In this Article you are about to read Acne & it's Clinical Presentation & 6 Best Homoeopathic Medicine for Acne
By - Dr. Samridhi Sharma
Acne vulgaris is a common, chronic disorder, involving inflammation of the pilosebaceous units that can be varied in presentation and difficult to treat. Acne pathogenesis derives from four main factors: sebaceous gland hyperplasia, abnormal follicular desquamation, Propionibacterium acnes, and inflammation. The primary lesion is the microcomedo, which may evolve into a noninflammatory comedo (open or closed) or become inflamed and form a papule, pustule, or nodule Most adolescents (80%) experience some acne; however, it may linger into adulthood. Lesions may begin as early as ages 8 to 10 years at adrenarche, when androgens of adrenal origin begin to stimulate pilosebaceous units. Severe disease affects boys 10 times more frequently than girls, and patients often have a family history of severe cystic acne Neonatal acne or cephalic pustulosis is self-limited with an onset around 2 to 3 weeks of age. Nearly one in five newborns is affected by at least mild neonatal acne characterized by erythematous nonscarring papules on the face and neck, most commonly on the cheeks and nasal bridge. This disorder spontaneously resolves within 1 to 3 months. Malassezia spp. have been implicated in the pathogenesis of neonatal acne. Topical 2% ketoconazole cream as well as benzoyl peroxide (BPO)
has been shown to be effective treatments, although parental reassurance alone is often sufficient, given the transient and benign nature of the eruption.
Infantile acne usually presents at 3 to 6 months of age and includes persistent comedones and inflammatory lesions with an increased risk of scarring. Immature infantile adrenal glands lead to elevated dehydroepiandrosterone (DHEAS) levels until the age of 12 months. Boys are more often affected than girls because of additional high testosterone levels between the ages of 6 and 12 months. Infantile acne usually resolves within 1 to 2 years; however, individuals with infantile acne may have an increased risk of severe acne as teenager’s acne. Acne in mid-childhood is relatively uncommon and may be a marker for adrenal or gonadal tumors. Further workup of these patients is advised.
Early-onset acne may be the first sign of an underlying hormonal abnormality, especially if there is an associated advanced bone age and early pubic hair development.
At puberty, hormonal stimuli lead to increased growth and development of sebaceous follicles. Female patients with severe acne or evidence of virilization often have abnormally high levels of circulating androgens. Several studies have demonstrated that many female patients with milder forms of acne and no evidence of virilization may still have ovarian and/or adrenal overproduction of androgens. In those patients with normal circulating levels of androgens, there is some evidence that suggests a heightened end-organ responsiveness of the sebaceous glands to androgenic stimulation. This heightened end-organ response may result in increased conversion of testosterone to dihydrotestosterone and other 5-α-reduced metabolites or suppressed follicular testosterone metabolism. Male acne patients tend to have higher levels of androstenedione, testosterone, free androgen index, and 11-deoxycortisol.
As many as one-third of adult women are affected by a low-grade acneiform eruption that may start de novo or merge imperceptibly with preexisting adolescent acne. The eruption may be induced by chronic exposure to comedogenic substances such as isopropyl myristate, cocoa butter, and fatty acids present in some creams and moisturizers, by androgenic stimuli from pro-gestins present in some oral contraceptives, by recent cessation of oral contra-ceptives, or by unknown causes.
Inflammatory acne may yield both scarring and pigmentary changes. Early treatment is essential to prevent and minimize the cosmetic disfigurement associated with acne scarring. Adequate therapy will, in all cases, decrease its severity and may entirely suppress this disease.
CLINICAL PRESENTATION
Acne has a significant impact on the patient’s self-image and quality of life, and the psychological toll of acne may be comparable to that of asthma or epilepsy. Even clinically mild acne may cause considerable social embarrassment to the patient. As with all medical and psychological conditions, the patient’s perception of the severity of the problem
is an important factor in choosing treatment.
A. Noninflammatory Lesions. The initial lesion is the closed comedo; visible as a 1- to 2-mm white bump (whitehead) most easily seen when the skin is stretched. If follicle contents extrude, a 2- to 5-mm, dark-topped, open comedo (blackhead) results. Patients should be advised that this black material is simply oxidized keratin, not dirt.
B. Inflammatory Lesions. Erythematous papules, pustules, cysts, and abscesses may be seen. Patients with cystic acne also tend to show polyporous comedones, which result from prior inflammation during which epithelial scarring caused fistulous links between neighboring sebaceous units. Acne lesions are seen primarily on the face, but the neck, chest, shoulders, and back may be involved. One or more anatomic areas may be involved in any given patient, and the pattern of involvement, once present, tends to remain constant
6 Best Homoeopathic Medicines for Acne
Sulphur - A very useful remedy in skin diseases. It is indicated in all sorts of skin eruptions. skin is dry, scaly, unhealthy; every little injury suppurates.
Itching, burning, worse scratching and washing. Pimply eruptions, pustules, rhagades, hang nails. Excoriation, especially in folds. Sensation of a band around the bones. Skin affections after local medication. Pruritus, especially from warmth, in the evening, often recurs at spring time, in damp weather. Suppression of skin disease causes diarrhoea. Also a good drug for suppuration. Every little injury suppurates. There are boils and abscesses, especially during summer season. Boils come in crops or a single boil is succeeded by another.
Kali-bi - Acne, Papular eruptions, Ulcers with punched out edges, with tendency to penetrate and tenacious exudation.
Sang - Eruptions on the face of young women, especially during scanty menses.
Ant-c - Pimples, Vesicles, pustules, sensitive to cold bathing, dry skin
Berb-aq - Pimply dry rough scaly skin. eruptions on scalp extending to face and neck
Thuja - The skin looks very unhealthy. Dirty brownish colour of the skin, brownish-white, mottled spots on the skin. There may be white, scaly, dry eruptions on the skin. Eruptions burn violently after scratching. Eruptions on covered parts only. Pustular eruptions like smallpox. Thuja aborts the process and prevents pitting.
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Thanks & Regards
Dr. Samridhi Sharma
(KNOW Homoeopathy Owner & Founder)
