Acne Vulgaris - Acne
- Overview, Causes, & Risk Factors
- Symptoms & Signs
- Diagnosis & Tests
- Prevention & Expectations
- Treatment & Monitoring
Overview, Causes, & Risk Factors
Acne is a common skin condition in which the hair follicles become clogged with sebum. The hair follicles are the openings around the hair shaft, and sebum is the oil produced by the glands within the follicle. The clogged follicles cause pimples and inflamed infected abscesses, or collections of pus.
What is going on in the body?
Acne tends to develop in teenagers because of an interaction among hormones, sebum, and bacteria. During puberty, the glands in the skin produce excessive sebum. In acne-prone skin, the sebum and dead skin cells clog the hair follicles and form comedones, or clogged pores.
What are the causes and risks of the condition?
Acne is caused by 4 factors:
Virtually every adolescent experiences some comedones. Generally, acne starts at about age 10 to 13, and lasts for 5 to 10 years. Around the age of 14 or 15, 40% of adolescents have acne that is serious enough to require a visit to a healthcare provider. Acne occurs in both male and female adolescents, but males are more likely to have a severe form of acne. Some people develop acne for the first time as an adult.
Certain forms of acne tend to run in families. If an adolescent's parents or older siblings have severe acne, the adolescent has a higher risk of developing severe acne.
Risk factors for development or worsening of acne include the following:
Symptoms & Signs
What are the signs and symptoms of the condition?
Acne may occur on a person's face, neck, chest, back, shoulders, scalp, and upper arms and legs. Comedones, or clogged pores, are the first signs of acne. There are 2 types of comedones:
A comedone may also break through the pore wall underneath the skin and release its contents. This causes a pimple or pustule. If this substance is released deep into the skin it will cause a cyst, which is a small, pus-filled bump beneath the skin.
Diagnosis & Tests
How is the condition diagnosed?
Acne is diagnosed when blackheads, whiteheads, pimples, pustules, or cysts are seen on the skin.
Prevention & Expectations
What can be done to prevent the condition?
Measures to prevent or minimize acne include the following:
What are the long-term effects of the condition?
Long-term acne can lead to permanent scarring. It can also decrease a person's self esteem and confidence.
What are the risks to others?
Acne is not contagious and poses no risk to others.
Treatment & Monitoring
What are the treatments for the condition?
The most important thing in treating acne is to keep the skin gently cleansed and pores unclogged. Over-the-counter products for acne include the following:
Prescription medications used to treat acne include the following:
Removal of comedones can also help to treat acne. This needs to be done with a special instrument to minimize skin injury. Cortisone may also be injected directly into the skin lesion in certain cases for large, painful cysts.
What are the side effects of the treatments?
Excessively dry and red skin is the most common side effect of medications applied to the skin for treatment of acne. Oral antibiotics may cause stomach upset, allergic reactions, and a sensitivity to sunlight. They may also decrease the effectiveness of oral contraceptives.
Isoretinoin, or Accutane, has been linked to birth defects and miscarriage when used by a pregnant woman. An advisory committee of the Food and Drug Administration has proposed a mandatory registry for women who take isotretinoin. The FDA has also received reports of depression and suicide in individuals taking the medication. At the request of the FDA, the medication's manufacturer has also notified healthcare providers that people taking isotretinoin must receive a medication guide and sign an informed consent document.
What happens after treatment for the condition?
Most treatments need to be continued on an ongoing basis to be effective. One exception is isotretinoin, which is used for 16 to 20 weeks.
How is the condition monitored?
Any new or worsening symptoms should be reported to the healthcare provider.
Author:Lynn West, MD
Editor:Ballenberg, Sally, BS
Reviewer:Eileen McLaughlin, RN, BSN