effect of sunlight. Sun bathing may beneficial for psychological reason and may produce euphoric effects. Besides that, the constant friction caused