Dermatology >
Acne Vulgaris

“Localised inflammation of the skin due to overactivity of the sebaceous glands”

Risk Factors
  • Hormonal changes: puberty, pregnancy, periods, PCOS
  • Family history
  • Medications (e.g. oral contraceptives, corticosteroids, lithium)
  • Use of oil-based cosmetic products
Aetiology
  • Chronic inflammation within the pilosebaceous units of the skin
  • +/- localised Propionibacterium acnes infection
Pathophysiology
  • Results due to sebum overproduction and dead skin cells blocking the pilosebaceous unit, which leads to inflammation
Clinical Presentation
  • Inflamed, red, painful spots, usually found on the face, chest and back
  • Highly variable severity
Investigations
  • Diagnosis is clinical, based on a detailed history and examination of lesions
  • Blood tests may be used to determine an underlying cause (e.g. hormone levels for PCOS)
Management
  • Mild: topical benzoyl peroxide, retinoids or antibiotics (e.g. clindamycin)
  • Moderate: oral antibiotics (e.g. lymecycline) or OCP (e.g. Dianette) in females only
  • Severe: oral retinoids (e.g. isotretinoin (Roaccutane)) – last line option
Complications
  • Reduced self-esteem, anxiety and depression, acne excoriee
  • Rare: pyogenic granulomas, osteoma cutis, acne with facial oedema

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