Understanding
Acne is an inflammatory disorder of pilosebaceous units. prevalent in adolescence. The lesions are open (black) and closed (white) comedones, inflammatory papules, pustules, nodules and cysts Acne can lead to scarring and pigmentary changes The pathogenesis of acne is multifactorial and includes abnormal follicular keratinization, increased production of sebum secondary to hyperandrogenism, proliferation of Propionibacterium acnes and inflammation. Lesions occur primarily on the face, neck, upper back and chest. When assessing the severity of the acne, one needs to consider the distribution, the type and number of lesion and the presence or absence of scarring Triggers Hormones & Diet Environment Stress levels & Underlying medical history Factors likely to contribute Exacerbating medication or endocrinologic abnormality causing hyperandrogenism (e.g., polycystic ovarian syndrome). Other Androgen excess include seborrhea, hirsutism and androgenetic alopecia. Endocrinologic testing is not ordered routinely for women with regular menstrual cycles
What next
Treatment plan Stage the acne Consider a referral Consider the goal and expected outcomes Commence skincare Commence LED therapy +++ IPL acne for white heads IPL photorejuvination for diffuse redness Skin needling for active lesion ( grade 1-2 ) and for scaring Skin care Asses the barrier to decide on the cleansing option Multi B Problem skin serum Exfol A or hydra A Hydrashield BHA Gel is an option
Grade One: Mild – Open and closed comedones with few inflammatory papules and pustules Two: Moderate- Papules and pustules, mainly on face Three: Moderately severe – Numerous papules and pustules, and occasional inflamed nodules, also on chest and back Four: Severe – Many large, painful nodules and pustules
