Ch.4 Disorders & Diseases Of Skin (Acne)

Question 1

What is acne?

Answer 1

Inflammatory skin disorder of sebaceous glands (excess sebum production) caused by propionibacterium acne.
Aka Acne simplex / vulgaris

Question 2

What is pilosebaceous unit?

Answer 2

The entire follicle : hair shaft , sebaceous gland, sebaceous duct/canal.

Question 3

What follicle is most involved in acne?

Answer 3

Hairless follicle attached to sebaceous gland

Question 4

Non inflamed buildup of cells, sebum, and other debris inside follicle ?

Answer 4

Comedo

Question 5

A blackhead open at the surface and exposed to air (oxidized)?

Answer 5

Open comedo

Question 6

Openings of follicle blocked with debri & white cells. White head ?

Answer 6

Closed comedo

Question 7

Similar to comedones. Small solidified impactions of oil without the cell matter. Often found on nose ?

Answer 7

Sebaceous filaments

Question 8

Milia?

Answer 8

Small cysts appear as small white firm papules. Pearl like masses no visible opening.

Can only moisturize

Question 9

What is retention Hyperkeratosis?

Answer 9

Hereditary factor where dead skin cells build up because they don’t shed from follicle

Question 10

What is sebaceous hyperplasia?

Answer 10

Doughnut shaped Benign lesions with indentations in center

Question 11

What is seborrhea?

Answer 11

Severe oiliness of skin, abnormal secretion from sebaceous glands.

Question 12

What are the grades of acne?

Answer 12

Grade 1 - minor breakouts. Mostly open comedones some closed. Few pustules

Grade 2- many closed comedones, more open comedones. Occasional papules & pustules

Grade 3- Red & inflamed. Many comedones, papules & pustules

Grade 4- cystic acne , cysts, inflammation, papules, pustules, comedones, scars

Question 13

What are the acne triggers?

Answer 13

Genetics- DNA programmed; familial disorder

Hormones- androgen fluctuations during puberty, pregnancy, menstrual cycle, peri menopause, birth control , iud,

Environment- poor air quality, pollutants, comedogenic exposure increases inflammatory response of sebaceous glands. Climate/seasons change , humidity & temp influence oil production

Lifestyle- stress, new or lost job? Romantic breakup, engagement/marriage, death of fam or friend, new home / town , difficulty at home, long drives, cell phone pressure , hats scarves transfer bacteria . Fragrance sheets , laundry detergent, shampoos

Diet-high glucose, processed foods, heavy iodine, dairy

Cosmetic & skin products- waxes, oils can clog follicle. (Comedogenic ingredients.) heavy products rich in emollients, occlusive products result in comedones. Moisturizers & sunblock should be oil & water (o/w) emulsions

Question 14

What is a plan of care for acne?

Answer 14

Regular skin care session with exfoliation , modalities, microdermabrasion, chemical peel

Keeps Corneum thin, keep oil under control, add hydration, & oxygenate the skin to eliminate bacteria

Question 15

What are 8 common meds used in acne treatment? Describe

Answer 15

•ADAPALENE (differin) - topical peeling agent similar to retinoic acid.

Side effect : D.R.I.P
drying, redness, irritation, photosensitive

•AZELAIC ACID Azelex- topical acidic agent that flushes out follicles

Side effect: D.R.I.P.
drying, redness,irritation, photosensitive

•BIRTH CONTROL PILLS- oral med to regulate androgen hormones that impact oil production

Side effect: irregular period, weight gain, cramps

•CLINDAMYCIN- topical antibiotic; kills bacteria

Side effect: VERY drying

•ISOTRETINOIN (acutane) - oral control med for severe acne. Requires close med monitoring; lab for liver function, used as last resort

Side effect: severe dryness , birth defects, suicide, depression, colitis

•SPIRONOLACTONE- oral med to regulate androgen hormones usually given to young women/teens.

Side effect: Breast tenderness, male pattern facial hair growth , dry mouth, irregular periods

•TAZAROTENE (tazorac)- retinoid, topical peeling agent less irritating that Tretinoin.

Side effect: D.R.I.P.
Drying, redness, irritation, photosensitive

•TRETINOIN- topical vitamin A acid. Strong peeling agent that is drying and flushed out follicles

Side effects: very drying R.I.P

Question 16

7 Considerations for medicated acne treatment:

Answer 16

•home care products should include benzoyl peroxide & vitamin A
•moisturizers & serums on low comedogenic scale
•benzoyl peroxide products are often combined with topical antibiotics
•vitamin A products should be applied at night (photosensitivity)
•Salicylic acid & Azuela I acid are antibacterial. (Salicylic is lipophilic so it works to digest sebum)
•oral meds are often to counter effects of androgen hormones. (Spironolactone)
•birth control pills , reduce breakouts from hormones

Question 17

What is Polycystic Ovarian Syndrome?

Answer 17

PCOS
HORMONAL CONDITION AFFECTING 1 in 20 women in child bearing years resulting in androgen production that causes development of cysts on ovaries.