Acne
Very painful... Acnes on my face... that why i search articles from the internet...
Actually i search many acticle... i find that few are very good. so i post these on my page. I hope i can help myself and others like me...I also link it to the original websites. please feel free to browse the websites!!!
What causes acne?
Acne is caused by the overactivity of the sebaceous glands that secrete oily
substances onto the skin.
The sebaceous glands of people with acne are especially sensitive to normal
blood levels of a hormone called testosterone, found naturally in both men and
women.
Testosterone in people prone to acne triggers the sebaceous glands to produce
an excess of sebum. At the same time, the dead skin cells lining the openings of
the hair follicles (the tubes that hold the hair) are not shed properly and clog
up the follicles.
These two effects combined cause a build-up of oil in the hair follicles.
This causes blackheads and whiteheads to form.
For some people, their acne does not progress beyond this stage.
However in other people, the build-up of oil in the hair follicles creates an
ideal environment for a bacterium called Propionibacterium acnes to grow.
These bacteria normally live harmlessly on your skin but when this ideal
environment is created, they grow. They feed off the sebum and produce
substances that cause a response from your body's immune system. This inflames
the skin and creates the redness associated with spots.
In more severe 'inflammatory acne', cysts develop beneath the skin's surface.
These acne cysts can rupture, spreading the infection into nearby skin tissue.
This can result in scarring.
Acne myths
Contrary to popular belief acne is not caused by:
- eating fatty food or chocolate1
- dirt - blackheads get their dark colour through excess skin pigment - not
dirt so washing more does not help, although if you do not wash your skin at
all, bacteria will be able to multiply1,5
Acne is not contagious, so you cannot catch it.1
What makes acne worse?
There are a number of things that can make your acne worse.
These include the following:
- picking and squeezing the spots may cause further inflammation and
scarring1 - stress can make acne worse in some people, although it is not clear why1,5
- in women, outbreaks may be affected by the hormonal changes that occur
during the menstrual cycle1,5 - excessive production of male hormones such as testosterone from conditions
such as polycystic ovary syndrome may be another cause.5 For more
information, please see the separate BUPA factsheet Polycystic ovary
syndrome - some contraceptive pills may make acne worse. This is due to the type of
progestogen hormone in some pills whereas some other types of contraceptive
pills can improve acne - see Treatments section below. Your GP will
advise you which contraceptive pill to take1,5 - some medicines can make acne worse. For example, some medicines taken for
epilepsy, and steroid creams and ointments that are used for eczema. Do not
stop a prescribed medicine if you suspect it is making your acne worse, but
tell your GP. An alternative may be an option1,5 - steroids can cause acne as a side-effect1,5
Diagnosing acne
Acne is easily recognised by the appearance of the spots, and by their
distribution on the body.
There are several varieties of acne and your doctor will be able to tell you
which type you have after examining your skin.
Treatment
Acne may cause you considerable emotional distress but there is a range of
treatment options to help you tackle the problem. No treatment will completely
'cure' your acne. The aims of treatment are to prevent new spots forming, to
improve those already present, and to prevent scarring.3
Home treatment
It is important to keep spot-prone areas clean, so wash the
affected area twice a day with an unperfumed cleanser.1,6 The skin
needs a certain amount of oil to maintain its natural condition, so avoid
aggressive washing with strong soaps.
There are a number of over-the-counter remedies available from pharmacies to
treat mild acne. These usually contain antibacterial agents such as benzoyl
peroxide (eg Oxy and Clearasil Max).
As well as its antibacterial effects, benzoyl peroxide can dry out the skin
and encourage it to shed the surface layer of dead skin. Together, these effects
make it harder for pores to become blocked and for infection to develop.
Benzoyl peroxide can cause redness and peeling, especially to start with.
This tends to settle down if you reduce the number of times you use it. You can
then build up your use gradually.7
No home treatments for acne will work immediately. It can take weeks, if not
months, for significant effects to be noticeable. If home treatments have not
worked after two months, or you have severe acne, you should visit your GP.7
Prescription medicines
Your GP may start your treatment by prescribing a
preparation containing benzoyl peroxide. If this does not work, or if you have
more severe acne, there are a range of other treatment options that you can
either rub onto your skin (topical) or take in tablet form (oral).
Topical treatments
There are several topical treatments you may be prescribed
including those listed below:
- azelaic acid (Skinoren) is an alternative to benzoyl peroxide and may not
make your skin as sore as benzoyl peroxide7 - topical retinoids (eg Adapalene) are medicines based on vitamin A, which
are rubbed into the skin once or twice a day.7 They work by
encouraging the outer layer of skin to flake off - a topical antibiotic lotion applied to the skin can be used to control the
P. acnes bacteria (eg Dalacin T). Treatment needs to continue for at least six
months. Preparations that combine an antibiotic with other acne medication are
available (eg Benzamycin which combines an antibiotic with benzoyl peroxide)7
Oral treatments
There are several oral treatments you may be prescribed
including those listed below:
- oral antibiotics (tablets), such as tetracycline, can be prescribed for
inflammatory acne. They should be taken daily for around three months,
although it might take four to six months for the benefits to be seen.7
The success of this treatment can be limited because the strains of bacteria
are often resistant to the common antibiotics. Antibiotics do not prevent
pores from becoming blocked so treatment to prevent blackheads, such as
benzoyl peroxide, is often also prescribed at the same time - some types of oral contraceptive tablets help women who have acne. A
combination of the usual pill hormone called ethinylestradiol with cyproterone
acetate (eg Dianette) suppresses male hormone activity so is often used in
women with acne4,7 - isotretinoin (eg Roaccutane) is a medicine known as an oral retinoid,
which also exists in a topical form (see above). Isotretinoin works by drying
up oily secretions. It tends to be prescribed to people with severe forms of
acne that have proved resistant to other treatments. There a number of serious
side-effects of this drug, such as liver disorders and depresssion.3,7
You should not take isotretinoin if you are pregnant, as it is very dangerous
to an unborn baby.7 For safety reasons, isotretinoin is only
prescribed under the supervision of dermatology specialists
most common medicines:
Anabolic steroids (e.g., danazol [Danocrine], testosterone)
Bromides
Corticosteroids (e.g., prednisone [Deltasone])
Corticotropin (H.P. Acthar)
Isoniazid (Nydrazid)
Lithium
Phenytoin (Dilantin)
Less commonly:
Azathioprine (Imuran)
Cyclosporine (Sandimmune, Neoral)
Disulfiram (Antabuse)
Phenobarbital
Quinidine
Tetracycline
Vitamins B1, B6, B12, and D2
----------------------------------------------
Antibiotics Used to Treat Acne
Acne is caused by the effects of hormones on the
pilosebaceous
unit, consisting of a hair follicle, sebaceous gland, and a hair. The
follicle becomes obstructed and an overgrowth of a normal skin bacteria,
Propionibacterium acnes, causes destruction of the lining of the follicle.
This process allows follicular material to enter the
dermis,
causing an inflammatory response. For a more detailed description of this
process, see
What Causes Acne?
How Antibiotics Work for Acne
Antibiotics work by several mechanisms. The most important is the decrease in
the number of bacteria in and around the follicle. Antibiotics also work by
reducing the irritating chemicals produced by white blood cells.
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Finally, antibiotics reduce the concentration of free fatty acids in the
sebum, also reducing the inflammatory response. The most frequently used
antibiotics for acne are summarized here.
Tetracycline
Tetracycline is the most widely prescribed antibiotic for acne. The usual
starting dose is 500 mg twice a day continued until a significant decrease in
acne lesions is seen. The dose can then be decreased to 250 mg twice a day or
discontinued. The main drawback for this antibiotic is that it must be taken
on an empty stomach to be the most effective. For a teenage boy who eats
frequently, this can be very difficult. Tetracycline should not be given to
pregnant women or children under 9 years of age.
Erythromycin
Erythromycin is a very commonly used antibiotic for acne. It has several
advantages over tetracycline. First, it has anti-inflammatory properties that
help reduce redness in
lesions, in
addition to killing bacteria. Also, it can and should be taken with food - a
benefit for teenagers. The dosage of erythromycin varies with the type used,
but it is typically prescribed as 250 - 500 mg twice a day. It can cause
stomach upset and nausea, but can be used in pregnant women.
Minocycline
Minocycline is a tetracycline derivative that has been used effectively
for decades as a treatment for acne. It is especially useful for
pustular
type acne. While the absorption of minocycline is decreased with food, it is
not as significant as the decrease seen with tetracycline. The usual starting
dose is 50 to 100 mg twice a day. Major side effects of minocycline include
dizziness, nausea, vomiting, skin pigmentation changes, and tooth
discoloration. The skin and tooth changes are seen more often in people who
have taken minocycline for a long time.
Doxycycline
Doxycycline is often used for people who do not respond to or cannot
tolerate erythromycin or tetracycline. The dosage of doxycycline is started at
50 to 100 mg twice a day. It should be taken with food; otherwise it can cause
significant nausea. Doxycycline is more likely than tetracycline to increase
sensitivity to the sun, or cause sunburns.
Clindamycin
Clindamycin is very useful as an oral antibiotic for acne, but it is most
widely prescribed as a topical antibiotic. The starting dose is 75 to 150 mg
twice a day. The major side effect of clindamycin therapy is serious
intestinal infection called pseudomembranous colitis caused by the bacteria,
Clostridium difficile.
Side Effects of All Antibiotics
All antibiotics can cause candida vaginal yeast infections in women.
Tetracycline seems to be the antibiotic that most frequently has this side
effect. All oral antibiotics can also lessen the effectiveness of birth
control pills,
Suggested Reading
What Causes Acne?Acne
- Blackheads & WhiteheadsTake
the Acne Quiz
Acne Treatment
Treatment of Acne With Accutane
posted by Day Dreamer @ 12:38 AM
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