An Overview About Acne Vulgaris

Background: Acne vulgaris (acne) is a long-term inflammatory skin disease. Typical features of acne that often appears in adolescents on the forehead include visible, clinically recognized blackheads or whiteheads (comedones) that develop into inflammatory red papules or pustules and possible scarring. Acne primarily affects skin with a relatively high number of sebaceous glands including face, neck, chest, and upper back. Acne and postinflammatory hyperpigmentation have a strong negative impact on mental health, including mood disorde,r, depression, and suicidal thoughts. Also acne may cause low self-esteem, decrease social interactions and quality-of-life scores in adolescents. Typical features of acne include increased secretion of sebum by the skin, microcomedones (a structure invisible to the naked eye), comedones, papules, nodules, pustules, and often results in scarring. It may result in psychological and social problems. Acne lesions are classified into non inflammatory and inflammatory. Non inflammatory acne lesions consist of open and closed comedones. Open comedones are clearly obvious in the skin and can be found in the face centrally. Closed comedones, by inspection in a good light room, are slightly hypopigmented ,tiny, usually less than 1mm in size, with no visible opening . Comedones are superficial and can remain with no progress or get inflammed and become deep. Inflammatory acne lesions include papules ( red, inflammed, raised lesions of size less than 5 mm), pustules ( scattered pus-filled papules) and nodules ( lesions, 5 mm or larger in size). these lesions affect deep structures in the skin so their inflammation can lead to formation of scars. Acne vulgaris is a chronic skin disease of the pilosebaceous unit that occurs as a result of the following four factors: increased sebum production (due to increased activity of androgens and IGF-1), excessive deposition of keratin in pilosebaceous follicles leading to comedo formation, colonization of the follicle by P. acnes bacteria, and the local release of pro-inflammatory chemicals in the skin through certain inflammatory mechanisms. Limited evidence supports comedo extraction, but it is an option for comedones that do not improve with standard treatment. Another procedure for immediate relief is the injection of a corticosteroid into an inflamed acne comedo. Electrocautery and electrofulguration are effective alternative treatments for comedones. Inflammatory and non-inflammatory lesions are common in acne vulgaris, which is a complex illness linked to the pilosebaceous follicle. Since inflammation can occur in both the early stages of acne vulgaris and the late stages of the disease, inflammation plays a critical role in the development of acne vulgaris lesions, both inflammatory and non-inflammatory. There are different updated modalities for acne vulgaris treatment.