Acne vulgaris – causes, symptoms, diagnosis, treatment, pathology

Acne vulgaris – causes, symptoms, diagnosis, treatment, pathology


learning medicine is hard work osmosis makes it easy it takes our lectures and notes to create a personalized study plan with exclusive videos practice questions and flashcards and so much more try it free today with acne vulgaris acne means eruption and vulgaris means common so acne vulgaris is a common skin eruption that happens when hair follicles or pores get blocked by particles like dead skin cells or oil once hair follicles are blocked they form small raised red bumps on the skin acne is particularly common among teenagers because of the skin changes that happen during puberty acne can be categorized into different types based on specific characteristics for example mild acne usually consists of whiteheads and blackheads moderate acne usually consists of pustules and severe acne usually consists of cysts and nodules now the skin is divided into three main layers the epidermis dermis and hypodermis the epidermis forms the thin outermost layer of skin and has 5 sub layers the stratum corneum as the outermost layer followed by the stratum granulosum the stratum spinosum and the stratum basale II in the palms and feet which are areas of thicker skin there’s a fifth layer called the stratum lucidum which is around one cell layer thick underneath the layers of the epidermis is the dermis and it’s mainly made of connective tissue but also contains nerve endings hair follicles sweat glands sebaceous glands lymphatic vessels and blood vessels focusing on the hair follicles each one contains a strand of hair composed of the shaft root and bulb that sits in the follicle the hair follicle is epidermal tissue that dips down into the dermis and is associated with other structures like a Pokhran glands sebaceous glands the erector pili muscle and nerve receptors now sebaceous glands or oil glands are located in the dermis layer of the skin and are connected to hair follicles each sebaceous gland secretes an oily substance called sebum into a nearby hair follicle or through pores that extend directly to the skin surface sebum is a substance made of different fatty acids and waxy esters to help transport nutrients in lubricate the skin as it turns out erector pylab mussels surround the sebaceous glands so when these tiny muscles contract sebum gets squeezed out sebum softens the hair shaft preventing it from becoming brittle sebum also prevents moisture loss from the skin and is slightly acidic which helps to deter pathogens and below all of this is the hypodermis which is made of fat and connective tissue that anchors the skin to the underlying muscle the cause of acne is not completely understood but we do know that there are a few main factors that contribute to acne formation keratin plugs sebum and bacterial overgrowth first there’s keratin plugs which are tiny clumps made of dead charata sites the protein keratin and the pigment melanin wind karate sights and hair follicles over produce keratin it’s called hyperkeratosis it leads some more keratin plugs forming and these little carrots and plugs block the opening of the hair follicle second their sebum which is released by sebaceous glands in response to increased androgen production like during puberty in both boys and girls the sebum contributes to clogging up the follicles and causes blockage just like the keratin plugs now when there’s an excess in keratin plugs or sebum or both it can start to fill up a hair follicle but not quite plug it up all the way if there are follicle is still open to the surface of the skin and it’s called an open komodo and it looks black so it’s also called a blackhead blackheads look black because melanin in the keratin plug ends up getting oxidized when it’s exposed to air and becomes dark in color now the third factor to consider in acne is bacteria like Propionibacterium which are always living within the follicles normally these bacteria don’t cause any problems they’re part of the normal skin flora but if the hair follicle gets completely plugged up with keratin plugs in sebum then it creates a closed environment and it’s called a closed Komodo in a closed comedones thing on the keratin plugs in sebum and they have no place to go resulting in bacterial overgrowth the overwhelming number of bacteria attracts immune cells which head over and start attacking the bacterial cells the result of this mix of bacterial cells and immune cells is white pus with surrounding red inflammation and it’s called a Whitehead or a pimple now there are a variety of genetic and environmental factors that can lead to acne both blackheads and whiteheads for example hyperkeratosis can have a genetic component and often runs in families in addition hormones as well as using specific physical products and behaviors can also lead to hyperkeratosis for example women with polycystic ovarian syndrome have increased androgen hormone levels which leads to more sebum and therefore more acne also psychological stress increases the release of cortisol a hormone that stimulates sebum secretion acne affects a person’s appearance and that can cause severe psychological stress creating a vicious cycle physical products and behaviors include the use of certain moisturizers and cosmetics that can block pores similarly doing things like wearing a headband can irritate the skin in block pores and that’s called contact acne or acne Vanna nada also washing the face excessively can irritate the skin surface predisposing it to acne formation finally some studies have found links between low fat dairy and acne as well as a correlation between compounds in chocolate acne vulgaris most often happens on the face chest shoulders and back the sites of oil glands and it can be categorized into four types based on severity in type 1 or mild acne there’s no scarring and only a few small comedones in type 2 or moderate acne there’s also no scarring but there are large closed comedones called papules which sometimes break in leak out pus in type 3 or moderately severe acne there’s some scarring along with popular acne as well as pustular acne which are comedones that contain necrotic or dead tissue in type 4 or severe acne there’s severe scarring and Nadja low cystic acne which has firm lumps called nodules and cysts which are fluid filled cavities in the skin Nadja low cystic acne invades deeper into the dermis forming interconnecting abscesses depending on the severity of acne treatments can vary for mild acne topical treatments like benzoyl peroxide or salicylic acid can help remove comedones by removing the top keratin layer in moderate cases antibiotics like doxycycline or tetracycline can be used both topically or orally occasionally spironolactone can be used particularly with hormonal regulation in women in more severe cases isotretinoin a vitamin a derivative has been shown to give significant improvement to acne due to its ability to impact sebum secretion the treatment for acne scars include tretinoin cream injectable fillers for tissue and micro abrasion for superficial scars there’s even laser treatments which can stimulate cell turnover and growth of new epidermal tissue in women the oral contraceptive pill can be beneficial as well for some individuals that suffer from acne there can be significant feelings of depression or anxiety especially when they are severe are frequent bouts of acne psychological counselling can help individuals cope with their condition in fact there’s a field called psycho dermatology which utilizes strategies like anti-anxiety medications biofeedback allergy and immune function testing and cognitive behavioral therapy alright as a quick recap acne vulgaris is very common among teenagers and young adults and primarily happens on the face chest shoulders and back key risk factors are characters sebum and bacterial overgrowth open comedones or blackheads develop when the hair follicle is open to the air and there’s oxidation of the melanin within the keratin plug closed comedones or whiteheads develop when the hair follicle gets blocked completely and leads to bacterial overgrowth and inflammation there are various oral and topical treatment options available as well as new areas of psycho dermatology which addresses the relationship between emotions and physical changes in the skin thanks for watching if you’re interested in a deeper dive on this topic take a look at as Moses org where we have flashcards questions and other awesome tools to help you learn medicine otherwise you can always support us by donating on patreon subscribing to our channel or following us on social media you

35 Replies to “Acne vulgaris – causes, symptoms, diagnosis, treatment, pathology”

  1. Mmmmm… couple of questions about this video .. isn’t it that part of the pathophysiology of acne is that skin responds abnormally to ‘normal’ circulating levels of testosterone? Equally I thought the ‘compounds in chocolate hypothesis’ has been discredited least not replicated in later studies? Awesome video as always of course… 😁

  2. The only effective treatment is oral Isotretinion. But the thing is you have to continue the therapy like forever. Whenever you stop taking it, after 40 days they are gonna pop up again..

    So just keep your face clean, use a good facewash and wait for 'em to go on their own..

  3. I had acne before but I learned why I had it and I was able to cure it, I learned that high glycemic carbohydrates or spikes of glucose stimulate the androgen hormone and the androgen hormone stimulates the production of sebum causing acne. Once I stopped spiking my blood sugar more that 60 acne was gone instantly (you have to learn a little bit about the glycemic index to make it work). Other things that you have to take care of are stress, hydration and inflammation, you get this wrong and it's difficult to get more acne.

  4. ❤️ Being able to work with you guys on this was such a blast!! Love how easy you make complex topics – can’t wait to work with you on more in the future!

  5. I’m subscribed to both osmosis and Cassandra and I was so happy when I saw that you guys collaborated together! There wasn’t I better person to collaborate this with then Cassy, she is awesome and has been educating herself on this topic for years. Nice video as always osmosis, I love watching your videos not only for school but also for personal education. Your videos are always very clear to understand and makes biology and diseases a bit more fun and easy to understand. Thanks ❤️

  6. What I don't understand is how can something block a hair. Are our hairs hollow on the inside? How can bacteria live in there? Is a 'hair follicle' the same as a hair?

  7. Causes of Acne is NOT fully understood….lol @3:15
    What's the point of this video???

    Good video about anatomy of the skin and pores but useless for control of acne……….

  8. I think that 🤔 mild acne may be open comedone which is black head or closed comedone which is white head not pustules 😉

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