Human Body structure: ACNE VULGARIS (PIMPLES)

ACNE VULGARIS (PIMPLES)

DESCRIPTION:

Acne is a chronic skin disorder that usually begins in puberty and is more common in males; lesions develop on the face, neck, chest, shoulders, and back.
Acne requires active treatment for control until it resolves.
The types of lesions include comedones (open and closed), pustules, papules, and nodules.
The exact cause is unknown but may include androgenic influence on sebaceous glands, increased sebum production, and proliferation of propionibacterium acnes (the enzymes reduce lipids to irritating fatty acids).
Exacerbations coincide with the menstrual cycle in female clients because of hormonal activity; oily skin and a genetic predisposition may be contributing factors.

ASSESSMENT:

Closed comedones re whiteheads and non inflamed lesions that develop as follicles and enlarge, with the retention of horny cells.
Open comedones are blackheads that result from continuing accumulation of horny cells and sebum, which dilates the follicles.
Pustules and papules result as the inflammatory process progresses.
Nodules result from total disintegration of a comedone and subsequent collapse of the follicle.
Deep scarring can result from nodules.

INTERVENTIONS:

Instruct the client in prescribed skin cleansing methods, with emphasis on not scrubbing the face and using only prescribed topical agents.
Instruct the client in the administration of topical or oral medications as prescribed.
Instruct the client not to squeeze, prick, or pick at lesions.
Instruct the client to use products labeled non comedogenic and cosmetics that are water based, and to avoid contact with products with an excessive oil base.
Instruct the client on the importance of follow up treatment.

ACNE PRODUCTS:

Acne lesions that are mild may be treated with non pharmacological measures such as gentle cleansing two or three times daily (oil-based moisturizing products need to be avoided), demabrasion, or comedo extraction.
Mild acne is usually treated pharmacologically with topical agents (antimicrobials and retinoids).
Moderate acne is usually treated with oral antibiotics and comedolytics.
Severe acne is usually treated with isotretinoin (Amnesteem or Claravis).
Hormonal medications such as oral contraceptives and spironolactone (Aldactone) may be orescribed to treat acne in female clients.
Combination therapy may be prescribed to treat the acne.
Actions of the medications may include suppressing the growth o propionibacterium acnes, reducing inflammation, promoting keratolysis, unplugging existing comedones and preventing their development, and normalizing hyper proliferation of epithelial cells within the hair follicles; some medications cause thinning of the skin, which facilitates penetration of other medications.
All topical products are kept away from the eyes, inside the nose, lips, mucous membranes, hair, and inflamed or denuded skin.

ACNE PRODUCTS:

TOPICAL ANTIBIOTICS:

Benzoyl peroxide
Clindamycin (cleocin) and erythromycin( Erythroderm)
Clindamycin/tretinoin combination gel (ziana)
Dapsone (Aczone)
Fixed dose combinations: Clindamycin/benzoyl peroxide (BenzaClin) and erythromycin/benzoyl peroxide (Benzamycin)

TOPICAL RETINOIDS:

ORAL MEDICATIONS:

HORMONAL MEDICATIONS: