Acne vulgaris

Acne vulgaris, or acne, is a skin problem that starts when oil and dead skin cells clog up your pores. Some people call it blackheads, blemishes, whiteheads, pimples, or zits. When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or, it can be bigger, solid, red lumps that are painful (cysts).

Acne starts when oil and dead skin cells clog the skin’s pores. If germs get into the pores, the result can be swelling, redness, and pus. For most people, acne starts during the teen years. This is because hormone changes make the skin more oily after puberty starts.

To help control acne, keep your skin clean. Avoid skin products that clog your pores. Look for products that say “noncomedogenic” on the label. Wash your skin once or twice a day with a gentle soap or acne wash. Try not to scrub or pick at your pimples. This can make them worse and can cause scars.

If you have just a few pimples to treat, you can get an acne cream without a prescription. Look for one that has benzoyl peroxide or salicylic acid. These work best when used just the way the label says.

It can take time to get acne under control. Keep using the same treatment for 6 to 8 weeks. You may even notice that it gets worse before it gets better. If your skin is not better after 8 weeks, try another product.

How various drugs work in treating acne

Acne Conglobata

This is the most severe form of acne vulgaris and is more common in males. It is characterized by numerous large lesions, which are sometimes interconnected, along with widespread blackheads. It can cause severe, irrevocable damage to the skin, and disfiguring scarring. It is found on the face, chest, back, buttocks, upper arms, and thighs.

Males are more likely than females to have acne conglobata; the age of onset is usually between 18 and 30 years. The cause of the condition is not well understood.

Isotretinoin is the usual treatment of choice for acne conglobata. Antibiotics may also be prescribed. Several courses of treatment may be necessary over a period of years. Even after effective treatment, the patient should have regular checkups by a dermatologist for any signs of recurrence. A dermatologist can also treat the scars.

Isotretinoin: Potent systemic medication used to treat severe forms of acne. Due to potential birth defects, a woman must not take this medication while pregnant or breast feeding and must not become pregnant while taking isotretinoin.

Taken from AcneNet Glossary – Isotretinoin

Figure showing stages of acne. (A) Normal follicle; (B) open comedo (blackhead); (C) closed comedo (whitehead); (D) papule; (E) pustule.

Acne Fulminans

Acne fulminans is a rare and very severe form of acne conglobata associated with systemic symptoms which most commonly affects adolescent boys. An acute onset associated with systemic symptoms such as fever, weight loss, arthralgia, myalgia, erythema nodosum and hepatosplenomegaly can occur.

Acne fulminans does not respond well to antibiotics. Isotretinoin (Accutane) and oral steroids are normally the recommended treatment for acne fulminans is a combination of oral steroids and isotretinoin.

• Oral steroids should be started and gradually reduced over 6 weeks to avoid adverse effects of a prolonged course of systemic steroids.
• Isotretinoin should be started at 4 weeks, initially at 0.25 mg/kg daily and gradually increased to achieve complete clearance.
• Isotretinoin with a minimum total dose of 120 mg/kg is recommended. Relapses are rare. If required, a repeat course of isotretinoin (150 mg/kg) may be used.
• Some authors suggest treating patients with spontaneous development of acne fulminans with oral steroids and supplemental intralesional therapy.
• The response to broad-spectrum antibiotic treatment is poor. Oral antibiotics are responsible for a slow response in the resolution of acne and systemic symptoms. The combination of oral isotretinoin and systemic steroids is better than the combination of oral isotretinoin and antibiotics.
• Infliximab, a monoclonal antibody against tumor necrosis factor-alpha, also may be a treatment option for patients with AF that is unresponsive to conventional therapies.

Natural acne treatment: drink 1 lemon water mixture per day and Vitamin C per day.

Acne Keloidalis Nuchae

Acne keloidalis nuchae develops as a result of ingrown hairs located on the back of the head and neck. As they grow into the skin, they become inflamed and cause scar tissue. This ailment typically begins following a short haircut and can often be avoided by the barber taking special care to not cut the hair too short.

Acne keloidalis nuchae is a condition most commonly found in men because they generally have shorter hair, but may also be a problem for women who choose to wear their hair in a very short style that is close to the neck.

Treatment of acne keloidalis nuchae includes suppression of the inflammation with antibiotics and steroid gels or intralesional steroid injections. Larger bumps of acne keloidalis nuchae present for a while or if not responding to treatments may need surgical removal. Unfortunately, to prevent regrowth they need to be cut out widely and deeply. They heal best if left open, which can take weeks to months. Intralesional steroid injections or radiation treatment after surgery helps prevent recurrence of the acne keloidalis nuchae.

Hair removal lasers may prove to be a very useful tool in early acne keloidalis nuchae. If a person knows he is prone to this condition, but before it becomes an advanced case, laser hair removal may prevent further acne keloidalis nuchae from developing.

If you’re going to eat fruits for acne, make sure to balance it with a lot of green vegetables as well.

Natural Acne Treatment

• Eliminate all ‘bad’ foods. (Bad as in fried, oily food and so on!)
• Steam
• Eat 1 small portion of salmon per day
• Drink 1 lemon water mixture per day
• Drink 1 ACV water mixture per day
• Get 15-25 minutes of sun per day
• Vitamin C per day

First, the most important thing when starting a treatment is to stick with it. Regardless of what treatment you choose, if you don’t go through with it, then you’ll never know if it works or not. This is especially important with the all natural treatment because if you don’t eliminate the ‘bad foods’, then you won’t see the full benefit of it.

Second, when starting natural acne treatments, it’s important to log and keep track of your progress. You should be taking notes on a daily basis of the improvement (or lack of) of the treatment. That way, you’ll see if you’re improving or not after a week. If you aren’t, then it’s time to change something!