ACNE CAUSES SYMPTOMS TREATMENTS AND ANTIBIOTICS

ACNE DEFINITION

Acne is a skin condition that occurs when  hair follicles
become plugged with oil and dead skin cells. Acne usually
appears on face, neck, chest, back and shoulders.
Effective treatments are available, but acne can be
persistent. The pimples and bumps heal slowly, and when
one begins to go away, others seem to crop up.

CAUSES MAIN   

Depending on its severity, acne can cause emotional
distress and scar the skin. when earlier start treatment,
the lower  risk of lasting physical and emotional
damage.

SYMPTOMS

Acne signs and symptoms vary depending on the severity
Whiteheads
Blackheads —
Small red, tender bumps
Pimples
which are papules with pus at their tips Large, solid, painful
lumps beneath the surface of the skin (nodules)Painful,
pus-filled lumps beneath the surface of the skin

The Food and Drug Administration warns that some
popular nonprescription acne lotions, cleansers and other
skin products can cause a serious reaction. This type of
reaction is quite rare, so don't confuse it with the redness,
irritation or itchiness where you've applied medications or
or tongueTightness of the throat

CAUSES IN DETAIL 

Four main factors cause acne:
Oil production Dead skin cells Clogged pores Bacteria
Acne typically appears on face, neck, chest, back and
shoulders. These areas of skin have the most oil
 glands. Acne occurs when hair follicles
become plugged with oil and dead skin cells.
Hair follicles are connected to oil glands. These glands
secrete an oily substance (sebum) to lubricate your hair
and skin. Sebum normally travels along the hair shafts and
through the openings of the hair follicles onto the surface
of your skin.
When body produces an excess amount of sebum
and dead skin cells, the two can build up in the hair
follicles. They form a soft plug, creating an environment
where bacteria can thrive. If the clogged pore becomes
infected with bacteria, inflammation results.
Pimples are raised red spots with a white center that
develop when blocked hair follicles become inflamed or
infected. Blockages and inflammation that develop deep
inside hair follicles produce cyst-like lumps beneath the
surface of your skin. Other pores in your skin, which are
the openings of the sweat glands, aren't usually involved in
acne.

Factors that may worsen acne

These factors can trigger or aggravate an existing case of
acne:
Hormones. Androgens are hormones that increase in boys
and girls during puberty and cause the sebaceous glands
to enlarge and make more sebum. Hormonal changes
related to pregnancy and the use of oral contraceptives
also can affect sebum production. And low amounts of
androgens circulate in the blood of women and can worsen
acne.Certain medications. Drugs containing
corticosteroids, androgens or lithium can worsen
acne.Diet. Studies indicate that certain dietary factors,
including dairy products and carbohydrate-rich foods —
such as bread, bagels and chips — may trigger acne.
Chocolate has long been suspected of making acne
worse. A recent study of 14 men with acne showed that
eating chocolate was related to an increase in acne.
Further study is needed to examine why this happens or
whether acne patients need to follow specific dietary
restrictions.Stress. Stress can make acne worse.

RISK FACTORS

Risk factors for acne include:
Hormonal changes. Such changes are common in
teenagers,  and people using certain
medications, including those containing corticosteroids,
androgens or lithium.Family history. Genetics plays a role
in acne. If both parents had acne, you're likely to develop
it, too.Greasy or oily substances. You may develop acne
where your skin comes into contact with oily lotions and
creams or with grease in a work area, such as a kitchen
with fry vats.Friction or pressure on your skin. This can be
caused by items such as telephones, cellphones, helmets,
tight collars and backpacks.Stress. This doesn't cause
acne, but if you have acne already, stress may make it
worse.

TREATMENTS AND DRUGS

If over-the-counter (nonprescription) products haven't
cleared up your acne, your doctor can prescribe stronger
medications or other therapies.
Control your acne Avoid scarring or other damage to your
skin Make scars less noticeable
Acne medications work by reducing oil production,
speeding up skin cell turnover, fighting bacterial infection
or reducing inflammation — which helps prevent scarring.
With most prescription acne drugs, you may not see
results for four to eight weeks, and your skin may get
worse before it gets better. It can take many months or
years for your acne to clear up completely.
The drug your doctor recommends depends on the type
and severity of your acne. It might be something you apply
to your skin (topical medication) or take by mouth (oral
medication). Often, drugs are used in combination.
Pregnant women will not be able to use oral prescription

medications for acne.

Talk with your doctor about the risks and benefits of
medications and other treatments you are considering.

Topical medications

These products work best when applied to clean, dry
skin about 15 minutes after washing. You may not see the
benefit of this treatment for a few weeks. And you may
notice skin irritation at first, such as redness, dryness and
peeling.

Retinoids. 

These come as creams, gels and lotions.
Retinoid drugs are derived from vitamin A and include
tretinoin (Avita, Retin-A, others), adapalene (Differin) and
tazarotene (Tazorac, Avage). You apply this medication in
the evening, beginning with three times a week, then daily
as your skin becomes used to it. It works by preventing
plugging of the hair follicles.Antibiotics. These work by
killing excess skin bacteria and reducing redness. For the
first few months of treatment, you may use both a retinoid
and an antibiotic, with the antibiotic applied in the morning
and the retinoid in the evening. The antibiotics are often
combined with benzoyl peroxide to reduce the likelihood of
developing antibiotic resistance. Examples include
clindamycin with benzoyl peroxide (Benzaclin, Duac,
Acanya) and erythromycin with benzoyl peroxide
(Benzamycin).Dapsone (Aczone). This gel is most
effective when combined with a topical retinoid. Skin side
effects include redness and dryness.

Oral medications

Antibiotics. 

For moderate to severe acne, you may need
oral antibiotics to reduce bacteria and fight inflammation.
Choices for treating acne include tetracyclines, such as

minocycline and doxycycline.

doctor likely will recommend tapering off these
medications as soon as your symptoms begin to improve
or as soon as it becomes clear the drugs aren't helping —
usually, within three to four months. Tapering helps
prevent antibiotic resistance by minimizing undue
exposure to these medications over a long time.
You will likely use topical medications and oral antibiotics
together. Studies have found that using topical benzoyl
peroxide along with oral antibiotics may reduce the risk of
developing antibiotic resistance.
Antibiotics may cause side effects, such as an upset
stomach and dizziness. These drugs also increase your
skin's sun sensitivity. They can cause discoloration of
developing permanent teeth and reduced bone growth in
children born to women who took tetracyclines while
pregnant.
Combined oral contraceptives.

Combined oral

contraceptives are useful in treating acne in women and
adolescent girls. The Food and Drug Administration
approved three products that combine estrogen and
progestin (Ortho Tri-Cyclen, Estrostep and Yaz).
The most common side effects of these drugs are
headache, breast tenderness, nausea, weight gain and
breakthrough bleeding. A serious potential complication is
a slightly increased risk of blood clots.
Anti-androgen agent. The drug spironolactone (Aldactone)
may be considered for women and adolescent girls if oral
antibiotics aren't helping. It works by blocking the effect of
androgen hormones on the sebaceous glands. Possible
side effects include breast tenderness, painful periods and
the retention of potassium.

Isotretinoin. 

his medicine is reserved for people with the
most severe acne. Isotretinoin (Amnesteem, Claravis,
Sotret) is a powerful drug for people whose acne doesn't
respond to other treatments.

Oral isotretinoin 

is very effective. But because of its
potential side effects, doctors need to closely monitor
anyone they treat with this drug. The most serious
potential side effects include ulcerative colitis, an
increased risk of depression and suicide, and severe birth
defects.
In fact, isotretinoin carries such serious risk of side effects
that women of reproductive age must participate in a Food
and Drug Administration-approved monitoring program to
receive a prescription for the drug.

Therapies

These therapies may be suggested in select cases, either
alone or in combination with medications.
Light therapy. A variety of light-based therapies have been
tried with success. But further study is needed to
determine the ideal method, light source and dose. Light
therapy targets the bacteria that cause acne inflammation.
Some types of light therapy are done in a doctor's office.
Blue-light therapy can be done at home with a hand-held
device.
Possible side effects of light therapy include pain,
temporary redness and sensitivity to sunlight.
Chemical peel. This procedure uses repeated applications
of a chemical solution, such as salicylic acid. It is most
effective when combined with other acne treatments,
except oral retinoids. Chemical peels aren't recommended
for people taking oral retinoids because together these
treatments can significantly irritate the skin.
Chemicals peels may cause temporary, severe redness,
scaling and blistering, and long-term discoloration of the
skin.
Extraction of whiteheads and blackheads. Your
dermatologist uses special tools to gently remove
whiteheads and blackheads (comedos) that haven't
cleared up with topical medications. This technique may
cause scarring.Steroid injection. Nodular and cystic lesions
can be treated by injecting a steroid drug directly into
them. This improves their appearance without the need for
extraction. The side effects of this technique include
thinning of the skin, lighter skin and the appearance of
small blood vessels on the treated area.

Treating children

Most studies of acne drugs have involved people 12 years
of age or older. Increasingly, younger children are getting
acne as well. In one study of 365 girls ages 9 to 10, 78
percent of them had acne lesions. If your child has acne,
you may want to consult a pediatric dermatologist. Ask
about drugs to avoid in children, appropriate doses, drug
interactions, side effects, and how treatment may affect a

child's growth and development.

Treatment of children with acne is often complicated by
their family situation. For example, if a child moves
between two homes due to divorced parents, it may help to
use two sets of medications, one in each home.