PATHOLOGY & CAUSES ▪ Common infl ammatory skin disorder affecting hair follicles, sebaceous glands ▪ May involve comedones, papules, pustules, cysts, scars ▪ Especially affects individuals who are ▫ Biologically male, with hormonal disorders producing androgens (e.g. polycystic ovarian syndrome), adolescent ▫ Symptoms decrease with age
TYPES 1.Mild ▪ Occasional, comedones, infl ammatory papules, pustules
2.Moderate ▪ Multiple pustules, nodules occur on trunk
3.Severe ▪ Cystic, large nodules predominant, with persistent involvement of trunk; scarring
CAUSES ▪ Androgen stimulates sebaceous follicles to overproduce sebum → follicles become blocked ▪ Hyperkeratinization of epithelium → accumulation → follicular blocking → debris accumulates further → skin follicles rupture ▪ Propionibacterium acnes replicates within follicle → releases lipase → sebum converted to free fatty acids → release of cytokines → infl ammation
RISK FACTORS ▪ Genetic predisposition ▪ Oil-based skin products ▪ Hormonal imbalance ▪ Infection ▫ Follicle colonization by Propionibacterium acnes ▪
Medications
▫ Lithium, glucocorticoids, anabolic steroids ▪ Polycystic ovarian syndrome ▪ Stress
COMPLICATIONS ▪ Cosmetic ▫ Scars, hyperpigmentation, pyogenic granulomas, osteoma cutis ▪ Psychiatric ▫ Low self esteem, depression
SIGNS & SYMPTOMS:-
Papules, pustules, painful nodules (cysts) on face, neck, chest, back ▪Closed comedones ▪Erythema
OTHER DIAGNOSTICS ▪Clinical presentation
MEDICATIONS ▪Target sebum production, infl ammation, bacterial/follicular proliferation
Mild ▪Benzoyl peroxide treats Propionibacterium acnes ▪Add topical retinoids to prevent follicular proliferation
TREATMENT ▪ In case of comedonal acne, use azelaic acid, salicylic acid as anti-infl ammatory, antibacterial, antiproliferative agent Mild to moderate ▪Benzoyl peroxide, retinoid ▪Add topical antibiotic (clindamycin) for synergistic effect with benzoyl peroxide
Severe ▪Oral isotretinoin decreases sebum production, bacterial proliferation, infl ammation ▪Avoid using tetracycline due to sun sensitivity
OTHER INTERVENTIONS ▪Clean skin with gentle agents ▪Comedones extraction ▪Pigmentation ▫Topical retinoid, azelaic acid, chemical peels ▫Photodynamic treatment with lasers (removes superfi cial layers of skin) ▫Dermabrasion (treatment of scars; may irritate skin
Treatment Management :-
Mild Acne (mostly whiteheads, blackheads, small pimples)
Topical Treatments:
- Benzoyl Peroxide – Reduces bacteria and inflammation.
Topical gel:-Benzac 4% 15gm tube AS A Benzoyl Peroxide AS A Acne treatment .preparations.
- Salicylic Acid – Helps unclog pores.
Cream:-Kerasol 6% 30gm tube AS A Salicylic Acid AS A Topical salicylic preparation.
- Topical Retinoids (e.g., adapalene, tretinoin) – Normalize skin cell turnover.
Cream :-Spotex 0.1% 50gm tube AS A tretinoin AS A Topical retinoid and related preparations.
Topical Antibiotics (e.g., clindamycin, erythromycin) – Reduce bacteria (often combined with benzoyl peroxide).
Capsule :-Clindabac 300mg AS A Clindamycin AS A Macrolides.
🟡 Moderate Acne (more inflammatory papules/pustules)
Combination Therapy:
- Topical Retinoid + Benzoyl Peroxide + Topical Antibiotic
- Oral Antibiotics (e.g., doxycycline, minocycline) – Used short-term (3–6 months).
- Hormonal Treatment (for females):
- Combined oral contraceptives
- Spironolactone – Reduces androgen effects.
🔴 Severe Acne (nodules, cysts, scarring)
Systemic Treatments:
- Oral Isotretinoin (Accutane) – Very effective; used for treatment-resistant or scarring acne.
- Requires strict monitoring (pregnancy prevention, liver tests, lipid profile).
- Oral antibiotics may be used initially but are often less effective alone.
💡 General Advice for All Severities:
- Gentle skincare: Use non-comedogenic products, avoid scrubbing.
- Sun protection: Retinoids increase sun sensitivity.
- Consistency: Most treatments take 6–12 weeks to show effects.
- Avoid picking: Prevents scarring and worsened inflammation.
Raiyyan Tahsan. Date:-4-05-2025 Sunday Time:-09-55-45 Pm