Acne is a chronic skin disorder affecting pilosebaceous units caused due to clogged skin’s hair follicles by dead skin, excess sebum, dust and pollution.
Its Also called Acne Vulgaris
Its characterised by oily skin, comedons, black-heads, white-heads, pimples and scarring and pigmentation.
It usually presents itself in region dense with sebeceous glands, like on face, chest and back.
Strong Genetic and Heredity association is found in 80% cases. During puberty surge in hormones triggers Acne in both sexes. Diet, cleanliness, medication, infections, pollution environmental factors ,sunlight exposure,stress, smoking and other lifestyle factor seems to contribute in not all but many cases in varing degrees. propionibacterium acnes a commonly found on skin which frequently outgrows in number and contribute to Acne in most of the cases.
Acne are categorised based on severity and there are various methods to do this Cook’s photographic scale of 0-8 grades, Leed’s scale of 0-10 with 2 modified versions of 0-11 and 0-12 and Pillsburry’s scale of 1-4 grades. A scale of mild, moderate and severe is commonly used which easily helps to quickly decide line of treatment.
Mild form has only clogged hair follicle called comedones also known as black-head(open mouth comedone) and white-head(closed mouth comedone) and very occasional pimples are found on trunk .
Moderate form has pappules and pustules forming on clogged hair follicles called pimples are found on face and trunk.
Severe form has cysts and nodules its termed severe nodular acne and is present extensively on face and trunk.
Acne is a chronic skin disorder affecting pilosebaceous units caused due to clogged skin’s hair follicles due to
- Excess sebum production under influence of androgen,
- Excess keratin deposition in hair follicle,
- Infection and colonization of the hair follicle by Propionibacterium acnes , and
- Local activation of inflamatory mediators.
Dihydroxytestosterone and increased amount DHEA-S of secreted during adrenarche leads to excessive Sebum production prevents dead cells and debri to clear itself from hairfollicle causing an initial keratin and debri clog within and form microcomedon, excessive skin cell proliferation also contributes in development of clog its further complicated by colonisation of Propionibacterium Acnes which forms a slimy biofilm within the hair folicle and helps forming a comedone.
If comedone is superficial the melanin pigments gets exposed giving it dark colour so its called blackhead also called open comedone.
If the comedone is deep within the hair follicle, unexposed , it is called whitehead also called closed comedone.
Many of the comedones further progress into papules , pustules and nodules, also it may affect deeper tissue and form deep tissue nodule.
Ars Sulph Flavum