The teenage years summon up many rites of passage with one of the least appealing being the onset of acne. This skin irritation can take on enormous relevance to young adults just as they are most focused on their appearance. The effective management of the different types of acne throughout the teen years and adulthood is paramount to ensuring that the irritated skin, especially on the face does not evolve into scars. Dermatologists strongly advise young adults and their parents to consult with a healthcare professional quickly if any signs that the condition worsening. With the many effective treatments available for the different types of acne, most cases can be resolved.
The American Academy of Dermatology has helped to define the different types of acne and to recommend treatments based on these types. Acne can be defined by appearance of morphological, severity of the condition, and pathophysiology or outcome. The appearance of acne can be mild in the form of comedones that are either closed pimples (whiteheads) or open (blackheads). It can be comprised of papules (red bumps) or pustules (pus filled bumps) or nodular acne that shows up as large red bumps resulting from repeated inflammation. As acne worsens, there may cysts (deep nodules with debris and necrotic tissue) and ultimate conglobata or nodules and cysts that are connected forming deep grooves in the skin. The severity of acne can also be assessed based on the number and types of pimples present from mild (less than 30 lesions) to severe with damaged skin on the face, chest and back. In the broadest classification, acne can be divided into non-inflammatory (comprised of only comedones) or inflammatory (papules, pustules, nodules, and cysts).
The causes of acne are multifactorial yet the root cause is abnormal cells inside a hair follicle on the face, chest or back. These cells, along with the activity of bacteria normally present in the skin, the changing levels of hormones and possibly genetics all contribute to the resultant acne infection. Adult adults going through puberty are especially vulnerable to acne because the levels of androgens (predominantly male hormones) and estrogens (mainly female hormones) can influence the growth of the hair follicles and increase production of oil-producing glands in the skin. The role of genetics needs further study as initial research has shown that acne appears more frequently in some families.
There are a few guiding principles for managing acne although treatment varies based on the difference types of acne present. The four main goals are to clear up acne pimples, prevent reoccurrence, reduce inflammation and prevent scaring. For comedones, cleaning the skin once or twice a day with mild soap and applying topical benzoyl peroxide to kill bacteria, and dry skin preventing more pimples from forming may be a sufficient non-prescription remedy.
Since over-the-counter medications are not effective for moderate to severe acne, prescription medications either topical or oral may be recommended. Antibiotics are often used with benzoyl peroxide in a topical gel to clear up moderate acne. Oral antibiotics may also be used for long periods to treat more severe acne, but precautions need to be taken with certain drugs that might cause sensitivity to sunlight.
Retinoids, chemically similar to vitamin A, can be used topical to clear up mild acne or orally as isotretinoin for extensive nodular or severely inflamed acne. Isotretinoin has been associated with severe birth defects, so patients on this therapy cannot be pregnancy and must be using effective birth control. Other side effects with the drug have been noted including liver toxicity and increased lipids levels.
When acne sufferers work together with healthcare professionals to identify and treat the different types of acne appropriately, the condition can be effectively managed and scar formation prevented.