🧴 Chapter 6 – Module 5 Acne vulgaris

 

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📘 Understanding Acne Vulgaris

Acne vulgaris is a chronic (long-term) inflammatory skin condition that affects the hair follicles and oil (sebaceous) glands.

👉 It commonly appears on the:

• Face
• Neck
• Chest
• Back

It is especially common during adolescence, due to hormonal changes.

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🧠 What Causes Acne?

Acne develops through a four-step process:

🔄 The Acne Process

1. Excess oil (sebum) production
2. Blocked hair follicles (pores)
3. Growth of bacteria (Cutibacterium acnes)
4. Inflammation (redness, swelling, pain)

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⚙️ Key Triggers

• Hormones (androgens)
  • Increase oil production (especially during puberty)
• Genetics
  • Up to 80% of risk is inherited
• Lifestyle & Environmental Factors
  • High-sugar (high glycemic) diets
  • Dairy products
  • Stress
  • Heavy or oily cosmetics

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🔍 Types and Severity

🟢 Mild Acne

• Blackheads (open comedones)
• Whiteheads (closed comedones)
• Few small spots

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🟡 Moderate Acne

• More papules (red bumps)
• Pustules (spots with pus)
• Occasional deeper lumps

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🔴 Severe Acne

• Painful nodules or cysts
• Widespread inflammation
• Higher risk of scarring

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🎨 Acne in Skin of Color

• May show less redness
• Higher risk of:
  • Post-inflammatory hyperpigmentation (dark spots)
  • Scarring

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💊 Treatment Options

Treatment depends on severity and skin type.

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🧴 Topical Treatments (Applied to Skin)

• Retinoids
  • Adapalene
  • Tretinoin
    👉 Help unclog pores and normalize skin turnover
• Antimicrobials
  • Benzoyl peroxide
  • Clindamycin
  • Erythromycin
    👉 Reduce bacteria and inflammation
• Other Options
  • Azelaic acid
  • Clascoterone

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💊 Oral (Systemic) Treatments

• Antibiotics
  • Doxycycline
  • Minocycline
• Hormonal Treatments (for females)
  • Birth control pills
  • Spironolactone
• Severe Acne Treatment
  • Isotretinoin
    👉 Very effective but requires close medical supervision

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🧪 Procedures

• Chemical peels
• Laser or light therapy
• Scar treatments

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⚠️ Complications

🧬 Physical

• Scarring
  • Depressed (atrophic) scars
  • Raised (keloid) scars

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🧠 Psychological Impact

Acne can affect:

• Self-esteem
• Confidence
• Social interactions

It is linked to:

• Anxiety
• Depression

👉 This impact is often underestimated but very important

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🚨 Rare but Serious Conditions

• Acne fulminans (severe sudden inflammation)
• Gram-negative folliculitis (linked to antibiotic use)

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🛠️ Daily Management Tips

• Wash skin 2–3 times daily with a gentle cleanser
• Avoid picking or squeezing spots (prevents scarring)
• Use non-comedogenic (non-pore-clogging) products
• Be patient—treatments can take 6–8 weeks to work

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💡 Key Messages

• Acne is common and treatable
• It is caused by biological processes, not poor hygiene
• Early treatment helps prevent scarring and distress
• Emotional wellbeing is just as important as physical treatment

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🧾 Summary

Acne vulgaris involves:

• Oil overproduction and blocked pores
• Bacteria and inflammation
• Different severity levels (mild → severe)
• Multiple treatment options (topical, oral, procedural)

👉 With the right care, most people can successfully manage acne and reduce long-term effects