Acne
vulgaris
Acne is
an inflammatory disease of the skin, caused by
changes in the pilosebaceous units (skin the hair
follicle and sebaceous gland).
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The typical acne lesions
are: comedones, papules, pustules, nodules
and inflammatory cysts. |
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After resolution of
acne lesions, prominent (but temporary) hyperpigmentation
is common and permanent scarring may also
occur. |
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Several factors occur
in combination to cause acne, including hormonal
changes, plugged pores and secondary bacterial
overgrowth in the hair follicle and sebaceous
gland units. |
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Further research is
necessary to establish whether reducing the
consumption of high-glycemic foods (such as
soft drinks, sweets, white bread) can significantly
alleviate acne. |
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There is no way to predict
how long it will take for acne to disappear
entirely. |
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Current treatments for
acne (these are often used in combination
for best results):
o Exfoliation
therpies (creams, toners, masks)
o Topical antibacterial medications
o Oral antibiotics
o Hormonal therapies (oral contraceptive
pills, spironolactone, cyproterone acetate)
o Topical retinoids (tretinoin, adapalene,
tazarotene)
o Isotretinoin (an oral retinoid medication)
o Blue light phototherapy (Levulan-Blu-U (Photodynamic Therapy)) with
or without aminolevulinic acid (Levulan)
o Laser therapy |
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Types of Acne Scars
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Hypertrophic
scars: raised, firm thickenings of
skin, sometimes red, most commonly occur on
back and shoulders. |
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Atrophic scars:
depressed skin (lower than surrounding
skin). |
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Pitted scars:
deep, narrow scars that are nicknamed “ice
pick scars” due to their appearance. |
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Acne scars are not
the purple, brown or red discolorations that
are noticed on the skin immediately after
a pimple heals. These marks are called post-inflammatory
hyperpigmentation (PIH). PIH resolves gradually
over months, and it does not leave scars in
most cases. |
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| Before
Treatment |
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| After
Treatment |
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Tools Used to Improve
or Clear Acne Scars
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Subscission
- a needle is used to break underlying scar
adhesions. |
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Chemical
peels can smooth textural abnormalities if
they are mild. |
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CROSS
technique (Chemical Reconstruction Of Skin
Scars) with tricarboxylic acid (TCA) is a
local (applied only to the scar) treatment
that is useful for pitted scars. |
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ThermaScan
laser (1319nm) helps to reorganize and regenerate
collagen and other connective tissue in the
dermis in a nonablative (no wound) fashion. |
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Resurfacing
lasers (Erbium, CO2, Fraxel) also smooth the
skin surface. They are ablative and semi-ablative
lasers that do create a skin wound. The depth
of wound and healing time depend on the device
that is used. |
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