Acne vulgaris by Pradeep Paudel

Pokhara University
School of Health and Allied Sciences
Acne vulgaris
Pradeep Paudel
Third Semester, B Pharm
Roll no:18
Pokhara University, Dhungepatan, Lekhnath, Kaski , Nepal

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Topics Under Discussion
• Introduction
• Causes
• Types
• Effects
• Treatments
• Precautions
• Conclusion
• References
25 October 2015 Acne vulgaris 2

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Introduction
• Acne vulgaris is a common human skin disease,
characterized by pimples, comedones (blackheads
and whiteheads), papules, nodules, cysts as a result
of obstruction of pilosebaceous gland.
• Hence, acne is a disorder of the pilosebaceous unit
caused primarily by increased sebum secretion and
follicular plugging.

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Contd…
• Overproduction of a
normal oil on the skin
called sebum increases
under the influence of
hormones and plugs
hair follicle.
• The plugged follicle
become inflammed and
have increased growth
of normal skin and
results in acne.

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Pokhara University
Contd…
• Acne can affect people of all age groups but is most
prevalent in adolescence and may persist or become
more severe in adulthood.
• Acne most often affects face, but it may also spread
to neck, chest, back and sometimes even more
extensively all over the body.

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Causes
Hormonal change
Inflammation and infection
Genetics
Unhealthy life style
Use of low quality and expired cosmetic products
Stressful condition
Abnormal sebum production

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Types of Acne
1. Non-inflammatory lesions
 Whiteheads or closed comedones
 Blackheads or open comedones
2. Inflammatory lesions
 Papules
 Nodules
 Cysts

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Comedones :
• A comedones is a hair follicle that has become
clogged with oil and dead skin cells.
• Comedones can develop into bumps called
whiteheads and blackheads.

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Whiteheads :
• Comedones that stay closed at the surface of the
skin are called whiteheads.
• They are also termed as closed comedones.
• This happen when oil and skin cells prevent a clogged
hair follicle from opening.

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Blackheads :
• Blackheads are comedones that are open at the
surface of the skin.
• They are also called as open comedones.
• They are filled with excess oil and dead cells.

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Papules :
• Papules are comedones that become inflammed,
forming small red or pink bumps on the skin.
• This type of pimple may be sensitive to the touch.
• Picking or squeezing can make the inflammation
worse and may lead to scarring.

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Effects of Acne vulgaris
Physical effects:
Acne Fulminans i.e acne break and causing scarring
Distortion of face
Inflammation
Pigmentation

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Contd…
Psychological effects :
Damage one’s self esteem and confidence
Anxity and depression
Social inhibition
Suicidal disposition in extreme cases

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Treatments
 Treatment for acne depends on the patient’s age and
sex, the extent and the severity of the acne, how
long it has been present and response to previous
treatments.
 Topical (or external) treatments for acne include one
or more creams, washes, or gels that include:
• Antibacterial agents and antibiotics such as benzoyl
peroxide, clindamycin, erythromycin, sulfur, sodium
sulfacetamide, and azelaic acid.

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Contd…
 Oral treatments may include:
• Antibiotics such as tetracycline, minocycline,
doxycycline, erythromycin, ampicillin, clindamycin,
azithromycin or cephalosporins.
• Oral contraceptives and spironolactone have been
found to help regulate hormones.
• Isotretinoin, a strong drug with many side effects, for
severe acne unresponsive to the above treatments.

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Contd…
• Treatment for
moderate acne include
acne antibiotics such as
benzoyl peroxide
tetracyclines or anti-
androgens.
• Treatment for severe
acne may require a
course of oral
isotretinoin.

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Other treatment methods:
Topical antibiotics:
• Inflammatory papules are often treated with topical
antibiotics.
• Erythromycin and clindamycin are the most
conventional topical antibiotics prescribed.
• Clindamycin is prescribed more often than
erythromycin, as it has maintained better efficacy.

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Contd…
Hormonal treatment:
• Hormonal treatment of acne is appropriate for
females only. It is geared toward decreasing
androgen levels, the hormone implicated in
stimulation of the sebaceous follicle.
• Combination pills with estrogen and progesteron
that have low androgenic activity should be choosen.
• Response to hormonal treatment can take 3 to 6
months.

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Contd…
Acne surgery:
• The term "acne surgery" refers to extracting
comedones and draining pustules and cysts.
• Comedones can be easily extracted with the use of a
comedone extractor tool or applying pressure
around the follicular opening with two cotton-tipped
applicators.
• Care must be taken not to cause tissue damage
when performing these procedures.

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Contd…
Laser treatment and phototherapy:
• The use of lasers and light therapy for the treatment
of acne is still in the early stages of development.
• The long-term safety and efficacy of light-based
treatments is still need to be clarified.
• However, these treatments are potentially helpful
for individuals who cannot tolerate other acne
regimens or those who have failed conventional
therapeutic treatments.

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Precautions
 Do not try to break your pimples as it can make them
more worse.
 Do not use strong soaps and chemicals on your face.
 Do not overexpose your skin to the sun.
 Avoid eating too much of junk food and spicy food.
 Include food containing vitamins A and E in your diet.
 Better avoid choclates, fatty food, fried food,
carbonated and caffeinated beverages or foods.
 Drink plenty of water and fruit juice.

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Conclusion
• Acne vulargis is a significant psychological and
financial burden for those affected.
• Although mild acne may improve with over-the-
counter treatments, more severe forms should be
treated by a dermatologist.
• Oral therapies are often necessary in moderate-to-
severe acne cases.
• Patients need to be aware that response to
treatment can take several weeks to months.

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References
 Walker BR and Ralston SH (2010)Davidson’s
Principles and Practice of Medicine (21st
Ed.), Elsevier,
Edinburg, pp1267-1268
 Medscape. Acne Vulgaris
(
http://emedicine.medscape.com/article/1069804-overvie
) (Accessed on June27, 2015)

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“DON’T HIDE YOUR FACE, REVEAL YOUR
BEAUTY WITH CONFIDENCE !”
October 25, 2015 Acne vulgaris 26

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Acne vulgaris by Pradeep Paudel

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