Acne VULGARIS
Acne is the disease of pilocebaceous follicle , hair follicle and sebaceous gland complex. It is an inflammatory lesion of sebaceous of sebaceous glands and hair follicle of the skin associated with excessive secretion of sebum and it’s accumulation.Acne is more common during adolescent period due to increased androgen level in girls and boys.increased androgen level activates the sebaceous glands and increased production of sebum.
CLASSIFICATION
♦Mild Acne
♦Moderate acne
♦Severe acne
MANIFESTATION
►Primarily noninflammatory lesions (comedones)
►Comedones plus inflammatory lesions such as papules or pustulates
►Lesions similar to moderate acne but more wide spread and presence of cyst
Incidence:-
►50-80% of adolocents between 12-16 years are more affected
►Acne affects 20% of neonate
►More common in boys than in girls
►It tends to improve in summer and flare up in winter
Risk Factors:-
Hereditary factors
Use of drugs like steroids
Use of oily cosmetics
Male
Cushing syndrome
Age
- Etiology:-
- Abnormal sloughing of skin cells that lines sebaceous hair follicles
- Overgrowth of normal bacteria
- Host factors :- heredity , hormonal influence , emotional stress.
- Pathophysiology:-
- ►Due to various etiological factors
- ►Excessive sebum production
- ►The stratum corneum
- ►Formation of keratin plug filling follicles
- ►Non-inflammatory lesions:
- Open(black heads)
- Closed (white heads)
- ►Overgrowth of propionibacterium acne
- ►Follicular wall perforation
- ►Inflammation that may be deep or superficial
- Therapeutic management includes-
Medicine therapy include a combination of benzoyl perioxide , salicylic acid , steroids and topical/oral antibiotics
Isotretinoin may be used in severe cases
In girls, oral contraceptives ma help
Diode laser or blue ultraviolet light therapy may be used
Co2 lasers and dermabrasion may be used to treat pits scarring
Nursing Management
ØAvoid oil-based cosmetics and hair products
ØMild cleansing with soap and water twice a day is appropriate
ØAvoid excessive scrubbing and harsh chemicle or alcohol based cleansers
ØAvoid picking and squeezing the lesions
Using non-comedogenic sunscreen with a SPF of 30 or higher
Health education on topical medicine prescribed
Instruct boys to shave gently and avoid using dull razors
Girls should wipe off makeup before sleep
References for you to read-
1)Kyle t. and carman s. , Essentials of pediatric nursing , 2nd edition, lippincottwilliams and walkins
2)Shrestha t. , essential child health nursing , 2nd edition , medhavi publication
3)Ashwill J.N. ,nursing care of children principle and practise , 4th edition ,elsevier
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