Acne affects 40 to 50 million people in the U.S., according to the American Academy of Dermatology. The most common type of this skin condition is papulopustular acne, which affects teens and adults in all racial and ethnic groups. Papulopustular acne is not considered a serious health problem, but it can affect your quality of life and sense of well-being.
Identification
Papulopustular acne consists of a combination of papules, inflamed lesions on your skin that appear as small pink bumps tender to the touch, and pustules, reddish lesions topped by white or yellow pus. Both types of lesions are approximately 2 to 5 mm in diameter. The condition is diagnosed by a doctor from a combination of your medical history and a skin examination.
Causes
Although the exact cause of all acne, including papulopustular, is unknown, it seems to be primarily related to a combination of hormone changes during puberty or menopause and genetics. Other contributing factors include medications such as androgens and lithium, steroid use, Cushing's disease, polycystic ovarian syndrome and greasy cosmetics. Acne forms when hair follicles and their accompanying sebaceous glands in your skin become clogged and inflamed, then infected with the normal skin microorganism Propionibacterium acnes, or P. acnes. Papules appear when enzymes from P. acnes metabolize triglycerides into free fatty acids that irritate the follicular wall in your skin. Pustules happen when an active P. acnes infection causes inflammation inside the follicle.
Significance
Severe forms of papulopustular acne can lead to permanent pigmentation changes and scarring. Many sufferers also experience psychosocial problems. Acne has been tied to an 18 percent rate of clinically significant depression, 44 percent clinically significant anxiety, and possible cases of nonpsychotic psychiatric disorder or suicidal thoughts, in various studies of acne patients compared to patients without acne, according to Dr. J.K.L. Tan of the University of Western Ontario and Acne Research and Treatment Center.
Prevention/Solution
It may not be possible to prevent an outbreak of acne if you have a genetic tendency, but you can improve your risks and the severity of symptoms by washing your face and hair gently every day with a mild cleanser and shampoo. If you use cosmetics, look for products labeled noncomedogenic, which means they won't promote the formation of closed pores. If you already have papulopustular acne, you'll likely need to use a combination of oral treatments such as the antibiotic tetracycline or a birth control pill and a topical preparation such as those containing benzoyl peroxide or retin-A.
A study by R.S. Stern et al published in December 1984 in the "Archives of Dermatology," reported that patients with papulopustular acne treated with a combination therapy had approximately 238 fewer weeks of acne breakouts and spent hundreds of dollars less on treatments than patients using either oral or topical therapy alone.
Acne scars can be treated with chemical peels, dermabrasion, collagen injections or laser resurfacing.
Warning
The oral drug isotretinoin is sometimes prescribed by doctors for patients with severe inflammatory acne that doesn't respond to other medications. Since this drug is known to cause birth defects, according to the National Institutes of Health, if you're a woman of childbearing age you will be required to take two forms of birth control while using isotretinoin. Other side effects from the drug may include dry eyes, mouth or skin, itching, nosebleeds, muscle aches, sensitivity to the sun, poor night vision and changes in liver function.
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