Acne Vulgaris

Acne vulgaris is a skin problem that affects a very high percentage of the world population in adolescence and young adulthood.
It is characterized by involvement of the sebaceous follicules, that turn to be very sensitive to action of androgen hormones whose production is greatest during puberty.

How does acne vulgaris develop?

Typical blemishes due to acne vulgaris are due to an obstruction of excretory ducts that prevent the outflow and release of sebum.
The primum movens is sebaceous lipids which offer a favourable environment to the proliferation of Propionibacterium Acnes resulting in inflammation of the entire follicule. The result varies from a visible oily skin to comedones characterized by small pads centered by a white point and the presence of pus.

There are three stages of evolution:

- Comedonic stage
This is the first stage of the disease; it is evident through minor lesions called comedones, or small plugs of sebum thickening up to lock the channel of the hair bulb and cause the appearance of white spots and black points.

- Inflammatory stage
Subsequently, the presence of Propionibacterium acnes lead to inflammation of sebaceous gland, clinically we assist to reddish pimples, papules.

- Pustular stage
The papules can become infected and filled with pus, turning into pustules (pimples).
These are elements with one characteristic yellowish tip. This is the classic polymorphous juvenile acne, the acne that affects most of the teenagers.

Nodulocystic acne - also known as acne conglobate, is widely considered the most severe form of acne. Usually it begins in people aged between 20 and 30 years. It is characterized by the presence of numerous subcutaneous nodules and cysts (also often very inflamed and painful) at the level of the face, neck and back. It requires a rapid dermatologic treatment because if not treated in time, can result in anti aesthetic scars and important psychosocial burden.

How to prevent and treat acne

Acne is a physical manifestation that is not difficult to control (at least in milder cases) and resolves without consequences with the use of topical treatments.
Prevention is the most important thing, which is based on the daily use of detergents and lotions dedicated to providing a greater adequate facial cleaning.
Often, some misconcepts such as squeezing blackheads and pustules, covering them with make up, a stressful lifestyle have a negative effect on skin and constitute a natural predisposition to acne.

Proper acne therapy should be conducted on several fronts, each of which has more or less importance depending on the stage and the personal case:
Hygiene and skin care - Cleansing the skin is crucial, especially if performed with appropriate products prescribed by a dermatologist, specific to the type of each patient skin.
Squeezing the pimples should be discouraged for the risk of infection and creation of scars or blemishes. If the pimple is very visible, some topical treatments could be applied on the single lesion at night time to accelerate the healing process and in these cases the camouflage/correction technique is allowed.
In female patients, cosmetics used should be free of any comedogenic action.

Drug treatment - for the most severe forms of acne creams or medications are prescribed based on retinoic acid, azelaic acid, antibiotics (tetracycline, erythromycin, etc.) and oral contraceptives for women, in the case of hormonal imbalances. Treatments using vitamin A and vitamin E and derivatives can be effective, but only under the specialist prescription, respecting the doses and the clinical follow ups.
Cosmetic surgery - Usually reserved for resolving the consequences of acne. The use of laser and abrasive peeling is useful in experienced hands to improve significantly the scars of acne treated badly or untreated.

For further information or appointment, please contact our clinics in Beirut, Lebanon.