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What is Acne?
Human skin suffers from various kinds of disease from excessive sebum secretion to polluted air as well as other causes. Bacteria or mold can infiltrate into the skin when using a small amount of penetrating cream-type material. The most important role of the skin is to protect the human body from moisture infiltration and microorganism penetration while preventing moisture evaporation from inside the body. The skin's defense mechanism against microorganism penetration has limitations. Thus, acne has become a serious condition for men and women in contemporary life, and controlling it essential for clear, healthy skin.
Pimples occur when excess skin oil and flaking skin plug the opening of a hair follicle and create the ideal environment for acne bacteria to grow. Endogenous hormones (mainly androgens), which are present in unusually high concentrations in the blood during adolescence and puberty give rise to an excessive production of sebum (or oil). The condition may worsen by a simultaneous increase in the rate of keratin in the skin's outer layer (the horny layer) that causes skin cell death. As the horny cells proliferate, they can form an occlusive plug or comedone which coupled with the increased production of the sebum, represents an ideal medium for the proliferation of the skin resident anaerobic bacterium, P. acnes.
People of all skin colors and ages get acne. Acne primarily occurs in adolescents although it is common among adults and about 80% of people have it to some extent. P.acne (Propionibacterium acnes) grows abnormally in the skin causing inflammatory cells and painful pustules. These pustular eruptions are localized abscessed formations and local inflammatory conditions of the dermis and epidermis skin layers.
Whiteheads, Blackheads, and Follicles
Oily secretions from sebaceous gland can lead to plugged follicles. This may take the form of either whiteheads, where the plug in the follicle remains beneath the skin's surface, or blackheads, where the plug in the follicle extends to the skin's surface and becomes visible. In the majority of these clogged follicles, the bacterium P. acnes will cause swelling, itching, and redness around the follicle.
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The bacterium P. acnes is normally present in all skin types as part of the skin's sebum maintenance system. In a hair follicle, P. acnes produces enzymes that break down sebum creating a balance of oil in the skin. However, a clogged follicle creates an ideal environment for this sebum-eating skin bacterium to multiply. Consequently, the increase of P. acnes and its enzymes irritates and inflames the skin resulting in acne. Furthermore, P. acnes is responsible for at least 90% of all acne cases. |
Acne Myths
There are many myths about what causes acne. Stress does not cause acne, and neither does eating greasy foods. Another common myth is that dirty skin causes acne, but studies have shown that blackheads and other acne lesions are not caused by dirt.
Treatment
For decades, people have experimented with and invented all manner of treatments and medications to clear acne, with varying degrees of success.
Prescription Acne Treatment
Pills, Topicals and Injectables
Examples of Prescription Acne Treatments. A variety of prescription medicine methods are used to prevent and treat acne: pill, topical, and injectables. Topical therapies such as Retin-A account for roughly half of the US prescription acne medicine market. Systemic therapies such as Isotretinoin (commonly called Accutane) make up the other half of this market (Micrologix BioTech 2003).
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In general, mild to moderate acne cases are treated with topical medications, with more severe acne cases being treated with systemic or a combination of topical and systemic therapies. Antibiotics taken by mouth such as tetracycline, doxycycline, minocycline or erythromycin are often prescribed for moderate to severe cases, especially when there is a significant amount of acne on the back or chest. Antibiotic treatment is used to kill the bacteria P. acnes that cause acne flares. Prescription oral and topical medicines are sometimes combined. |
Be Cautious of Prescription Acne Treatment
Problems exist with most of these acne treatment options. Accutane has been linked to serious side effects. Antibiotics are not as useful as they once were as P. acnes has developed resistance to them. Antibiotic resistance in P. acnes strains has been reported worldwide, and the incidence of antibiotic resistant P. acnes has increased dramatically from 20% in 1978 to 60% in 1996 (Guttman; Micrologix Biotech 2002). In addition, the use of antibiotics has also been linked to serious side effects.
In Office Procedures
Doctors sometimes use other procedures in addition to drug therapy to treat acne. For example, the doctor physically removes the patient's comedones during office visits. Some doctors inject cortisone directly into lesions to help reduce the size and pain of inflamed cysts and nodules.
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