Acne is one of the commonest reason for visiting skin doctor.Apart from the face, acne can occur on the back, arms and chest also. It is common for such individuals to also have oily facial skin.
Age group- seen mostly during 10 to 40yrs of age. Maximum incidence during 15 to 20 years.
Types of lesions in acne- comedones (white heads and black heads), red papules, nodules (big painful lesion), cystic lesion (filled with fluid, pus).
Causes
- Most important cause of acne is hormonal spurt during pubertal years. In this age group upto 70% persons can have acne, but only 10-30% have severe acne.
- Hormonal acne- PCOS, congenital adrenal hyperplasia and other syndromes.
- Cosmetic induced acne especially in married women.
- Drug induced acne example steroids, antipsychotic drugs, lithium, SSRI etc
- Stress and pollution can increase acne.
- Food especially high glycemic diet, junk food can exacerbate acne
Hormonal acne- increased facial hair growth in female, increase hair loss from scalp, irregular or decreased periods or increase in acne before periods, no improvement in acne with treatment can indicate hormonal acne. In such cases hormonal tests such as FSH, LH, DHEAS, Testosterone, Prolactin, 17 hydroxyprogesterone, urinary cortisol, USG pelvis are required.
Treatment
- Most important thing is to treat early to prevent scar formation. Severe acne is more likely to leave scar
- Don’t ever use cream given by friends or chemist if your face is important to you, always take skin specialist opinion, otherwise your face can get damaged
- Usually acne improvement takes time, around 4 weeks to start drug action and complete improvement may take 6 months or more. Treatment should not be stopped in between, even after improvement drugs need to be continued for few months
- Depending upon severity of acne, either oral and/or topical drugs are needed
- Topical drugs – topical retinoids, benzoyl peroxide, topical antibiotics, azelaic acid, dapsone etc
- Oral drugs – oral isotretinoin, oral antibiotics, hormonal treatment in form of OCPs, spironolactone tablet etc.
- Others like chemical peels and light therapy can be used for fast improvement
- Other things- take healthy diet, proper sleep, avoid stress, avoid heavy cosmetics.
- Acne scars – usually needs some procedural treatment like microneedling, subscision, chemical peels, Lasers etc. and acne scars usually take months to improve.