$Unique_ID{BRK03417} $Pretitle{} $Title{Acne} $Subject{Acne Acne Vulgaris Cystic Acne Acne Conglobata Acne Fulminans Excoriated Acne of Young Women Acne Excorie Des Jeunes Filles Chloracne Atypical Acneiform Eruptions Acne Rosacea} $Volume{} $Log{} Copyright (C) 1990 National Organization for Rare Disorders, Inc. 818: Acne ** IMPORTANT ** It is possible that the main title of the article (Acne) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Acne Vulgaris Cystic Acne Information on the following disorders can be found in the Related Disorders section of this report: Acne Conglobata Acne Fulminans Excoriated Acne of Young Women (Acne Excorie Des Jeunes Filles) Chloracne Atypical Acneiform Eruptions Acne Rosacea General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Acne is a common skin disorder. Acne Vulgaris, the most common form of acne, affects many adolescents during puberty. The skin eruptions primarily appear on the face, upper back and/or chest due to overactive oil-secreting (sebaceous) glands. Hormone changes during puberty activate the oil- secreting glands. Symptoms Characteristics of acne include blackheads and/or whiteheads (comedones). Sometimes more severe skin lesions appear such as papules, pustules and cysts which develop on the face, and sometimes on the neck, shoulders, upper back and/or chest. Whiteheads (comedones) are plugs of oil (sebum) and dead skin cells caused by clogged skin pores that block oil (sebum) and prevent it from flowing freely to the surface of the skin. Blackheads (open comedones) occur when the plug reaches the surface of the skin where it turns black when exposed to air. Whiteheads (closed comedones) begin under the surface of the skin and either turn into blackheads or lead to inflammation. Inflammation causes small elevated growths (papules), some containing dead skin cells and inflammatory fluid (pustules). Cystic Acne is a severe form of acne in which small fluid-filled cysts develop in the skin. Causes The exact cause of acne is unknown. A contributing factor to acne in adolescents is overactive oil-secreting sebaceous glands which are related to changes in activity of hormones. Other possible factors may be heredity, emotional stress, oil-based moisturizers and cosmetics. Most doctors now believe that acne is not related to personal hygiene or diet, although some still recommend staying away from peanut butter, fried foods, chocolate, and other foods that are greasy or have a high sugar content even though there is no evidence that diet is related to acne. Affected Population Acne is extremely common, affecting many adolescents during puberty. Four out of five teenagers develop acne at some point. Most cases of acne last only a few years. Some cases last for just a few weeks or months, others can last for many years. Related Disorders The following disorders are subtypes of acne: Acne Conglobata may occur alone, or may be part of a symptom complex in conjunction with Hidradenitis Suppurativa and connective tissue inflammation (cellulitis) of the scalp. Skin lesions from Acne Conglobata usually occur on the neck and upper back or chest, but may spread to the upper arms, lower back, buttocks, and thighs. The typical acne skin eruptions are present, but symptoms are chronic with abscesses and circumscribed tissue masses (nodules). Cysts also develop. The cysts contain foul-smelling fluid, and severe scarring often occurs. Although this form of acne resists treatment with ordinary antibiotics, symptoms may be controlled by the use of the drug Accutane (isotretinoin) in some cases. Acne Fulminans is a rarer form of acne which occurs most often in adolescent males. Mild Acne Vulgaris initially develops but it is unexpectedly followed by markedly inflamed and painful lesions on the upper back and/or chest and occasionally the face. Lesions may bleed and/or crust, and may be accompanied by fever and other systemic abnormalities. Treatment with isotretinoin, with or without corticosteroid drugs and antibiotics, can be effective in most cases. Excoriated Acne of Young Women (Acne Excorie Des Jeunes Filles) is a type of acne caused by inflicted rubbing or scratching of skin eruptions resulting in increased scarring. Although it is often found among young women, it can be found in any age group and both sexes. Chloracne may develop among workers exposed to chlorinated hydrocarbons. Treatment of the skin lesions should be accompanied by removal of the irritating substance from the environment. Atypical Acneiform Eruptions are seen in any age group and are not always limited to oil-secreting (sebaceous) glands. These eruptions may appear as a result of corticosteroid, androgen, or progesterone drug therapy. Occupational problems such as skin contact with machine oils, especially insoluble cutting oils, may also cause this type of acne. Eating iodine or bromine salts, and drugs such as diphenylhydantoin (phenytoin) and lithium, can induce this skin condition. Acne Rosacea is limited to the nose, cheeks and forehead, typically beginning during adulthood. The facial skin, especially the nose, becomes oily, reddened and bumpy. Small red blood vessels are visible. In extreme cases, the nose may appear very red and bulbous. (For more information on this disorder, choose "acne rosacea" as your search term in the Rare Disease Database). Therapies: Standard Treatment of acne includes gently washing affected areas two to three times a day with medicated soap, shampooing as necessary, and if necessary treatment with benzoyl peroxide products which can be purchased in any pharmacy without prescriptions. It is important to keep affected areas free from oil. Water- based rather than oil-based moisturizers and cosmetics are recommended. For more serious cases of acne, physicians or dermatologists can help. Tretinoin (which contains vitamin A acid), or antibiotics such as clindamycin, erythromycin, minocycline, or tetracycline are often prescribed. In severe cases that are resistant to antibiotics, Accutane (isotretinoin) may be prescribed. However, this drug can cause severe birth defects if taken by a pregnant woman, so women of child-bearing age should use contraceptives while taking Accutane. If scarring from acne occurs, dermabrasion (professional skin planing) may be of cosmetic benefit to the patient once the acne has subsided. Therapies: Investigational Research on skin disorders is moving forward at a rapid pace. A better understanding of the skin and its components is necessary for development of new treatments for acne. For information about skin research, contact the National Institute of Arthritis, Musculoskeletal and Skin Disorders Clearinghouse listed in the Resources section of this report. This disease entry is based upon medical information available through November 1990. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on acne, please contact: National Organization for Rare Disorders P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Acne Research Institute 1236 Somerset Lane Newport Beach, CA 92260 (914) 722-1805 The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse Box AMS Bethesda, MD 20892 (301) 495-4484 References CECIL TEXTBOOK OF MEDICINE, 18th Ed.: James B. Wyngaarden, and Lloyd H. Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 2332-2333. THE COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS COMPLETE HOME MEDICAL GUIDE: Donald F. Tapley, M.D., et al., eds; Crown Publishers, Inc., 1985. Pp. 246, 626-628. INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 1379-1380. WORLD BOOK MEDICAL ENCYCLOPEDIA: Erich E. Brueschke, M.D., et al., eds; World Book, Inc., 1988. Pp. 12-13.