Acne Vulgaris: Western Medicines Clinical Diagnosis
Medical approach to Acne Vulgaris:
Acne Vulgaris today is one of the most common dermatological problems that about 80% of western adolescents suffer from. Though this is not a condition to be worried about, if left untreated, it can become the source of physical sequelae and lots of psychological problems. In fact, it has also been found through studies and research that acne is a problem that not only affects the youth, but can also persist to middle age.
There has been an increase in the pathogenic processes related to acne vulgaris over the last few decades. It has been widely accepted now that acne basically arises through four distinct processes which include increased proliferation, cornification and shedding of follicular epithelium, increase in sebum production and the colonization of the follicle with propionibacterium acnes along with the induction of inflammatory responses through bacterial antigens and cell signals.
Acne Vulgaris is a skin condition where the earlier it is treated, the less scarring it will produce. This is why it is necessary to develop a proactive approach to treating and managing acne. Today the development of oral isotretinoin has offered those suffering from severe and nodulocystic acne a chance at not only the containment of acne, but also at its suppression. However this approach to acne treatment is still available by targeting all four pathological processes that involve acne vulgaris.
Treatment of Acne Vulgaris:
Acne can range from a mild condition to a severe form in the lifetime of the adolescent. With its severity, there is an increased possibility of extensive scarring in the adolescent that can very well pass on to the later years of their life. Keeping this in mind, you today find many effective therapeutic agents that can both treat acne and prevent its progress.
However despite this, dermatologists find many patients suffering with acne scarring just because they delay seeking medical attention for the acne. And to add oil to the fire, there are also many practitioners who procrastinate over the use of effective anti-scarring options available in the market.
The patients who are already suffering from scarring find that repeated courses of antibiotics only lead to the recurrence of acne, and with it, additional scarring. This will in turn exacerbate the despair of the sufferer and all the other adverse psychological effects that acne brings with it. Though there are many agents and devices that can be used to help prevent the scarring of acne, its successful treatment cannot be guaranteed as residual scarring is usually evident in most cases.
So it can be said that the most effective means of managing the scarring of acne would be to prevent its occurrence in the first place. There are many effective anti-acne agents that can help control the disease like antibiotics and hormonal agents. But it is only isotretinoin that has shown the potential of inducing long-term, drug free remission and curative potential.
The pathophysiology of Acne Vulgaris:
It has been found out, and proven that many factors constitute the pathophysiology of acne which includes an alteration in the pattern of keratinization in the pilosebaceous follicles that tend to lead to the comedone formation of acne. The comedome formation is a situation where increased sebum production is experienced, and this increase is due to the influence of the androgens, the proliferation of Propionibacterium acnes and because of the production of perifollicular inflammation. There are also many genetic and hormonal factors that contribute to the formation of acne.
It is through the better understanding of the pathophysiology of acne that novel therapies have been developed. These therapies are directed to one or more of the etiologic factors of acne. It has always been systemic antibiotics that were used for the treatment of acne for many years. However the cause of concern of using antibiotics is the emergence of antibiotic-resistant strains of P. acnes.
It is suggested that the concomitant use of non-antibiotic treatment for acne like benzoyl peroxide greatly helps in decreasing the occurrence of resistance and is effective in treating both resistant and nonresistant propionibacterial strains. However there never has been a single agent found that eradicate all the resistant strains of acne completely. And because these resistant strains tend to correlate to poor clinical responses to therapy, most of the prescribing strategies used by doctors aim at minimizing the occurrence of resistance to P. acnes.
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