Acne is by far one of the commonest reasons in the world for a visit to the skin-care professional like Skin specialist in Islamabad. Acne has a substantial impact on the psychosocial wellbeing of an individual and can be quite debilitating in some cases. But what exactly causes acne and what are the interventions for acne treatment? Read on to find out:
What is the cause behind acne?
Acne is a chronic disorder, that results in blockage of the pilosebaceous unit—hair follicle and its sebaceous gland. Acne lesions involve both inflammatory and noninflammatory changes and sometimes be a mixture of both. While the most common site of acne is the face, it can also occur on the chest and back—referred to commonly as backne.
The pathogenesis of acne involves the excessive proliferation of follicles, along with excess sebum production that ends up clogging the pore and infection by the commensal acne bacteria that can add the element of inflammation. The symptoms of acne often manifest as pain, redness, and pustules.
Interventions of acne
Most healthcare professional target acne based on the known factors causing pathogenicity. For instance, targeting hyperproliferation of the follicles, antibiotics for the C acnes bacteria and inhibiting excess sebum production are the management goals in acne.
The treatment plan for each individual patient varies, based on their type of acne, causative factors, age and response to treatment. Even two people with the same type of acne can have a different treatment regimen. Topical therapy is effective for mild to moderate disease, while severe lesions should be treated with combination therapy and systemic medication.
Retinoids: Retinoids are derivatives of vitamin A and act to reduce blockage of follicles by targeting follicular keratinocytes. Retinoids also reduce inflammatory mediators and bring down the inflammation associated with acne. The best response to retinoids occurs about 12 weeks after starting treatment. To prevent flare-ups, maintenance therapy is used.
Benzoyl peroxide: is a bactericidal agent that reduces superinfection by C acnes bacteria. Additionally, it has anti-inflammatory and comedolytic properties. It is one of the fastest acting antiacne medication, with responses as early as within five days of treatment.
Azelaic acid: is derived from yeast and has antibacterial properties. If used twice a day, azelaic acid is quite effective at treating acne. Many healthcare providers prefer prescribing azelaic acid for pregnant and lactating mothers for acne treatment. It is also helpful for managing post-inflammatory discoloration which is seen in many acne cases.
Salicylic acid: is available as over-the-counter face washes and leave-on products. Its use in acne is to prevent plugging of hair follicles, but research data regarding its efficacy is limited. Salicylic acid can cause mild skin irritation after use.
Oral antibiotics: like tetracyclines are prescribed when the acne lesions are severe. These are prescribed to reduce bacterial superinfection. For pregnant women, children under 8, macrolides are used. These medications are used only under the care of a healthcare professional and used for the shortest duration recommended.
For mild acne
Mild acne with black and white heads is treated with one of the following or the combination thereof: retinoid, benzoyl peroxide, salicylic or azelaic acid and antibiotic.
For moderate acne
Moderate acne with pimples is also dealt with by topical creams. One or more of the following are used for this type of acne: benzoyl peroxide, azelaic acid, retinoid, topical antibiotic and birth control pill. The latter is useful when there are continuous breakouts. The US Food and Drug Administration (FDA) has also approved of birth control patches to treat acne.
For severe nodular and cystic acne
Nodulocystic acne is the most severe type of acne, and needs long-term treatment under the care of a professional such as the Best dermatologist in Lahore. The treatment consists of prescription medication, oral antibiotic, isotretinoin and hormonal therapy for women.