Acne Flashcards
what are the 3 main causes of acne?
keratin plugs
- collection of dead keratinocytes, overproduction of keratin and melanin forms a plug which blocks the opening of the sebaceous gland
overproduction of sebum can also block the opening
blockage of the opening of the sebaceous gland can create a closed environment for commensal bacteria in the hair follicle to proliferate
proliferation of this bacteria attracts immune cells which cause inflammation and pus etc
what type of bacteria is associated with acne?
proprionibacterium
what types of lesions can occur in acne?
comodones
- open (blackheads) = where pus/keratin plug/sebum is exposed to the air and oxidises, turning it black
- closed (whitehead) = where blockage by keratin plug/sebum creates a closed environment for proprionibacterium and they proliferate, attracting immune cells which attack, forming pus
what can cause an increase in sebum?
increase in androgens - puberty - PCOS increased cortisol - stress - cushings
what is type 1/mild acne?
no scarring
few small comedones
what is type 2/moderate acne?
no scarring
large closed comedones (papules)
what is type 3/moderately severe acne?
some scarring
popular and pustular acne (comedones containing necrotic tissue)
what is type 4/severe acne?
severe scarring nodulocystic acne (nodules and cysts)
what is nodulocystic acne?
invades deeper into dermis
forms abscess
how is mild acne managed?
topical treatments
- benzoyl peroxide
- salicylic acid
- topical retinoids
how is moderate acne managed?
antibiotics
- doxycycline or tetracycline
how is severe acne managed?
isotretanoin (vit A derivative)
- impacts sebum secretion
how can hormonal acne be managed in women?
oral contraceptive pill
