Acne advice, information, documentationBy LILY of Bigplanners.com
Acne affects more than 85 percent of teenagers but frequently continues into adulthood.
Although there are more than 2 million visits to office-based physicians per year for patients
in the age range of 15 to 19 years, the mean age at presentation for treatment is 24 years, with
10 percent of visits taking place when patients are between the ages of 35 and 44 years.
Patients evaluated at tertiary care centers are prone to depression, social withdrawal, anxiety,
and anger and are more likely to be unemployed than persons without acne. Scarring can lead to
lifelong problems in regard to self esteem. The direct cost of in the United States is
estimated to exceed $1 billion per year, with $100 million spent on over-the-counter
products.
Classifying (The severity of is generally assessed by the number, type, and
distribution of lesions.):
Mild (no inflammatory lesions) are the main lesions.
Papules and pustules may be present but are small and few in number (generally <10). Multiple
open and closed comedones are present, with few inflammatory papules.
Moderate Acne - numbers of papules and pustules (10-40) are present. Mild disease of the trunk
may also be present. Erythematous papules and pustules are the predominant lesions, and disease
is limited to the face.
Moderately Severe Acne - numerous papules and pustules are present (40-100), usually with many
pimples (40-100) and occasional larger, deeper nodular inflamed lesions (up to 5). Widespread
affected areas usually involve the face, chest, and back.
Severe Nodulocystic and conglobated with many large, painful nodular or pustular
lesions are present, along with many smaller papules, pustules, and comedones.
Topical antimicrobial agents are effective in the treatment of inflammatory disease. Benzoyl
peroxide is a bactericide and is an excellent first-line medication. The response to this agent
is rapid, with improvement noted as early as five days after treatment has begun, but irritation
is common. Water-based products, as compared with alcohol based products, when used at low
peroxide concentrations (2.5 to 5 percent) will help to limit this problem and have an efficacy
similar to that of other products in this class. Benzoyl peroxide does not induce resistance;
when used with topical or oral antibiotics, it protects against the development of this problem.
Oral antibiotics are indicated for moderate-to severe disease, for the treatment of on the
chest, back, or shoulders, and in patients with inflammatory disease in whom topical
combinations have failed or are not tolerated. After control of the is achieved and
maintained for at least two months, a reduction in the dose can be attempted.
Hormonal
treatment is especially useful in women who desire contraception or have other manifestations
of hyperandrogenism, such as irregular menstrual cycles or hirsute. Oral antibiotics and topical
therapy may be used in combination with hormonal treatments.When the use of this agent is being
considered, an assessment of the severity of disease should include the effect of the on
the patient, such as the potential for scarring.
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