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