Acne

Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It can affect people of all ages, but is most common during puberty when the body undergoes hormonal changes. In this article, we will discuss the case, pathophysiology, signs and symptoms, investigation, treatment, and advice for acne.

Case:
A 16-year-old girl presents to the dermatology clinic with complaints of persistent acne for the past six months. She reports having numerous papules, pustules, and comedones on her face, chest, and back. She has been using over-the-counter acne treatments, but has not seen any improvement. Her medical history is unremarkable, and she is not taking any medications.

Pathophysiology:
Acne is caused by a combination of factors, including increased sebum production, bacterial growth, inflammation, and abnormal follicular keratinization. Androgens, such as testosterone, play a role in stimulating sebum production, which can lead to clogged hair follicles. When bacteria, such as Propionibacterium acnes, colonize these follicles, they can cause inflammation and the formation of papules, pustules, and nodules.

Signs and Symptoms:
The signs and symptoms of acne can vary depending on the severity of the condition. Mild acne may present as comedones (blackheads and whiteheads), while moderate to severe acne may result in papules, pustules, nodules, and cysts. Acne can occur on the face, chest, back, and shoulders. It can be painful and may lead to scarring if not properly treated.

Investigation:
The diagnosis of acne is primarily clinical, and a physical examination of the skin is usually sufficient. In some cases, a skin biopsy may be necessary to rule out other conditions. Laboratory tests are generally not required, unless there is a suspicion of an underlying endocrine disorder.

Treatment:

The treatment of acne depends on the severity of the condition. Mild acne can often be managed with over-the-counter topical treatments containing benzoyl peroxide, salicylic acid, or retinoids. Moderate to severe acne may require prescription topical or oral medications, such as antibiotics, isotretinoin, or hormonal therapies. In some cases, procedures like chemical peels, laser therapy, or extractions may be necessary to help clear the skin.

Advice (Dos and Don’ts):

Do wash your face twice a day with a gentle cleanser.
Do use oil-free, non-comedogenic skincare products.
Do wear sunscreen to protect your skin from further damage.
Don’t pick or pop your pimples, as this can lead to scarring and further inflammation.
Don’t use abrasive scrubs or harsh cleansers, as this can irritate the skin and make acne worse.
Don’t apply oily or greasy products to your skin, as this can clog pores and lead to more breakouts.

Reference:
American Academy of Dermatology. (n.d.). Acne. Retrieved February 10, 2022, from https://www.aad.org/public/diseases/acne-and-rosacea/acne