Acne Vulgaris

Question 1

What is acne vulgaris

Answer 1

Acne - spots and pimples

Question 2

Acne vulgaris presentation

Answer 2

13-18yrs with sore spots/pimples most commonly on face but may spread to neck, chest and back. May be open and/or closed lesions. Inflammation and redness.
Ice pick scars from healed acne lesions

Question 3

Causes of acne vulgaris

Answer 3

Chronic inflammation, with or without localised infection, in pockets within the skin known as pilosebaceous follicle (contain hair follicles and sebaceous glands).
Increased production of sebum from sebaceous glands traps keratin and blocks the follicles.
Causes swelling and inflammation (comedones)
Androgenic hormones increase sebum production - exacerbated in puberty.

Question 4

Acne vulgaris complications

Answer 4

Psychological and social effects

Question 5

Acne vulgaris management

Answer 5

Topical retinoids (related to VitA) to slow production of sebum - especially for comedones
Topical benzoyl peroxide - reduced inflammation, helps unblock the skin and is toxic to P. acnes bacteria - no antibiotic = good
Oral/topical antibiotics (Clindamycin)
Oral contraceptive pill (Co-cyprindiol (Dianette))
Severe acne:
Oral retinoids (Isotretinoin) as last-line option. Highly teratogenic so need reliable contraception. Can cause dry skin, depression and rarely stevens-johnson syndrome