health care information

INTRODCUTION:

Acne vulgaris (acne) the bane of teenage existence occurs almost universally in both young men and women in their teens and early 20s. It is almost ubiquitous in teenage years. The peak severity is in the late teenage years but acnes may persist into the third decade and beyond especially in females who may experience flare-ups before menstruation. The hormonal changes responsible for premenenstral bouts, with acne are responsible for breakouts some women experience when taking oral contraceptives, during pregnancy or while undergoing menopausal hormone therapy.

Although acne is not dangerous, it is unsightly and can have a negative psychological impact on adolescents particularly at a time when they are most anxious about their appearance. Consequently, they seek all sorts of advice and medication so as to curb this “ugly” incidence. Being so “mirror-conscious”, they strictly follow these medications to retain their beauty. To make this situation even worse, acne is rarely cured. However, its symptoms can be controlled; acne eruptions can be reduced and scarring can be minimized with proper care.

This scourge has stolen beauty from many faces, generated undue worries and anxiety among the younger population, and presented a myriad of “unanswered questions” to health workers. Hence it is necessary to proffer solutions, on how to reduce its incidence lest it becomes a source of global worry.

DEFINITION: WHAT IS ACNE?

Acne is an eruption, predominantly of the face, upper back, shoulder and chest composed of comedones, cysts, papules and pustules on an inflammatory base. Simply put, it is an inflammatory eruption involving the pilosebaceous apparatus. The common name Pimple is usually used to denote the inflammatory lesion of acne. This condition occurs ina majority of people during puberty or adolescence due to androgenic stimulation of sebum secretion with plugging of follicles by keratinization associated with proliferation of Propionibacterium acnes.

CAUSES:

The cause if multifactorial, but there are 3 major pathogenic factors that clearly summarize its aetiology.

* Elevated sebum excretion

* Infection with Propionibacterium acnes

* Blockage or occlusion of the pilosebaceous unit.

There is a clear relation between the severity of acne and sebum excretion rate. Acne does not occur in complete absence of sebum. Therefore, sebum excretion is necessary for the development of acne but not sufficient to cause acne on its own. Androgen stimulation greatly determines sebum excretion. This accounts for the onset of acne in teenage years. Progesterone also increases sebum excretion while oestrogens reduce it. In another development, the bacterium Propionibacterium acnes colonizes the pilosebaceous ducts and acts on the lipids to produce a number of proinflammatory factors. Finally, the occlusion of the pilosebaceous unit contributes to the development of acne.

Acne can be exacerbated, or even caused by a number of factors including:-

* Genetic susceptibility leading to the hyperconification of pilosebaceous duct and its blockage.

* High humidity, frequent or prolonged sweating.

* Local irritation, friction, rough or occlusion clothing, which can be conducive to lesion formation of acneprone individuals.

* Long term use of hair-care products that contain occlusive petroleum of liquid petroleum, causing acne along the hairline (sometimes “pomade acne”)

* Drug such as corticosteroids which can sensitive hair follicles and produce “steroid acne” and other systemic drugs like androgens, some oral contraceptives, halothane and thyroid preparations known to precipitate acne eruption.

* Oil-based cosmetics can be occlusive and plug the follicles.

* Prolonged exposure to sun, prolonged stress and other emotional extremes.

CLINICAL FEATURES:

Acne presents in areas rich in sebaceous glands such as the face, back, shoulder and sternal (chest) area. The cardinal features are open comedones (black heads) due to plugging of the pilosebaceous orifice by kertain or sebum or closed comedones (white heads) due to accretions of sebum abd keratin deeper in the pilosebaceous ducts.

* Inflammatory papules circumscribed solid elevation up to 100cm diameter on the skin, which may be pedunculassted, sessile or filiform.

* Pustules circumscribed superficial elevation of the skin (about 1cm diameter) containing purulent materials.

Other clinical variants of acne include infantile acne, conglobate acne, acne fulminans, follicular occlusion traid, steroid acne and oil acne each with its distinctive features.

TREATMENT:

Self treatment should be limited to those patients who have non-inflammatory acne of mild-to-moderate severity (ie eruptions are limited to white heads and black head). The role of a detmatologist in severe cases of inflammatory acne (consisting of papules, pustules and nodules) must be south.

Treatment is aimed at decreasing sebum production, bacterial proliferation, normalizing duct keratinization or decreasing inflammation. Management starts with paying attention to exacerbating factors.

Topical agents such as:

* Benzyol peroxide (a keratolytic agent) and Fretinoin (A topical retinoid) should be used in individuals with fairly minor disease (particularly those dominated by the presence of comedones).

* Patients with anything but minor degrees acne will require therapy with antibiotics (local or systemic). Local antibiotics widely used include Clindamycin or Erythromycin. The principal oral antibiotic is Oxytetracycline. Monocycline may be used if oxytetacycline’s response is inadequate.

* If these topical and systemic agents fail to produce a sufficient clinical response within 3-6 months, treatment with Isotretinoin is considered. Remember, these drugs have their different modes of administration and side effects therefore, the physician’s role on prescription and monitoring of treatment is very essential.

Good skin care habits are essential in the treatment and management of acne. These should be emphasized by health workers. They include:

* Avoidance of prolonged exposure to the sun.

* Patient’s should be encouraged to switch from oil to water-based skin care products. If the hair is oily, frequent shampooing with water-based shampoo should minimized hairline eruptions.

* Patients should wash their faces 2-3 times daily using warm water, a mild medicated or unmedicated facial soap and a soft wash-cloth.

* Mild abrasive soaps (such as those containing pumice, polyethylene or Aluminum oxide) can be helpful in removing the outer layer of dead skin cells.

* Squeezing, pinching or picking at acne lesions can aggrevate the condition and cause permanent scarring. Avoid this!

CONLCUSION

The understanding of the basic aetiology and underlying pathology of any form of sickness is a great step in the pursuit of an effective treatment. Improper understanding may “rubbish” a good scientific treatment formular, or elicit a wide- range of side effects. With these steps for acne, the beauty and cosmetic concern of every individuals will be achieved.

REFERENCES:

1. Barbara white Sax (2000): Acne and Wrinkles: Skin care for baby boomers and their kids; Pharmacy times (Oct. 2000); P. 55-57.

2. Christopher Haslett et al (2000): Davidson’s principles and practice of medicine, Churchill Livingstone; P. 1051-1082.

3. Kumar and Clark (2000): Clinical Medicine (5th Ed.); 1320.

4. Lippoincolt, Williams, Wilkins (1998); Steadman’s Medical Dictionary. (27th Ed.) p. 15-16.

Most people have the misconception that acne occurs mainly to teens and once you’re past your hormone crazy teen days you would be rid of acne as well. Then you are wondering, how is it here I am in my twenties, thirties or even forties and am still suffering from frequent acne breakouts! This in turn will lead to diminished self esteem and later even depression.

You can rest assured that you are not alone! Acne in adults is actually a common occurance that affects at least 25% of males and 50% of adult women. Most people are then left feeling helpless by this stage and have no clue why their acne has not left them along with their teenage years? This then will lead you to seek a skin doctors advice and most adults usually end up using either a benzol peroxide treatment regime or are put on courses of anti-biotics.

This will NOT get rid of your acne and will only prolong your agony as the moment you get off these treatments, your acne will definitely be back with a vengeance. So what should you do to get rid of your adult acne? In fact Why on earth are you having acne in the first place…may be a few questions on your mind. The answer is actually very simple but its just that people don’t seem to want to accept simple treatments anymore. They are made to believe that there is some deep rooted complex problems that can only be cured by some extremely complex medications that will also burn a nice big hole in their pockets! People seem to be made to think that the more expensive the treatment the better it must be! You couln’t be further from the truth.

As complex as Acne may seem, there is a very simple explanation to the development of acne and an even simpler cure for it but its just a matter of whether the individual is ready for a change in lifestyle or not! Period! O.K. now that I have gotten that off my chest, let me start to explain the reasons for adult acne and I’ll end of with the simplest, cheapest and most effective method for every single person who wants to cure their acne will need to do. Fair? Lets begin….

If you are under the impression that acne is caused by hormone imbalance, which is why most teens experience acne, you are only partially right. Acne occurs because something in your body is out of sync. What do I mean? When anything in your body including all your organs is not performing as it should be and is out of balance, your body will try to find a way of telling you this. So if you are constantly breaking out with pimples, then its your body trying to communicate with you and tell you something is wrong internally and should be addressed and corrected.. So what is a pimple? A pimple is made up of a build up of toxins and impurities that your body is excreting.So what should you do? Listen to your body and start fixing the internal problem that causes your acne to appear in the first place; you will not only get rid of your acne you will also achieve beautiful, healthy, even toned clear skin complexion, re-balance your body and prevent future hormonal or toxic overload related conditions.

We are not born with acne. No one is. Acne is formed because there is an overload of toxins in your body and your body has to get rid of these toxins thus acne. Look at it this way, to make it easier to understand, I’ll use the acne formula.

Acne happens when there is a cause and a trigger thus:

CAUSE + TRIGGER = ACNE

What are the causes of acne? Well as I was mentioning above,ultimately, every disease results from a breakdown within your body. All major diseases and chronic conditions are warning signs of something very fundamentally wrong inside. Cause could vary depending on the individual. They could be any of the following:

The accumulation of toxins, the hormones not in balance, high Blood sugar levels, chronic constipation…

Then there are the triggers which most of you would know about but have actually regarded as the cause instead of the trigger.A Triggers are usually factors that “trigger” your acne to form once you are suffering from any of the causes. Namely: anything from wrong feeding habits, such as irregular hours of eating, improper food, excess of starches and sugar, excess of fatty foods,use of tea, coffee, alcohol or tobacco, strenuous studies, masturbation and sedentary habits which lead to indigestion and general debility, chocolates, seafood etc. If you are an acne sufferer, you probably know exactly which triggers you a re more suceptible to already.

So now you know that Acne is formed by underlying causes within your body that are sensitive to triggers that will actually form the acne. So which do you treat? The cause or the trigger? You could do either or both but that is what you need to decide. I will lay the facts out for you. If you choose to address and eliminate the root cause of acne, that will bring your body back to a state of balance thus it will no longer be sensitive to any triggers and “voala”! No more acne! Or you could go the easy way and just stay away from the triggers. Now this method does not fix anything. As long as you don’t eat or do any of the triggers, you will not get a breakout but the moment you do, you will have a massive breakout. Moreover, this may mean you have to stay away from things that you love forever! Plus in the long run, your body’s imbalances could lead to more serious deseases and forms to eliminate the toxin build up etc. So there you have it. Eliminate either the cause or the effect and you eliminate acne. However, I would definitely go with eliminating the cause so I don’t have to fear whether my body may develop new triggers over time and acne will be back again.

Now how do you treat the casue? This is where you will need to do the simplest form of acne treatment that I was talking about in the beginning. You need to detox your system and get it back into a state of balance. There are only 2 programs that I will recommend for the best results. If you go through this program, you will never have to worry about acne in your adult years again. You will be rid of acne and what’s more, you would have actually done a huge service to your health as well. So find the best treatment below for you and go with it. You will not regret it and that’s a guarantee!

To Your Success!

Even though acne is not subject to one particular age demographic, it is preponderant in young people–at one of the most self-conscious stages of life–their teenage years.  The pharmaceutical corporations have basically jumped at the opportunity to quickly profit in on the struggles of acne that are being faced by many hapless people across the country.  This is why you see hundreds of acne creams on the shelves of supermarkets today.  There’s no doubt that if you go to the nearest pharmacy, you’ll see a flood of acne creams manufactured by pharmaceutical companies.  There are whole sections that are dedicated to the handling of acne breakouts.  It’s no surprise that acne creams are by far the most popular treatment for acne than any other remedy out there.  Even though all of these fancy creams exist, acne still continues to plague those very same people.

I had acne and before I cleared out my skin I was always asking myself “Why is there all of these acne products on the market but none of them seem to do squat about the problem?”  The most little-known answer to this question is that poor hygiene does not completely attribute to acne.  People wash their faces vigorously every day hoping to rid themselves of their acne . But facial washes are not even the answer to mitigate your acne problem.  The best ways to fighting acne are not acne creams either.  Acne creams may have the illusion of doing an excellent job of taking out the acne and helping the skin remain highly hygienic but in reality, there are tons of clear solutions that people are bypassing. Somebody has to say it: acne cannot be cured by any pharmaceutical company’s product.  Period. Acne creams, despite their ineffectiveness, are still purchased everyday by many Americans who are unconsciously wasting hundreds of dollars each year.  The way to relieve yourself of acne is done not with acne creams or facial washes, but by natural methods that you should and will take advantage of once you find out about them.