Dermatology Glossary

Acne

Acne vulgaris is a disease of the sebaceous follicle.
Increased production of oil in adolescence is associated with the development of comedones, erythematous papules, pustules, and, in some patients, cysts.
The initial lesions appear to be closed or, less commonly, open comedones.
There is an associated inflammatory response with the development of pustules in areas of maximal oil production: the central face, anterior chest, and upper back.
Acne can be mild with only a few comedones. It can also be very severe with cyst formation, draining sinuses, malaise, and fever.
Acne vulgaris affects at some time, perhaps 90% of the population.

Variants of acne:

Acne excoriée
Endocrine acne
Drug induced acne
Chloracne
Tropical acne
Neonatal acne
Acne conglobata
Acne fulminans
Gram-negative acne
Topical medication acne

Treatment

There are various grading systems for acne:

Acne grade 1: comedonal acne

Responds well to topical tretinoin 0.1% cream. This treatment, continued for many months can result in very significant improvement.
All acne patients should be advised to avoid oil containing preparations to the skin.
Expression of large open comedones, "blackheads", can result in more rapid clearing.
Closed comedones (whiteheads) are frequently irritated by expression.

Acne grade 2: pustular acne without significant associated scarring

Responds quite well to topical benzoyl peroxide 2.5-10% gel, as well as topical tretinoin.
A faster response can be obtained by the addition of tetracycline HCl 500 mg daily.

Acne grade 3: more severe acne, with associated scarring

Makes the use of a systemic antibiotic more imperative.
Tetracycline HCl 500 mg to 1 gram per day is generally very effective when combined with topical benzoyl peroxide 2.5 to 10% gel once daily.

Acne grade 4: cystic acne

May respond well to tetracycline HCl 1 gram to 2 grams per day.
Failure to respond to tetracycline HCl warrants consideration of minocycline 100 mg po bid. Response to tetracycline HCl or minocycline is usually over two to three months of therapy.
Failure to respond to minocycline warrants consideration of isotretinoin .5-1 mg/kg.

Isotretinoin has revolutionized the management of severe cystic acne. Previously untreatable acne became treatable.
A typical course of isotretinoin is 1 mg/kg/day for 12 to 16 weeks. At the end of this time, the acne may or may not show any signs of improvement but the isotretinoin is stopped in any case. Following cessation of therapy, there is frequently a dramatic improvement in the acne.
A teratogen, its use should be undertaken with great care in females. Females on isotretinoin must be employing birth control methods and have shown to have a negative pregnancy test, followed by a normal menses before beginning this agent.

Diet does not appear to have any significant role in the development or control of acne.

For comprehensive information about Acne please visit www.acneguide.ca or www.acneguide.com


Acne Vulgaris	Acne Agminata	Acne Conglobata

Acne Excoriee	Acne Fulminans	Drug Induced Acne

Endocrine Acne	Neonatal Acne	Chloracne

Back to Glossary Index

SkinCareGuide Network of Patient Guides: