In a fruitful and useful dialogue with Dr. Mohammed Qashmar consultant dermatologist in the Kingdom, he mentioned many points about acne.
He defined acne is skin disease or inflammation caused by changes in the skin pores and sebaceous glands that leads to excreting excessive oils from glands in addition to having a natural layer of dead skin cells blocking pores.
It is an accumulation of fatty secretions under clogged skin, which provides an excellent environment for bacteria to multiply and have much activity. And thus skin is irritated and forms inflamed area.
Acne usually appears on the face, shoulders, back, upper arms and most of the acne-causing anaerobic bacteria. Acne or acne skin disease is a chronic inflammatory group of follicular elements.
Why does acne occur?
There are three key factors to acne formation:
1. Excessive increase in the secretion of the sebaceous glands: This leads to a greasy face.
2. The role of bacteria, which break down fat into fatty acids and these acids cause violent inflammation in the skin.
3. Inflammation: It causes redness and pimples may cause rupture of unity fatty pulp and accumulated materials leak into the surrounding tissue in the dermis, causing inflammation
How does acne appear?
Acne lesions are divided on several types depending on the severity of the situation and can be divided into two main types:
A - Non-inflamed lesions: start the emergence of whiteheads in the fatty areas of the body
B - Inflamed lesions: an extension of the non-inflamed lesions, which produces inflammation that causes redness and swelling.
When do you get acne?
Infection usually begins during the early years of adulthood, and acne is one of the first signs of puberty, especially for girls, and the usual symptoms are black-and-whiteheads in their early teens, which then evolve into inflammatory lesions.
When does acne disappear?
Often acne begins to disappear or shows relative improvement in the mid to late twenties but may extend to several more years. In severe cases, it could continue actively to a later age in the fifth decade or even sixth, especially when men cannot predict its end, especially if left untreated.
What are the possible complications of acne?
A. Autosomal complications:
These complications result from the effects of acne and include the following:
• Chromosomal raised: brown skin abound, and one should always understand that the treatment should be focused on the acne itself with the effects.
B / psychological complications:
Since most adolescents suffer psychologically from the presence of grain and suffer more if they do not find sympathy from their parents or from physician, and these grains may lead to a distorted severe depression.
Could acne be due to other reason?
Acne in women can be due to hormonal complications and there are some signs that could be evidence of the existence of these complications:
1 - Severe acne
2 - Acne starting strongly at the age of puberty
3 - The presence of disturbances in the menstrual cycle.
4 - Having difficulty in pregnancy for married women.
What are the signs of the severity of the problem and the need for treatment?
It is largely left to the patient if they desire to have therapy or not. But all types of acne must be controlled medically.
How is it treated?
After assessing the situation your doctor choses the form of therapy from the therapeutic ladder ranging from topical treatments to oral treatments:
A / non-pharmacological measures:
It aims to reduce the greasy face, and consist of the following:
1 - The use of fat-free cosmetics and an extension to avoid an increase in fat in face. The person is also advised to try to use cosmetic foundations in the form of powders.
2 - Wash face every day with any kind of soap so as to remove the fat.
3 - Avoid trying to remove black and whiteheads and inflamed lesions or tamper with them, and that there is a possibility of exploding the inflammation.
B / pharmacological measures:
Designed to fix the dysfunction problem and consists of the use of following drugs:
• Topical treatments:
1 - Topical antibiotics: According to this treatment the use of topical antibiotics is made in the treatment of inflammatory light lesions.
2 - Derivatives of vitamin A topical
How to use the topical treatment?
Should start in a phased manner for example, (preferably at night) every two or three days for a period ranging from two to three weeks if you do not have severe irritation which may increase the frequency to once every two days and then once every night is then maintenance on use.
Oral treatments:
A / oral antibiotics:
• Notes on Usage:
Do not use antibiotics only to kill bacteria, but also to use its anti-inflammatory properties.
What are the most important side effects of antibiotics?
In general are simple ailments, it causes some sort of stomach discomfort and can be avoided by taking the medication after a meal.
B / Medicine (Roaccutane )
This drug has the latest pre-revolution in the science of dermatology and still resonates with concrete effects even today. This treatment has been considered a revolution for the following reasons:
1 - It has made possible the treatment of acne types, which were considered incurable in the past as a result of severity.
2 - This treatment and its derivatives opened that doors to large research in the treatment of many diseases and is not limited to dermatology but also to various other diseases..
What are the side effects of Roaccutane:
1 - Fetal abnormalities therefore advisable to use two means to prevent pregnancy during and after treatment for two months for women.
2 - May lead to a rise in triglyceride and cholesterol.
How to use?
This medicine is used in capsules and taken daily in different doses according to body weight and the doctors are often required to do blood tests, check liver and the amount of fat before starting treatment, including a pregnancy test for married women and then repeat these tests monthly, or at the discretion of the physician.
Dr. Mohammed Qashmar
Consultant dermatologist
