Editing Acne

[[file:Acne_vulgaris_on_a_very_oily_skin.jpg|thumb|left]] [[file:Comedo.png|thumb|left]] [[file:Blausen_0811_SkinPores.png|thumb|right]] [[file:Acne_Pathogenesis_Medscape.png|thumb|right]] [[file:Benzoyl_peroxide_gel.jpg|thumb|right]] {{Short description|Common skin condition characterized by pimples, blackheads, and cysts}}
{{Infobox medical condition (new)
| name = Acne
| image = 
| caption = 
| field = [[Dermatology]]
| synonyms = Acne vulgaris
| symptoms = Pimples, blackheads, whiteheads, cysts, oily skin, scarring
| complications = Scarring, anxiety, depression
| onset = Puberty
| duration = Long-term
| causes = [[Hormonal changes]], [[genetics]], [[bacteria]], [[excess oil production]]
| risks = [[Adolescence]], [[family history]], [[hormonal changes]]
| diagnosis = Based on appearance
| differential = [[Folliculitis]], [[rosacea]], [[keratosis pilaris]]
| prevention = Proper skin care, avoiding triggers
| treatment = [[Topical treatments]], [[oral medications]], [[laser therapy]], [[chemical peels]]
| medication = [[Benzoyl peroxide]], [[salicylic acid]], [[retinoids]], [[antibiotics]], [[hormonal treatments]]
| frequency = Common
}}

'''Acne''', also known as '''acne vulgaris''', is a common [[skin condition]] that occurs when [[hair follicles]] become clogged with [[oil]] and [[dead skin cells]]. It often causes [[pimples]], [[blackheads]], [[whiteheads]], and sometimes [[cysts]] or [[nodules]]. Acne typically appears on the [[face]], [[forehead]], [[chest]], [[upper back]], and [[shoulders]]. It is most common among [[teenagers]], though it affects people of all ages.

== Pathophysiology and Causes ==

=== Pathophysiology ===
Acne occurs when [[hair follicles]] become clogged with a combination of [[sebum]] (skin oil), [[dead skin cells]], and [[bacteria]]. The four primary factors contributing to acne development include:
* 1. '''Increased sebum production''' – Overactive [[sebaceous glands]] produce excess oil.
* 2. '''Follicular hyperkeratinization''' – The normal shedding of [[keratinocytes]] (skin cells) is disrupted, leading to clogged pores.
* 3. '''Bacterial colonization''' – The bacterium ''[[Cutibacterium acnes]]'' thrives in clogged pores, leading to [[inflammation]].
* 4. '''Inflammatory response''' – The immune system reacts to bacterial overgrowth, causing [[redness]], [[swelling]], and [[pus]] formation.

=== Causes of Acne ===
Acne is a multifactorial condition with various contributing causes:

==== 1. [[Hormonal changes]] ====
Hormonal fluctuations play a significant role in acne development:
* Increased [[androgens]] during [[puberty]] cause [[sebaceous glands]] to enlarge and produce more [[sebum]].
* [[Menstrual cycles]], [[pregnancy]], and [[birth control]] use can influence acne flare-ups.
* [[Polycystic ovary syndrome]] (PCOS) is associated with persistent hormonal acne.

==== 2. [[Genetics]] ====
A family history of acne increases the likelihood of developing the condition. Studies suggest that genetic factors affect:
* [[Sebum]] production rates
* Skin's inflammatory response to bacteria
* [[Pore]] structure and susceptibility to clogging

==== 3. [[Bacterial infections]] ====
''[[Cutibacterium acnes]]'', a [[commensal bacteria]] of the skin, can proliferate in clogged [[hair follicles]], causing [[inflammation]].

==== 4. [[Excess oil production]] ====
The overproduction of [[sebum]] by [[sebaceous glands]] leads to clogged [[pores]].

==== 5. [[Diet and lifestyle factors]] ====
Certain dietary and lifestyle factors may exacerbate acne, including:
* '''High-glycemic diets''' – Foods that spike [[blood sugar levels]] can increase insulin, which triggers [[sebum]] production.
* '''Dairy consumption''' – Some studies link dairy intake to acne due to [[hormonal]] effects.
* '''Stress''' – Elevated levels of [[cortisol]] can worsen acne.
* '''Cosmetics and skincare products''' – Oil-based or [[comedogenic]] products can clog [[pores]].

== Symptoms, Risk Factors, and Diagnosis ==

=== Symptoms of Acne ===
Acne presents with various [[lesions]], which can be classified into '''non-inflammatory''' and '''inflammatory''' types:

==== Non-inflammatory lesions ====
* '''[[Blackheads]]''' (open comedones) – Pores clogged with [[sebum]] and [[dead skin cells]] that remain open.
* '''[[Whiteheads]]''' (closed comedones) – Clogged pores covered by skin, preventing oxidation.

==== Inflammatory lesions ====
* '''[[Papules]]''' – Small, raised, red bumps caused by inflammation.
* '''[[Pustules]]''' (pimples) – Papules filled with [[pus]].
* '''[[Nodules]]''' – Large, painful, solid lumps under the skin.
* '''[[Cysts]]''' – Deep, pus-filled lumps that can cause [[scarring]].

=== Risk Factors for Acne ===
Several factors can increase the risk of developing acne:
* '''[[Adolescence]]''' – Hormonal changes during [[puberty]] are a major trigger.
* '''[[Family history]]''' – Genetic predisposition influences the likelihood of acne.
* '''[[Hormonal changes]]''' – Related to [[menstruation]], [[pregnancy]], or [[polycystic ovary syndrome]].
* '''[[Stress]]''' – Can trigger hormonal imbalances leading to breakouts.
* '''[[Certain medications]]''' – Such as [[corticosteroids]], [[anticonvulsants]], and [[oral contraceptives]].

=== Diagnosis of Acne ===
Acne is typically diagnosed based on clinical presentation. A [[dermatologist]] may:
* '''Examine the skin''' – Assess lesion type, location, and severity.
* '''Consider hormonal evaluations''' – For patients with persistent or severe acne.
* '''Perform a bacterial culture''' – In cases of suspected [[antibiotic-resistant acne]].

==== Differential Diagnosis ====
Conditions that may resemble acne include:
* '''[[Rosacea]]''' – Characterized by facial redness and inflammatory papules.
* '''[[Folliculitis]]''' – Infected hair follicles mimicking acne.
* '''[[Keratosis pilaris]]''' – Small rough bumps caused by keratin buildup.

== Treatment and Management ==

=== Prevention and Skincare Routine ===
Preventive measures for acne include:
* '''Gentle skin cleansing''' – Using a mild [[cleanser]] twice daily.
* '''Non-comedogenic skincare''' – Avoiding oil-based products.
* '''Avoiding excessive touching''' – Picking at acne can cause [[scarring]] and [[hyperpigmentation]].

=== Medical Treatments ===
Treatment varies based on severity:

==== 1. [[Topical treatments]] ====
* '''[[Benzoyl peroxide]]''' – Kills ''[[Cutibacterium acnes]]'' and reduces [[inflammation]].
* '''[[Salicylic acid]]''' – Exfoliates [[dead skin cells]] and unclogs [[pores]].
* '''[[Retinoids]]''' (e.g., [[tretinoin]]) – Promote [[skin cell turnover]] and prevent comedone formation.
* '''[[Topical antibiotics]]''' – Such as [[clindamycin]] and [[erythromycin]].

==== 2. [[Oral medications]] ====
* '''[[Oral antibiotics]]''' – Used for moderate to severe inflammatory acne.
* '''[[Hormonal treatments]]''' – [[Oral contraceptives]] and [[spironolactone]] for hormonal acne.
* '''[[Isotretinoin]]''' – A powerful [[retinoid]] for severe, cystic acne.

==== 3. [[Procedural treatments]] ====
* '''[[Laser therapy]]''' – Reduces bacteria and inflammation.
* '''[[Chemical peels]]''' – Helps with exfoliation and unclogging [[pores]].
* '''[[Drainage and extraction]]''' – Removes large [[cysts]] or [[nodules]].

== Complications and Psychological Impact ==

=== Complications of Acne ===
Acne can lead to long-term complications, including:
* '''[[Scarring]]''' – From severe [[nodular]] or [[cystic acne]].
* '''[[Post-inflammatory hyperpigmentation]]''' – Dark spots that remain after lesions heal.
* '''[[Skin infections]]''' – Secondary infections may occur if lesions are picked.

=== Psychological and Social Effects ===
Acne can significantly impact [[mental health]]:
* '''[[Anxiety]] and [[depression]]''' – Studies link acne to increased psychological distress.
* '''[[Social withdrawal]]''' – Patients may experience self-esteem issues.

=== Prognosis and Long-Term Outlook ===
* '''Mild acne''' often improves with consistent [[skincare]].
* '''Severe acne''' may require aggressive treatment to prevent [[scarring]].

== See also ==
* [[Dermatology]]
* [[Skin care]]
* [[Hormonal acne]]
* [[Cystic acne]]

{{Acne Agents}}
{{Diseases of the skin and appendages by morphology}}
{{Disorders of skin appendages}}
{{DEFAULTSORT:Acne}}
[[Category:Acne]]
[[Category:Acneiform eruptions]]
[[Category:Cutaneous conditions]]
[[Category:Puberty]]
{{dermatology-stub}}
[[Category:Dermatology]]
[[Category:Skin conditions]]