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ACNE
DR. ANERI PATWARI
MPT-: CARDIO-RESPIRATORY
ASSISTANT PROFESSOR
CONTENT
•INTRODUCTION
•FACTORS
•SIGNS AND SYMPTOMS
•TYPES
•GRADINGS
•SEVERITY
•MANAGEMENT
08-04-2024 2
INTRODUCTION
•The prevalence of acne in adolescents has been reported to be as high as 95%
with a 20% to 35% prevalence of moderate to severe acne.
• Acne may persist into adulthood in up to 50% of affected individuals.
• Acne rarely cause serious systemic problems, but quality of life issues are a very
important concern for individuals (especially teenagers) with acne.
• Depression, anxiety, and low self-esteem are more common in patients with
acne.
08-04-2024 3
FACTORS
RISK
1. Obesity: hyperandrogenism
2. A significant positive family history of
acne has been demonstrated especially
when acne is found in:
– Twins
– Mother
– First degree relative
– Multiple family members
AGGREVATING
1. Smoking
2. Stress
3. Facial therapy or, salon facial massage
4. High glycemic loads diet
5. Milk and milk products
6. Tight cloths/ head bands
08-04-2024 4
FACTORS
DIET
1. High glycemic loads diet
2. Milk and milk products
3. Risk of acne increased by:
a) 4 fold when milk intake frequency
increased from < Than 1 time a week
b) Seven-fold when ice cream intake
frequency is between less than once a week
to daily consumption
c) Low fibre and high fat diet
DIETARY SUPPLEMENTS
1. There is no conclusive statement on the
effectiveness of zinc supplement in acne
2. There is no retrievable evidence on the
efficacy of vitamin A, vitamin C, vitamin E
and omega-3 fatty acids in the management
of acne
08-04-2024 5
FACTORS
CAUSES
1. Excess oil production
2. Hair follicles clogged by oil and
dead skin cells
3. Bacterial infection
(Propionibacterium acnes)
4. Excess activity of a type of
hormone (androgens)
SIGNS & SYMPTOMS
1. Whiteheads (closed plugged pores)
2. Blackheads (open plugged pores)
3. Small red, tender bumps (papules)
4. Pimples (pustules), which are papules with
pus at their tips –
5. Large, solid, painful lumps beneath the
surface of the skin (nodules)
6. Painful, pus-filled lumps beneath the
surface of the skin (cystic lesions)
08-04-2024 6
08-04-2024 7
08-04-2024 8
ACNE PATHOGENESIS
08-04-2024 9
ACNE PATHOGENESIS
08-04-2024 10
TYPES
ACNE
CONGLOBATA
OCCUPATIONAL
ACNE
COSMETIC
ACNE
DRUG-
INDUCED
ACNE
INFANTILE
ACNE
LATE ONSET
ACNE
ACNE
EXCORIEE
ACNE
FULMINANS
POST-FACIAL
MASSAGE ACNE
08-04-2024 11
ACNE CONGLOBATA
•Severe form, Multiparous
• intercommunicating abscesses, cysts
and sinuses loaded with
serosanguinous fluid or, pus.
•Lesions take months to heal and on
healing leave behind deep pitted or,
hypertrophic scars, joined by keloidal
bridges.
• Occlusion syndrome
OCCUPATIONALACNE
• caused by exposure to industrial
chemicals.
• Predominantly comedones Suspected
in
•-unusal sites of involvement e.g.
forearms
•-unusal age e.g. middle age males
08-04-2024 12
COSMETIC ACNE
• Eruption seen in women using
cosmetics, especially oil based ones.
• Almost always comedones
• Lesion frequently on the chin
DRUG –INDUCED ACNE
•steroids, androgens, anabolic steroids,
OCPs, anti-TB drugs,iodides, bromides
and anticonvulsant can cause
acneiform eruption.
• lesions- monomorphic, consisting of
papules and pustules.
• Trunk especially back and face may
be involved.
08-04-2024 13
INFANTILE ACNE
•Due to presence of maternal
hormones in the child.
• higher in males.
• May present at birth and may last
for upto 3 yrs.
•Lesions similar to those of
adolescent acne
LATE ONSET ACNE
•Acne with onset after 25 years old.
•Predominantly as deep seated,
persistent lesions on lower half of
face.
•Exclude underlying androgen
secretion pathology, especially
polycystic ovarian syndrome
08-04-2024 14
ACNE EXCORIEE
1. seen in young girls, who excessively pick
their mild acne.
2. results in discrete excoriations on the face,
while comodones and papules are few and
far in between.
ACNE FULMINANS
1. Acute onset
2. Presents as crusted, ulcerated lesions.
3. associated with fever, myalgia and
arthralgia.
08-04-2024 15
POST-FACIAL MASSAGE ACNE
•Facial massage may be followed (3-6 wks later) by an acneiform eruption in
about 30% patient.
•Indolent deep seated nodules with very few ( or no) comedones.
• Heal with hyperpigmentation after several weeks.
• Lesion: Predominantly on cheeks, along the mandible.
08-04-2024 16
GRADES:
PILLSBURRY’S CLASSIFICATION
08-04-2024 17
SEVERITY OFACNE
08-04-2024 18
SEVERITY OFACNE
CHEST ACNE BACK ACNE
08-04-2024 19
MANAGEMENT
ACNE
PHARMACOLOGY
TOPICAL SYSTEMIC
NON
PHARMACOLOGY
PHYSICAL
THERAPY
UVR CRYOTHERAPY
PHOTO
THERAPY/
LASER
CHEMICAL
PEEL
COMODEONE
EXTRACTION
08-04-2024 20
08-04-2024 21
AIMS OF TREATMENT
1. Control & trae existing acne lessions
2. Limit duration of disorders
3. Prevent permanent scarring
4. Prevent psychological complications
08-04-2024 22
GENERALALLIANCE ACNE
TREATMENTALGORITHM
08-04-2024 23
ADVANTAGES OF
PHYSIOTHERAPY
1. Quick – results are achieved in a rapid fashion
2. Efficient – addresses both aetiology and pathogenesis to
3. eliminate cause not just symptoms Safe
4. causes minimum adverse reactions Specific – drugs or treatment delivered to
affected organs or tissues Painless
5. uses non-invasive procedures Stressless
6. avoids unnecessary surgical procedures and use of general anaesthetics
7. Improve skin health & Promote peeling
08-04-2024 24
UVR
•High pressure air-cooled mercury vapour burner is used.
• UVR TYPE: 190-390 nm
•Skin – burner distance: 45 cm
08-04-2024 25
DOSIMETERY
DOSE FREQUENCY THEORY
E1 dose ▪ 2-3 times a week ▪ For 3-4 weeks • increased circulation
provides extra amino acids,
oxygen & other nutritive
substances to enable the
synthesis of healthy skin
E2, E3 • ▪ Clears within 6-8 weeks.
• If no improvement in 12 weeks ,
than stop the treatment.
• Because there is a danger of skin
cancer with excessive UVR.
• E2 is tolerated on face, upper
back or chest.
• While E3 is only tolerated on
upper back or chest.
• affected skin is removed
more quickly & healthy
skin will replace it.
• The E2 Or E3 will open up
the pilo-sebaceous opening
causing the infected
material to be discharged
rather than retained within
the skin.
08-04-2024 26

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physiotherapy in Acne condition.....pptx

  • 1. ACNE DR. ANERI PATWARI MPT-: CARDIO-RESPIRATORY ASSISTANT PROFESSOR
  • 3. INTRODUCTION •The prevalence of acne in adolescents has been reported to be as high as 95% with a 20% to 35% prevalence of moderate to severe acne. • Acne may persist into adulthood in up to 50% of affected individuals. • Acne rarely cause serious systemic problems, but quality of life issues are a very important concern for individuals (especially teenagers) with acne. • Depression, anxiety, and low self-esteem are more common in patients with acne. 08-04-2024 3
  • 4. FACTORS RISK 1. Obesity: hyperandrogenism 2. A significant positive family history of acne has been demonstrated especially when acne is found in: – Twins – Mother – First degree relative – Multiple family members AGGREVATING 1. Smoking 2. Stress 3. Facial therapy or, salon facial massage 4. High glycemic loads diet 5. Milk and milk products 6. Tight cloths/ head bands 08-04-2024 4
  • 5. FACTORS DIET 1. High glycemic loads diet 2. Milk and milk products 3. Risk of acne increased by: a) 4 fold when milk intake frequency increased from < Than 1 time a week b) Seven-fold when ice cream intake frequency is between less than once a week to daily consumption c) Low fibre and high fat diet DIETARY SUPPLEMENTS 1. There is no conclusive statement on the effectiveness of zinc supplement in acne 2. There is no retrievable evidence on the efficacy of vitamin A, vitamin C, vitamin E and omega-3 fatty acids in the management of acne 08-04-2024 5
  • 6. FACTORS CAUSES 1. Excess oil production 2. Hair follicles clogged by oil and dead skin cells 3. Bacterial infection (Propionibacterium acnes) 4. Excess activity of a type of hormone (androgens) SIGNS & SYMPTOMS 1. Whiteheads (closed plugged pores) 2. Blackheads (open plugged pores) 3. Small red, tender bumps (papules) 4. Pimples (pustules), which are papules with pus at their tips – 5. Large, solid, painful lumps beneath the surface of the skin (nodules) 6. Painful, pus-filled lumps beneath the surface of the skin (cystic lesions) 08-04-2024 6
  • 12. ACNE CONGLOBATA •Severe form, Multiparous • intercommunicating abscesses, cysts and sinuses loaded with serosanguinous fluid or, pus. •Lesions take months to heal and on healing leave behind deep pitted or, hypertrophic scars, joined by keloidal bridges. • Occlusion syndrome OCCUPATIONALACNE • caused by exposure to industrial chemicals. • Predominantly comedones Suspected in •-unusal sites of involvement e.g. forearms •-unusal age e.g. middle age males 08-04-2024 12
  • 13. COSMETIC ACNE • Eruption seen in women using cosmetics, especially oil based ones. • Almost always comedones • Lesion frequently on the chin DRUG –INDUCED ACNE •steroids, androgens, anabolic steroids, OCPs, anti-TB drugs,iodides, bromides and anticonvulsant can cause acneiform eruption. • lesions- monomorphic, consisting of papules and pustules. • Trunk especially back and face may be involved. 08-04-2024 13
  • 14. INFANTILE ACNE •Due to presence of maternal hormones in the child. • higher in males. • May present at birth and may last for upto 3 yrs. •Lesions similar to those of adolescent acne LATE ONSET ACNE •Acne with onset after 25 years old. •Predominantly as deep seated, persistent lesions on lower half of face. •Exclude underlying androgen secretion pathology, especially polycystic ovarian syndrome 08-04-2024 14
  • 15. ACNE EXCORIEE 1. seen in young girls, who excessively pick their mild acne. 2. results in discrete excoriations on the face, while comodones and papules are few and far in between. ACNE FULMINANS 1. Acute onset 2. Presents as crusted, ulcerated lesions. 3. associated with fever, myalgia and arthralgia. 08-04-2024 15
  • 16. POST-FACIAL MASSAGE ACNE •Facial massage may be followed (3-6 wks later) by an acneiform eruption in about 30% patient. •Indolent deep seated nodules with very few ( or no) comedones. • Heal with hyperpigmentation after several weeks. • Lesion: Predominantly on cheeks, along the mandible. 08-04-2024 16
  • 19. SEVERITY OFACNE CHEST ACNE BACK ACNE 08-04-2024 19
  • 22. AIMS OF TREATMENT 1. Control & trae existing acne lessions 2. Limit duration of disorders 3. Prevent permanent scarring 4. Prevent psychological complications 08-04-2024 22
  • 24. ADVANTAGES OF PHYSIOTHERAPY 1. Quick – results are achieved in a rapid fashion 2. Efficient – addresses both aetiology and pathogenesis to 3. eliminate cause not just symptoms Safe 4. causes minimum adverse reactions Specific – drugs or treatment delivered to affected organs or tissues Painless 5. uses non-invasive procedures Stressless 6. avoids unnecessary surgical procedures and use of general anaesthetics 7. Improve skin health & Promote peeling 08-04-2024 24
  • 25. UVR •High pressure air-cooled mercury vapour burner is used. • UVR TYPE: 190-390 nm •Skin – burner distance: 45 cm 08-04-2024 25
  • 26. DOSIMETERY DOSE FREQUENCY THEORY E1 dose ▪ 2-3 times a week ▪ For 3-4 weeks • increased circulation provides extra amino acids, oxygen & other nutritive substances to enable the synthesis of healthy skin E2, E3 • ▪ Clears within 6-8 weeks. • If no improvement in 12 weeks , than stop the treatment. • Because there is a danger of skin cancer with excessive UVR. • E2 is tolerated on face, upper back or chest. • While E3 is only tolerated on upper back or chest. • affected skin is removed more quickly & healthy skin will replace it. • The E2 Or E3 will open up the pilo-sebaceous opening causing the infected material to be discharged rather than retained within the skin. 08-04-2024 26