April 8, 2018

Acne

 Acne vulgaris

Acne form due to the hyperactivity of sweat & oil glands results in clogging of pores  with oil and dead skin. The acne appears  most commonly on the face, as well as the back, chest and shoulders. It can be caused by having an overabundance of oil on the skin, bacteria buildup, and irregular shedding of dead skin cells that result in the irritation of the pores. Other factors which can make acne worse are hormones, medications, and diet. Pregnancy related hormonal alterations can make acne worse and oral birth control medications have been known to effect sebum (oil) production. Some Medications like lithium, corticosteroids, and androgens have been known to cause acne.  A diet that is rich in dairy and carbohydrates may also attribute to acne on the face.

 Eating too much chocolate or consuming greasy foods have not been proven to give one acne. Another myth is dirty skin will give one acne. Acne is not caused by dirt but rather by having the pores become clogged with oil and dead skin.  Over washing the face can actually lead to acne, since excess oil may be produced.

 Acne-Types

Type-1 – These are comedones, or also known as whiteheads or blackheads noninflammatory in nature They are formed due to the clogging of skin follicular openings of the skin follicles by excess oil and dead skin.  Open comedones are generally referred black heads due to the dark appearance of the plugs in the hair follicles. Closed comedones are called whiteheads as the contain sebaceous material.

Type-2 – These are inflammatory lesions and is of four types generally.

Papules are raised bumps that are small, red and tender and signal inflammation or infection in the hair follicle.

Pustules are tender, red bumps with white pus at the tip.

Nodules are solid, painful lumps beneath the surface of the skin, formed due to a buildup of secretions deep in the hair follicle.

Cysts are painful lumps that are filled with pus, look like boils and can lead to scarring.

Acne Treatments

Sometimes acne resolves spontaneously by its own but treatments are generally required to avoid post inflammatory hyper-pigmentation & and scarring.

Type-1 are generally treated with topical therapy and the most effective is Retinoid cream adjunct with comedone extraction.

Type-2 are generally treated with antibiotics, oral retinoids and topical antibiotic, retinoid creams. Aggressive lesion required procedure treatments like :

Chemical peels : Most commonly used is Glycolic, Lactic, Salicylic acid & Jessner’s peel. Experts can do multiple peel treatments but required expertise.

Laser & Light therapy : Used to damage oil glands & bacteria.

Skin surgery : can be done to take out cysts & nodules.

Facewash and pack containing Salicylic acid, Resorcinol, Resveratrol, sulfur etc. can be used to avoid excessive oil.

Some lifestyle amendments may prevent acne flare like  hair should be clean, telephones should not be allowed to rest on the face, and pillow cases should be cleaned weekly, or every few days.

THE MOST COMMON CAUSE OF ACNE FLARE UP IN INDIA IS THOROUGHLY USE OF OVER THE COUNTER STEROID CREAMS WHICH LEADS TO STEROID INDUCED ACNE.

Antiacne plus treatment is the right line of treatment.

 

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Ichthyosis (ick-thee-OH-sis) is a skin disease that causes extremely dry, thick, and scaly skin resembles fish scales.

These are a heterogeneous group of disorders with both inherited and acquired forms. these are the types
Ichthyosis Vulgaris- Most common type of icthyosis Lamellar Ichthyosis- Lamellar ichthyosis is characterized by dark, plate (armor)-like scale. Epidermolytic Hyperkeratosis- characterized by generalized redness and fine white scale Congenital Ichthyosiform Erythroderma- newborn infant with ichthyosis who presented at birth with collodion baby appearance. X-linked Ichthyosis- due to a defect in the enzyme steroid sulfatase, affects males with generalized scaling that usually begins soon after birth.

Ichthyosis Treatment

Several hours each day may need to be devoted the skin if ichthyosis is present in an individual. Daily, a person will need to take a shower or a bath. The skin should be exfoliated on a daily basis, and moisturised well. Moisturising ointments or creams may need to be prescribed by a dermatologist for the individual. Oral retinoids can be prescribed to reduce scaling. If a secondary infection occurs on the skin, oral antibiotics will need to be prescribed. Tips that will help keep the skin looking and feeling its best include applying a good quality lotion within 3 minutes of bathing. Apply to wet skin to keep moisture trapped into the skin. Products that contain lactic acid, alpha hydroxy acids and urea will help to keep skin not only moisturised but also exfoliated. Rubbing a wet pumice stone over crusty scales on the skin can help to remove them. Should there be scales on the scalp, brushing wet hair gently will aid in removing the scales.  

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