Last reviewed by Editorial Team on August 13th, 2018.
Acne Vulgaris Definition
Acne vulgaris is a common skin condition characterized by the formation of seborrhea, comedones, nodules, papules, pustules and cyst. It occurs in the areas of the skin with abundant hair growth such as in the upper chest, back, face and legs.
Acne vulgaris is a common skin condition that the general population experienced at one point in their lives. It primarily occurs among adolescent with the onset that starts during puberty while acne vulgaris is uncommon among older people. Acne vulgaris affects both men and women although it is slightly prevalent among women. It can, however, occur during the first week to first months of life while maternal hormone is still high. The acne vulgaris in newborn babies on the other hand resolve spontaneously although there are cases where treatment is necessary.
Acne vulgaris is not a life-threatening or serious condition. It is, however, a discomforting condition which can affect the quality of life. The incidence of acne vulgaris can be a social stigma on the part of the patient as the incidence is unappealing particularly when it develops in the face. The patient can have a low self-esteem due to the physical appearance of their skin marked by numerous acne vulgaris. It is a very apparent skin condition especially in severe inflammation. Acne vulgaris can also result in permanent scarring after it has healed. It can also result to hyperpigmentation which is basically apparent among individuals with dark skin tone.
Acne Vulgaris Symptoms
The symptoms of acne vulgaris depends on the form of acne it has developed. The appearance of the acne generally varies in color depending on the skin tone. The onset can also be inflammatory or non-inflammatory, again, depending on the form of acne that occurred.
Scars can develop in acne vulgaris which is often due to the effort of the lesion in healing itself subsequently the accumulation of excessive collagen occurring in one area. The formation of acne scar is brought by the inflammation that occurred in the dermis. The scar can be an ice pick scar which is a physical scar that causes a depression in the surface of the skin. It can also be a box car scar which is similar to the scar created by chickenpox. This can be either deep or superficial and occurring at the cheeks or temples. Hypertrophic scars are rather thickened or similar to a keloid while rolling scars are those that create a wave like appearance of acne vulgaris.
Pigmentation scar is the result of cystic acne and nodular acne. Pigmentation acne often leaves a reddish discoloration on the surface of the skin as a result of the inflammation. This pigmentation scar on the other hand tends to fade or lighten in color in a matter of two months to two years but may stay on permanently if no treatment has been applied.
The lesion of acne vulgaris can either be inflammatory or non-inflammatory and the appearance of the lesion depends on the form of acne vulgaris.
Comedones are non-inflammatory lesion and are a form of acne vulgaris in the form of whiteheads or blackheads. The whitehead is open comedones that are whitish or flesh colored while blackhead is closed comedones with core that is rather dark in color. Both are palpable lesions with about 1mm to 3mm in diameter. Comedones are the result of an obstruction in the opening of the hair follicles from dead skin cells and oil secretion.
Pustules or pimples are inflammatory lesions characterized by red and tender bumps. Pustules are superficial lesions that have whitish or yellowish tips that can be squeezed. The size of the lesion is about 2 mm to 5 mm in diameter.
Papules are also inflammatory and superficial lesions characterized by raised bumps that are small and tender and with reddish color.
Nodules are inflammatory lesions that occur deeper in the dermis. Nodules are large and solid lumps that are painful. The appearance is similar to an inflamed epidermoid cyst although there is no existence of a true cystic structure.
Cyst is a form of acne vulgaris characterized by the formation of lump. It is an inflammatory and deeper lesion and is a suppurative nodule that develops in the deeper portion of the skin. This form of acne vulgaris is rather painful which tend to cause acne scarring particularly ice pick scar.
Acne vulgaris may be painful or not and may also be tender depending on whether it is an inflammatory or non-inflammatory form. It is not a serious and life-threatening condition and without the manifestation of systemic symptoms.
Acne Vulgaris Causes
Acne vulgaris occurs when there is the presence of an obstruction in the opening of the hair follicles due to the 3 factors considered to trigger the onset of acne vulgaris.
- Acne vulgaris occurs when there is an excessive production of sebum
- Acne vulgaris occurs as a result of obstruction of the opening of the hair follicles due to the blockage from dead skin cells
- Acne vulgaris may also result from the accumulation or the buildup of bacteria
The factors that resulted in the onset of acne vulgaris are influenced by different causes such as:
- Hormonal activity influences the formation of acne vulgaris. This is mainly due to the overproduction of sebum that causes the obstruction in the opening of the hair follicles. Hormonal activity makes acne vulgaris common during the puberty stage and during pregnancy and menstrual flow owing to the irregularity in the hormonal activity.
- Genetic predisposition is another factor considered to influence acne vulgaris. It is believed to be the main underlying cause of acne vulgaris.
- Infectious agents such as Propionibacterium acnes and Staphylococcus aureus are believed to cause acne vulgaris.
Acne vulgaris can be managed with multitude of treatment methods. The aim is to reduce the inflammation, diminish sebum production and shedding of dead skin to prevent blockage of the opening of hair follicles.
Pharmacological treatment for acne vulgaris includes the following:
- Retinoids such as isotretinoin and tretinoin
- Azelaic acid
- Erythromycin or Clindamycin antibacterial lotion
- Oral antibiotics such as Oxytetracycline
- Oral retinoid
- Oral contraceptives
Laser and light therapies are also included in the treatment of acne vulgaris with the use of a specialized instrument intended to target the deeper layer of the skin affected by the acne vulgaris. Several cosmetic procedures are also helpful in the treatment of acne vulgaris such as the like of chemical peel and microdermabrasion.