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Indo American Journal of Pharmaceutical Research, 2015 ISSN NO: 2231-6876
P. Ravisankar*1, O. Sai Koushik1, V. Himaja1, J. Ramesh1, P. Pragna2
1Department of Pharmaceutical Analysis and Quality Assurance, Vignan Pharmacy College, Vadlamudi, Guntur (Dist.) - 522213,
Andhra Pradesh State, India.
2Malla Reddy Medical College for Women, Jeedimetla, Hyderabad-500055, Telangana State, India.
Corresponding author
P. Ravisankar
Flat no. 501, Door no.4-1-16,
Sapthagiri Sesha Sai Sadan,
4/2, Lakshmipuram, Guntur-522007,
Andhra Pradesh, India.
Copy right © 2015 This is an Open Access article distributed under the terms of the Indo American journal of Pharmaceutical
Research, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article history
Received 18/07/2015
Available online
Acne Vulgaris,
Acne Rosacea,
The word acne comes from the word acme meaning "the highest point," which comes from
the Greek akme meaning “point or spot”. In the entire world 650 million people with acne
have been suffering, which is about 9.4 % of the world population out of which females are
9.8 % men amounting to 9.0 % which indicates females are more prone to this acne disease .It
attracts nearly 40 to 50 million population in the United States (16 %) and more or less 3 to 5
million people in Australia (23 %). Acne is most common skin disease. Acne effects all races
and ages and became the most common skin disease, especially in teenagers and young
adults. It is estimated approximately 90 % out of age group between 11 and 30 are being
attacked by acne outbreaks and during puberty in both sexes, acne can born owing to an
increase in androgens such as testosterone and 90 % are suffering from acne at puberty stage
all over the globe. Nearly 80 % out of age group of 11 to 30 year-olds are the sufferers with
acne at any time of this stage basing on their physiological condition of their body and some
people in their age at 40s and 50s still get acne disease. Acne is one of the greatest skin
problems faced by adults. As many as 25 percent of all adult men and 50 percent of adult
women suffer from acne disease at some point in their life. But adult acne can be particularly
frustrating. Research shows 35 % of women in their 30s, 26 % in their 40s, and 15 % age 50
+ are the sufferers from acne disease. Women over the age of 33 are more likely to get
premenstrual pimples than younger women. The chief ground for this disease is the bad
environment, eating an inflammatory diet or living a sedentary lifestyle or both can contribute
to the underlying cause of acne. The information on this article can help to understand acne,
types of acne, causes for development of acne treatment and home remedies and treatment.
Please cite this article in press as P. Ravisankar et al. Acne-Causes And Amazing Remedial Measures For Acne. Indo American
Journal of Pharm Research.2015:5(07).
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
Medically, acne termed as acne vulgaris [1] a common form of skin disease that involves the oil glands at the base of hair
follicles. Acne is an infection of the skin. It commonly occurs during puberty when the sebaceous (oil) glands come to life. The said
glands are stimulated by male hormones produced by the adrenal glands of both males as well as females. The form of acne is
called acne vulgaris, which implies "common acne". It is an infection of the skin, caused by changes in the sebaceous glands. The red
color comes out of the inflammation of the skin owing to the infection existed in the skin. Acne is a common skin disease with
pimples which is common in young people. Most of the people develop acne but it primarily affects teenagers who are undergoing
hormonal changes. Acne may be mild with few, occasional pimples, moderate with inflammatory papules, or may be severe with
nodules and cysts and the treatment depends on the type of condition of the disease. Acne is common during puberty, which is a stage
when a person is shaped from a child into an adult, owing to secretion of high levels of hormones. Acne becomes common as people
reach adulthood.
Human skin has pores (tiny holes) which connect to oil glands located under the skin. The glands are connected to the pores
via follicles which are small canals. These glands produce Sebum an oily liquid which carries dead skin cells through the follicles to
the surface of the skin. A small hair grows through the follicle out of the skin. Pimples grow when these follicles get blocked, resulting
in an accumulation of oil under the skin. The skin consists of tiny holes called pores that can become blocked by oil, filth and bacteria
which paves way to develop a pimple or “zit.” Under the blocked pore, oil builds up. Skin bacteria then grow very quickly. This
infection makes the skin become swollen and red, which becomes visible. And if skin is repeatedly affected by such state, acne may
appear but it is not a life-threatening condition, though painful when it turns violent. In human beings the common places acne disease
usually occurs are the face, neck, chest, back, and upper arms. Acne that appears on the face chronically may cause permanent
scarring, yet not dangerous.
Scientists from the Washington University school of medicine found that there are good and bad strains of bacteria that
determine the severity and frequency of developing acne. They explained in the journal of investigative dermatology (March 2013
issue) that not all acne bacteria trigger pimples, in fact, one strain they identified can help keep the skin pimple free [2]. To express in
a nut shell, skin cells, sebum and hair can clump together into a plug, which gets infected with bacteria resulting in a swelling. A
pimple starts to develop when the plug begins to break down.
Acne - Various types
Acne rosacea, rosacea
It is a skin disease of adults often affected by women in which blood vessels of the face enlarge indicating a flushed
appearance. Rosacea is a common, chronic, incurable, adult acne-like skin condition that is easily controllable and curable medically.
Rosacea usually acts upon the central third of the face, especially the nose with periodic aggravation and relief. The symptoms may
come and go and the skin may be clear for weeks, months, or years and then may emerge time and again. Rosacea inclind to develop
in certain stages and causes to create inflammation of the skin of the face, especially the forehead, cheeks, nose, as well as chin.
Symptoms and signs of rosace are: Redness of the face, tiny red pimples and fine red lines on the facial skin [3]. An enlarged, bulbous
red nose. Eye problems, like swollen, red eyelids and conjunctivitis.
Acne vulgaris
The most common form of acne; usually affects people from puberty to young adult hood. Acne vulgaris is a general skin
condition characterized by the development of seborrhea, comedones, nodules, papules, pustules and cyst. It comes in the areas of the
skin with plentiful hair growth such as in the upper chest, back, legs and face. Sebecaous glands get infected and clogged.
Development of several large and small eruptions.
Hickey, pimple, zit
A small inflamed elevation of the skin; a pustule or papules which are common symptoms in acne. Difference between a
pimple and acne: Unlike common acne, rosacea is not primarily a disease of teenagers but occurs most often in adults (ages 30-50),
especially in those with fair skin. Different than acne, there are usually no blackheads or whiteheads in rosacea. Certain people get one
or two spots off and on while others get frequent eruption of spots with lots of pus-filled pimples indicates acne which is a chronic or
prolonged condition that affects many teens and adults. More or less all human beings in the world gets pimples at some point of time
sooner the body enter into puberty stage at the age of 12, there commence to release hormones and start to function in the bodies of
man or woman irrespectively and at this juncture food or pollution, ought to upset hormonal balance thereafter.
Types of pimples
Pimples or spots come out when the skin produces much more oil, causes breeding bacteria which clog the existing pores
creating swelling and redness on the skin. Pimples are not at all contagious. Out of various kinds of pimples the most common types
are mentioned below and are shown in Figure 1- 6.
Whiteheads Remain under the surface of skin and are very small.
Blackheads Vividly look black and rise to the surface of the skin but are not formed due to dirt.
Black heads are not black because of dirt they are black in color. Generally air oxidises the protein called keratin.
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
Papules They are small tender pink bumps which are clearly seen on the skin.
Pustules Pustules (pimples or zits) are red at the bottom level consisting of pus at its top and can be looked on the surface of the
Nodules Clearly visible on the surface of the skin. They are painful, large, solid pimples existing deeply in the skin and can be seen
on the skin surface.
Cysts Clearly visible on the surface of the skin. They are deeply rooted, painful and pus filled and easily prone to form scars.
Figure 1- 6. White heads, black heads, papules, pustules, nodules, cysts.
Acne can be found anywhere on your body. Commonly it develops on the face, back, neck, chest, and shoulders. If you have
acne, you will typically notice pimples that are white or black in appearance. Both blackheads and white heads are known as come
downs. Black heads open at the surface of the skin giving them a black appearance. White heads are closed just under the surface of
the skin, giving them a white appearance. While whiteheads and blackheads are the most common types of acne, other lesions can
occur. Inflammatory lesions namely papules, pustules, nobules and cysts are more likely to create scarring of the skin. [5-9].
Salient causes for the development of acne
Acne appears when the pores on the skin are blocked either with oil, dead skin, or bacteria or both. Each pore on the skin is
the opening to a follicle which is made up of a hair and a sebaceous oily gland. The oil gland releases natural substance called sebum
which lubricate and protects the skin passes up to the hair root, through the pores, and skin. At this juncture acne is spread out due to
one or more problems occurred in this lubrication process due to increased oil production and plug the follicular pore. If it is covered
by a thin layer of skin, the said plug either appears to be a whitehead or if it is exposed to the air, the darker exposed portion of the
plug is termed as blackhead. The plugged hair follicle gradually emerged as a bump. As the follicle expands, the wall become rupture,
allowing normal skin bacteria enter into the deeper layers of the skin, duly creating inflammation as a result of which the surface of
the skin produces a pustule and deeper inflammation become pimple and if penetrates more deeper a cyst is formed which may leave
incurable permanent scars on the skin.
Due to excess production of oil, a pore clogged by dead skin cells, as well as bacteria are caused to the development of pimples. A zit
appears when the bacteria grow in the clogged pore and the oil is unable to escape.
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
Acne - facts in brief
Acne is a skin disease wherein the oil glands at the base of hair follicle are involved. Experts believe the primary cause of
development of acne is, increase in androgen hormone levels and also genetic is the presumed ground.
Acne can affect people irrespective of all races and ages yet it is not dangerous, but may leave scars on the skin if it formed as
cyst. Acne can be affected by the anxiety and stress, hot and humid climates, menstrual cycle, makeup with oils, greasy hair and
squeezing of pimple.
Acne affects the skin with numerous oil glands on the face, upper part of the chest, and back and their increased severity is
associated with high levels of stress.
Normally Acne emerges during puberty. Hormonal activity, such as menstrual cycles and puberty, may cause to the formation of
Various types of pimples are whiteheads, blackheads, papules, pustules, nobules and cysts.
Acne is commonly categorised as mild, moderate or severe and to cure them optical antibiotics are used based on the need.
Cigarette smoking aggravates the acne and worsens its condition. There is no specific clarity to show relationship between acne
and diet.
During puberty in both sexes, acne can born owing to an increase in androgens such as testosterone are the sufferers with acne at
any time of this stage basing on their physiological condition of their body.
Oral antibiotics are indicated for moderate to severe cases of inflammatory acne with benzoyl peroxide, antibiotics, retinoids,
antiseborrheic medications, anti-androgen medications, hormonal treatments, salicylic acid, alpha hydroxy acid, azelaic acid,
nicotinamide, and keratolytic soaps.
Acne - baby pimples
Baby‟s acne is very common and exists at birth itself but appears after a couple of weeks. They akin to the teenage acne and
can be seen as white or red bumps or pimples with red skin. Baby acne usually appears on the cheeks and sometimes on the forehead,
the chin, and even the back and they become more clearly seen when the baby is hot or noisy. Baby acne usually clears up within a
few weeks, but it may be delayed for months. In case it won‟t clear up within three months, treatment with mild topical medication is
inevitable. Don't use over-the-counter acne medicines. Don't scrub. Baby acne isn't caused by dirt so too much washing get more
irritation to skin of the baby. Don't apply oily lotions on the skin which make the baby‟s acne worse. Simple wash of baby‟s face with
mild baby soap and water once in a day is enough and gently pat it dry.
Acne causes
The following are some of the risk factors that may influence for developing acne.
Hormonal changes caused by puberty or pregnancy.
Certain medications such as birth control pills or corticosteroids.
A diet containing huge refined sugars or carbohydrates like bread and chips.
Young people are most at risk for developing acne during puberty. During this time, the body undergoes drastic hormonal
changes. These hormones can trigger oil production, leading to an increased risk of acne. Hormonal acne related to puberty
usually subsides when a teenager reaches adulthood.
Acne lesion implies whiteheads, blackheads, small bumps, nodules and cysts.
Despite acne is fundamentally a normal physiological occurrence, the following prominent conditions may make worse its state.
Fluctuation of hormone levels of women at the time of menstruation.
Disturbing the acne lesions by picking or prodding or hardly press them.
Covering especially total forehead and face with Clothing, hats and sports helmets etc, which badly press the acne lesions.
Better to avoid pizza, greasy and fried foods, and junk foods which are not at all good for overall health, in spite of the fact that
they don‟t create acne or make it worse.
Excessive washing to get rid of dirt from acne can dry and irritate the skin. So essentially gentle wash should be prefferd.
Pressure over the acne to be totally avoided.
In certain patients acne may occur from heredity or can aggravate them.
In some patients, pressure from helmets, chin straps, collars, suspenders, and the like can aggravate acne.
Some medications may cause or worsen acne, which containing iodides, bromides, or oral or injected steroids ,
prednisone, deltasone, orasone, prednisone-M, liquid pred or the steroids. Anyhow many acne cases are not drug related.
In certain specific jobs holders are prone to expose to industrial products may cause of production acne.
Some cosmetics and skin-care products are pore clogging. So water-based products are normally best among lot for those are
suffering from acne.
Rosacea: This condition is characterized by pimples but not comedowns and occurs in the central part of the face showing
redness, flushing, generally occurs to the people above 30 to40 years of age.
Pseudofolliculitis often called razor bumps or razor rash which cause tender bumps those who suffer from acne, if they use razor
for shaving.
Pimples (folliculate) can also occur on other parts of the body namely the abdomen, buttocks, or legs, which are not acne but
inflamed follicles. If they don‟t cure automatically, then oral or external antibiotics are preferred on the medical advice.
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
Acne - treatment
Treating acne requires great patience and proper care and perseverance. Any of the treatments mentioned below may take two
or three months to start working if no side effects such as excessive dryness or allergy is found, it is important to allow ample time to
each regimen or drug to work well before stopping on it and proceed with other methods by the skin specialist [10].
Acne - mild cases treatment
Mild acne can generally be treated with OTC (over-the-counter) medications containing the following active ingredients which
are available without a doctor's prescription and can be applied to the skin. Generally the medications uses for acne depend on
type and severity.
Resorcinol helps break down blackheads and whiteheads.
Benzoyl Peroxide is white crystalline peroxide kills bacteria and slows down the glands to produce oil. It works as a peeling agent
duly accelerating skin turnover and clearing pores, and reduces the bacterial count in the affected area. For decades, doctors have
said the "gold standard" for treating mild to moderate acne has been a combination of a deep pore cleanser such as benzoyl
peroxide and a topical antibiotic or sulphur medication to fight the bacteria [11].
Salicylic Acid is a white crystalline substance helps break down blackheads and whiteheads, also reduces shedding of cells which
line the follicles of the oil gland sand most effective in treating inflammation and swelling and preventing pores duly allowing
new cells to grow.
Sulphur, is a yellow crystalline solid substance properly act to break down blackheads and whiteheads.
Retin-A and Renova contains Tretinoin, an acid from of vitamin A which is effective for most patients to helps blackheads,
whiteheads, severe or inflammatory acne and unplug the clogged pores( removing the dead skin cells) and used to protect aging of
the skin, which also acts as a chemical peel. Tazorac (tazarotene) which is very useful for severe cases [12].
Azelaic Acid is a saturated dicarboxylic acid found naturally in wheat, rye, and barley to reduce inflammation and help patients
with dark skin to heal dark patches on their face as well as bad acne spots with brown marks.
Acne medicines are available as gels, soaps, pads, creams and lotions. In case of sensitive skin cream or lotion may be preferred.
Gel form medicines are alcohol-based and may prone to dry the skin and thus useful to oily skin people only.
Acne-severe cases treatment
In case of acne become more severe, a skin specialist has to be consulted for proper treatment who prescribes creams or lotions
containing benzoyl peroxide, azelaic acid, Clindamycin, sodium sulfacetamide and adapalene apart from oral or topical antibiotics
like Erythromycin, Doxycycline, Minocycline, Tetracycline for fighting against the growth of bacteria and to reduce
If an acne cyst becomes severely inflamed, there is a high risk of rupturing. If acne cyst is ruptured the skin specialist may inject a
diluted corticosteroid for treating inflamed cyst to prevent scarring and lessen the inflammation duly healing scars as well as cyst.
If no response is found with this medicine a strong oral retinoid medicines are to be used to treat severe cystic acne.
Oral antibiotics are frequently prescribed for patients with severe acne and some patients with moderate acne too. The dosage of
oral antibiotics initially high and then gradually lessens the dosage depending on the reduction of acne. Anyhow maximum usages
of antibiotics are not more than six months. Co-cyprindiol is a hormonal treatment that can be utilized for more severe acne that
doesn't respond to antibiotics. It helps decrease the production of sebum. Co-cyprindiol for two to six months should be used for
significant improvement of your acne. Co-cyprindiol may develop breast cancer in later life. There is a small chance of co-
cyprindiol causing a blood clot also.
Women generally use oral contraceptives (birth control pills) which can help to regulate hormones that may be contributing to
suppress the overactive gland as long-term treatments for acne disease. The journal entitled dermatology and therapy published an
article where in it was explained that a compound derived from red grapes and red wine by name resveratrol may be an effective
treatment for acne disease when used in combination with existing utilised medicines.
Washing face with hot or cold water should not at all preferred. Instead lukewarm water and a mild cleanser to be used twice in a
day for gentle wash of the face duly avoiding soaps and other such products containing harsh chemicals which may spoil the
existing acne.
Washing face with hot or cold water should not at all preferred. Instead lukewarm water and a mild cleanser to be used twice in a
day for gentle wash of the face duly avoiding soaps and other such products containing harsh chemicals which may spoil the
existing acne.
Hands must be kept away from pimples and other lesions on the body to avoid squeezing of pimples. Shave gently to avert
opening of existing lesions.
Chemical peeling of the skin with lycolic, salicylic or lactic acid is the next level of acne scar and active acne treatment to peel
away the spoiled top layer of the skin which start the formation of a new smooth layer.
The second type of acne scars is more commonly treated with dermabrasion where in. the top layer of the skin is removed with a
high-speed rotary wire brush or diamond-coated stone.
A better treatment for scars is the laser resurfacing of the skin where in concentrated light of the laser beam to burn off a smaller
or bigger part of the top layer of the skin is utilised.
The Food and Drug Administration warned the consumers about the skin products of over-the-counter for acne and advice to stop
if they experience extreme allergic reactions like feeling faint, breathing problems, throat tightness or swelling of face lips, tongue
or eyes.
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Acne scars or pock marks treatment
Acne scars are the marks left by lesions that are not healed or inflamed and their size and type depend on several genetic
causes, which vary person to person. Therefore people must ensure lesions to heal properly. Scars are left behind by inflamed lesions
only, namely pustules, nodules or cysts. But squeezing open a comedo could result in an inflamed lesion with a scar. The pigmented
scars are emerged as a result of self process of skin itself while rebuilding the natural colour in the healing tissue. The first type of
scar is small scar is nothing more than a spot of skin bearing a brown, pink or purple colour, which indicate a pimple existed on that
spot. The second type is called the ice pick scar or pock mark and it is a small hole in the skin where the lesion used to be. Mild acne
scars require upto six weeks to disappear. If the over-the-counter products don't work properly a stronger treatment with creams based
on retinoids are necessary to heal scars to avoid acne flare-ups and to promote the shedding of skin around the scars. The next level in
acne scar treatment is the chemical peeling of the skin with lycolic, salicylic or lactic acid to peel away the damaged top layer of the
skin to enable the formation of a new and smoother layer for a period of certain estimated weeks and this treatment is more effective
against pigmented scars [13]. The second type of acne scars is more commonly treated with dermabrasion or laser resurfacing where
in the top layer of the skin is removed with the help of a high-speed rotary wire brush or diamond-coated stone which require more
than one session for each scar.
Several amazing home remedies for acne
Some natural treatments may be useful in reducing acne inflammation and breakouts
Instead of spending money for expensive treatments, some home remedies are mentioned below to get clear skin with natural
treatments at home.
Apple cider vinegar:
It is a perennial source to work as an acne remedy by using a ratio of one part vinegar to three parts of water since it kills the
bacteria that may be caused acne. It contains lactic and malic acid. When it used it changes into alkaline which balances the pH of
your skin, and act against bacteria and make it feeble to exist and reduce the red marks and treat acne. Lemon juice will also aid to dry
up excess oil and flush pores, but to be used them moderately.
Cinnamon honey:
It has antimicrobial properties, so it can help stop bacteria from acne. The honey has a natural anti-bacterial property to draw
out buggers from the skin. Two tablespoons of honey and one teaspoon of cinnamon mixed together until they are thoroughly blended
and have formed a sort of paste before application to acne. Honey and cinnamon (literally killer combo when it comes to acne) act as
killing agent when it applies to acne area.
The acids in the milk:
The acids in the milk act as antibacterial where as the fat in it provides moisture, making it quite nourishing for skin.
Therefore milk soothes the irritated skin, and helps to reduce the redness. One tablespoon plain low-fat or full-fat yogurt or milk, but
skimmed and one tablespoon of natural raw, honey.
Raw papaya fruit:
It is a natural acne remedy for the removal of dead skin cells as well as excess lipids from skin surface keeping it soft. Papaya
also contains an enzyme papain, which reduces inflammation and aids to stop pus formation. One fresh papaya is needed.
Turmeric is usually considered as an effective home remedy for acne. Mix ¼ teaspoon of turmeric powder to two teaspoons
of coconut oil. Mix the mixture well. Apply the mixture on face. Let the mixture sit fifteen minutes. Then wash with cool water.
Tomatoes are naturally rich in antioxidants and vitamin-C and A. Tomatoes are used for acne remedy because these are
available at any food store. First slice a small tomato in half. Rub the opened half over areas of the skin where acne is present.
Massage the juice on skin for few seconds is very easy application. Eventually rinse face with warn water. Apply twice a day for
getting decorous results.
Sea salt mixture:
Sea salt mix with honey can aid dry out pimples and absorb excess of oil. It can be used as an effective home remedy for
treating acne.
It is used to speed wound healing and prevent colds and flu, infact its antibacterial and anti-inflammatory properties can aid
with acne as well. Utilize Echinacea tea as a daily face wash or Dab it on blemishes with Echinacea tea soaking cotton ball.
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
Aspirin (Acetyl salicylic acid:
The salicylic acid in acetyl salicylic acid (aspirin) is used to help battle acne treatments. The aspirin can dry up pimples and
decrease inflammation. The aspirin tablet paste is prepared by mashing aspirin in little water or dissolve 4 pills in two tablespoons of
Sodium bicarbonate (baking soda):
It is a fabulous substance which is ability to fight off fungus and bacteria and dry up excess oil and makes your skin soft and
beautiful. Mix half a cup of baking soda with one eighth a cup of water. Apply the paste well on the effected part in slow circular
motions. After 6 to seven minutes of this, wash your face thoroughly with warm water.
Garlic: It is a good natural remedy to fight acne. It has antibacterial properties. It can be applied topically to aid to reduce the
breakouts in the future. The garlic juice extract is mixed in one teaspoon of water or mash up two or three cloves in water or aloe vera
gel for ten minutes. Using cotton pad apply the mixture on acne.
Sugar scrub:
White or brown sugar aids get rid of the excess skin cells and clogging up acne pores by acting as gently exfoliator. Just
sugar is adding it up with honey, plain water or olive oil and prepares sweet scrub which is used to remove acne woes.
It helps to reduce the inflammation from acne. In coffee grinder mix the contents of a chamomile tea bag with sufficient
water to form a paste. It is applied to the acne or extract of chamomile tea powder is applied to the acne with cotton ball.
Witch hazel:
Witch hazel can act as an astringent particularly to the naturally drying and shrinking blemishes. Pour witch hazel on to a
cotton ball and efface your face every morning and night.
Egg white yolk:
It can help tighten the skin‟s surface, reduce the pores and fight acne. Proteins and vitamins contain in the egg yolk fight
against acne and cause to rebuild skin cells. 2 to 3 egg whites, separated from yolks one bowl one washcloth are necessary.
Orange peel:
The peel of orange face mask helpful to the growth of new healthy cells, keeping the skin in fit condition owing to its huge
content of vitamin C. Two Orange peels and clean fresh water is required.
Strawberries and honey:
Strawberries and honey mix used to acne disease commonly in harsh, facial scrubs and cleansers. Strawberries are high in
salicylic acid which helps the epidermis of the skin to shed its cells more readily duly opening the clogged pores, duly neutralizing
bacteria and aids for the growth of new skin cells. Three fresh strawberries and two teaspoons of good honey to be kept ready.
Lemon act as an exfoliant, disinfectant and skin lightener to decrease the appearance of new pimples forming and scars. Dab
with a cotton ball or cotton swab dipped in a lemon juice on a clean face then rinse with cool water. Lemon juice works as a
disinfectant. It will kill bacteria that cause acne. Lemon juice can also stimulate circulation to the skin which will get essential
nutrients from body to aid fight acne.
Bananas peels:
It contain something substance known as lutein, one of the powerful antioxidant which decreases the swelling and
inflammation, and helps healthy cell growth of the skin of one banana peel is required.
Aloe vera gel:
Aloe vera gel is having antibacterial properties and soothing substance which works as an anti-inflammatory duly reducing
redness and swelling of acne. Sufficient aloe vera gel to be applied duly covering the acne affected areas.
Garlic: It is one of the natural remedy for acne due to its antibacterial properties. It can be ingest or apply it topically to reduce the
breakouts of acne and prevent them not to reoccur in the future. Garlic is considered to be a good natural remedy for acne because of
its supposed antibacterial properties. 2-3 cloves of garlic and fresh drinking water are needed.
Soaked or cooked oats to be used in the face mask, which can reduce the inflammation and redness with breakouts. One
serving of oatmeal, Water and two tablespoons honey is necessary.
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
White Sugar:
It helps to get rid of the excess skin cells clogging up pores. Mix it with honey, olive oil, and fresh water and scrub to clear
acne woes.
Raw potato:
Take raw potato and rub the pulp and juice on the face for a few minutes let it dry for 15-30 minutes, and then rinse off
completely with lukewarm water. potatoes consists of potassium, sulphur, phosphorus, and chloride aid to relieve from trouble
shooting blemishes and help to grow new cells.
Mint: It has menthol content, which works as a natural anti-inflammatory and pain killer but it cannot cure acne yet it acts as
helping agent to lessen the redness spot on the skin.
Australian tea tree oil:
It is pleasant smelling oil derived from Australia This tree oil works as a natural astringent and can stimulate the immune
system, and can fight against acne. Gels containing five percent tea tree oil may be as effective as lotions which containing five
percent benzoyl peroxide. Infact it might work more slowly. It should be used only topically.
Fuller‟s earth (multani mitti) is good for greasy and ache-prone skin because it absorbs excess of oil and unclogs the pores.
Just mix equal parts of fuller‟s earth in rose or sandalwood powder. Use this mud pack to your face. Just wash up it dries up . This
process can be repeated once a week.
Alpha hydroxy acid:
This natural acid found in citrus fruit. When applied on the skin this alpha hydroxy acid helps to remove dead skin cells and
unclog pores.
Azelaic acid:
This is naturally occurring acid is found in whole grain cereals and animal products. 20 percent azelaic acid cream seems to
be as effective as many other conventional acne treatments when used twice daily for 4 weeks. This can be sometimes used with
erythromycin. Azelaic acid has antibacterial properties.
Bovine cartilage:
Creams containing five percent bovine cartilage, applied to the affected skin twice a day, may be effective in reducing acne.
Zinc in lotions and creams may lessen acne breakouts.
Green tea extract:
A lotion of two percent green tea extract helped lessen acne in two studies of adolescents and young adults with mild to
moderate acne. It has anti-microbial and antioxidant substances that can aid to fight acne. For getting its effects, utilize a cooled cup of
green tea as a face wash or put the bag over the affected area.
Brewer's yeast:
A specific strain of brewer‟s yeast, called CBS 5926, seems to aid reduce acne. Brewer's yeast is the only item in this list
that's taken orally. It may cause flatulence.
Omega-3- fatty acids:
Omega-3- fatty acids have anti-inflammatory properties that can fight acne. Taking a multi- nutrient capsule containing fish
oil or add flaxseeds, salmon, albacore tuna and walnuts to your diet.
Treating acne with proper diet:
Eating a well balanced diet ensures that body gets the correct nutrients and therefore promotes healthy skin. Eat ample of
fruits and vegetables. A high fiber, low-fat diet is superb in promoting overall general health. Addition of food complements in your
diet like Zinc, Vitamins A, C & E may assist in the acne treatment.
Drink plenty of water throughout the day:
Water flushes toxins out of your body and improves the circulation. Drinking more water is helpful in the compact against
acne. (Good rule: The urine color should be clear you have had enough water, suppose if it is yellowish, aim to have more water in
your diet).
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
Good fats:
Fatty foods are bad for acne. Good fats that aid fight acne. Omea-3 fattly acids aids keep the skin flexible and drain sebum
out the pores. This will reduce the oil that is related with acne. For goods fats nuts, avocados, cold water fish.
The body utilizes the amino acids from protein to construct collagen. This nutrient helps keep the skin healthy and hydrated.
Good sources of proteins are poultry, dairy products, eggs, beans seafood and soy.
Vitamin A:
Vitamin A helps to reduce the oil your skin products. Best sources are carrots, sweet potato and dark green vegetables.
Artificial sugars:
Generally sugar stimulates levels of insulin in blood which can increase the amount of oil your skin products. Intake of soft
drinks and junk foods to reduce the amount of sugar in your system.
A hint found on many websites is that toothpaste can dry up individual spots. While toothpaste does have antibacterial
substances, it also contains substances that can irritate and damage your skin so it may not be preferable. Apply a minute amount of
white toothpaste on the affected area prior to going to bed. The toothpaste will decrease the swelling and dry out the acne. Within a
day or two considerable improvements is seen. Acne is not caused by dirt, poor hygiene, not washing face etc. Too much scrubbing or
cleansing with harsh soaps or chemicals can actually irritate your skin and make the acne brings to worst condition. Stress can affect
hormones, and thus promote acne. Yet, perfect acne treatment regime will surpass stress to some extent anytime. After treatment with
banana peels or over the counter creams application of a moisturizer can help to balance the treated skin.
Prevention of ace to become work:
Avoid mental stress as it affects some hormones levels like cortisol and adrenaline, which can make acne worse. 2. Always
keep away from hot and humid climate since it can make the acne worse. 3. As far as possible don‟t apply moisturizing creams,
lubricating lotions, and any makeup substances that contain oil content which can speed up the blocking of your pores. 4. Don‟t apply
greasy hair products as they have the same effect as oil based makeup. 5. Girls and women with acne likely to become worse before
the arrival of menstrual period due to certain changes occurred in their hormones. 6. Don‟t squeeze pimples since the acne is more
likely to become worse, apart from increase of scarring. 7. Washing of face twice a day with an oil-free cleanser is must. Cleaning the
skin thoroughly before bed, including removing makeup is inevitable [14].
Acne - health care
The following habits to be dopted systematically to evert acne apart from keeping good health.
Avoid strenuous exercises, alcohol, smoking, and foods which cause the skin to flare-up.
Eat fruits and vegetables with high content of vitamin. Try to avoid eating late at night especially right before bedtime as your
body will not break down the food as effectively which leads to building toxins in the body.
Eat leafy greens, avoiding drugs and reduce fat intake to keep overall health.
Avoid too much cold food which causes gastric acid secretion. Eat less sugar.
Eat less pungent foods spices, garlic etc and less meat and eat warm temperature foods.
Get more fresh air and do exercise everyday preferably walking at least 20 minutes and take more rest. Massage abdominal area
in a clockwise motion. Practice recreation techniques to avert worry. To keep proper hygiene washing hair, hats etc. Try to spend
more time on fresh air every day. Try to keep a positive mood.
Add more fresh green vegetables and fruits, fish, various cereals to the diet. Also include more food containing fiber in diet.
Include oatmeal and brown rice in your diet. Eat more cool effective foods like gourds, winter melons, and green beans. Don‟t
over eat. Have a cup of green tea after each meal. Avoid intake of fizzy drinks and high caffeinated drinks. Change your pillow
cover at least once a week; wipe down your phone with an antibacterial wipe once in every few days.
Don‟t pick or press the pimples. Get your hormones checked periodically.
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
Acne -the Social impact
Acne is a common disease, non-threatening condition that may come and go on its own way and any psychological effects
attached to it is to be taken into account as it has stronger than assumed impact on the lives of people which are noted below.
1. Low self-confidence 2. Frustration 3. Inadequacy feelings 4. Depression 5. Refusal to socialize. 6. Low self-esteem 7. Feeling
shyness in the society 8. Feeling psychologically weak 9. Inferiority complex among people.
The above effects are enhanced by ugly look of acne in the presence of various functions resulting under the assumption of
negative reactions from others there by People suffering from acne may lead unsatisfied living which made them to fail in education,
jobs and social interactions with Inferiority complex, shyness and Low self-esteem then they fell pry to depression. The social impact
of acne is a bitter animy to the acne patients. The unpleasant sight of pimples make many people run to the nearby pharmacy shops
because of feeling that ugly acnes influence others adversely and badly effect their social relations among them [15-16].
Despite recent scientific investigations, researchers are still not able to arrive at correct conclusions scientifically about acnes
on the various parts of the body. But the proper option is to abandon all things that may cause or worsen the acne by keeping face and
body skin clean every day. Diet, lifestyle and herbs can be an important part of natural remedies. Born of Acne cannot be cured. After
its emergeit can be controlled with treatment. The main goal of acne treatment is to decrease or clear up the spots through treatments
or skin care to inhibit sebum production, bacterial growth, shedding of skin cells and unclogging pores. Acne comes and goes,
between the age of twelve and twenty-three, but some people develop severe acnes because of production of higher level of androgens
in their systems but men are more sufferers from acne than women. More than 40 percent of all teens develop acne if severe require
medical attention yet most cases are usually solved without treatment. Anyhow, modern medical treatment and over-the-counter
products cater to the need of people suffering from acne without feeling pain. In women, acne is associated with their fertility cycle
and change of hormone levels. Stress doesn't cause acne, but stress can make it worse. Neck acne is a difficult proposition as the neck
is one of the most sensitive areas of the body and requires proper moisturizing and care. Further investigations and research is going
on to find out the root for the cause of Acne.
Vol 5, Issue 07, 2015. P. Ravisankar et al. ISSN NO: 2231-6876
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Improve Outcomes in Acne group, J Am Acad Dermatol, 2009; 60:5: S1-S50.
15. Simonart T., Dramaix M., De Maertelaer V, Efficacy of Tetracyclines in the treatment of acne vulgaris: a review, Br J Dermatol,
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phosphate 1.2 % and benzoyl peroxide 2.5% for the once-daily treatment of moderate to severe acne vulgaris: assessment of
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... In the study of keloid in the Dermatology and Venereology of RSUP Prof. Dr. R. D. Kandou Manado on 2011-2015, patients as students were dominating. 1 The high production of hormones, especially the androgen hormone at puberty, causes frequent acne because these hormones stimulate the oil glands to produce oil. 13 Acne is one of those factors that can cause the occurrence of keloid and hypertrophic scar. 5 Trauma is also susceptible to happen to students in their activities. ...
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Introduction: Keloid and hypertrophic scar are pathological scars resulting from excessive accumulation of collagen in wound healing process. Data about profiles of keloid and hypertrophic scar are rarely found in Indonesia. Therefore, it is necessary to conduct research related to keloid and hypertrophic scar. This study aimed to provide valuable data for further research. Methods: This was descriptive retrospective study evaluating 105 patients treated for keloid and hypertrophic scar from 2014 to 2017 using medical records of working-age patients. Results: Mostly in patients between 17-25 years old (40%). Comparison between male and female patients were 1.07:1 (keloid) and 1.09:1 (hypertrophic scar). As many as 10.71% of patients of keloid and 17.39% patients of hypertrophic scar were private employees. 23.21% patients with keloid and 23.91% patients of hypertrophic scar were Javanese. 14.29% patients of keloid and 19.57% patients of hypertrophic scar tend to have daily indoor activities. 17.86% patients of keloid and 26.09% patients of hypertrophic scar felt dark-skinned toned. Most keloid scars were caused by traumatic lesions (32.14%), located on the chest (19.54%), and treated by corticosteroid injection. Hypertrophic scar mostly caused by burn injury (54.35%), located on the face (29.55%), and treated by excision surgery. Conclusion: Both keloid and hypertrophic scars were mostly developed in 17-25 years old, male, private employees, Javanese ethnic, dark skin tone patients, with daily indoor activities, caused by traumatic lesion and located on the chest, earlobe, and hand, treated by corticosteroid injection (keloid). Meanwhile, hypertrophic scars are mostly caused by a burn injury on the face and treated by excision surgery.
Acne is a common but chronic skin disease that influence large population especially juvenile. Acne can continue, begin, or grow into severe form in adult age, affecting face, back, and chest. It may be a serious issue if not cared or treated timely. Even if acne got treated it leaves a persistent scar, which is difficult to alleviate. These acne lesions are long‐lasting and result in significant impact on mental and physical health of an individual. There are four mechanisms that are involved in acne lesion formation. However, the accurate series of events of the interaction among the factors in acne pathogenesis is still unsettled. Pubescent acne is due to increase hormone levels, when in fact adult acne is due to fluctuation in hormone levels. There are various approaches for the treatment of acne, including oral medications, creams or gels, acupuncture. Traditional Chinese Medicine stated acne as a infection that is associated with the pathogenic influence of damp heat and heat on specific meridians. As an ancient and integral part of Chinese medicine acupuncture therapy is employed in the treatment of many diseases including acne. It functions by ameliorating the deep‐rooted mechanisms playing crucial role in acne development. In this review, we have explained the acne causes, pathogenesis, and its available treatment options. Additionally, we also discussed the acupuncture therapy methods, devices, different techniques. and its mechanism of action in treating acne. Furthermore, clinical trials studies motivated us to highlight the scope of acupuncture in the growing system of medicine.
The long-term benefits of isotretinoin in otherwise therapy-resistant acne were investigated, together with risk factors which could influence long-term outcome. A sample of 88 patients who had suffered from acne for a mean of 7.4 years was treated with isotretinoin, initially at doses of 0.5 or 1.0 mg/kg per day, adjusted according to response and side-effects. Most patients required only 4 months' therapy to produce at least 85% clinical improvement. Patients were seen up to 10 years after treatment when 61% were still virtually clear of acne and 16% had required treatment with conventional antibiotics and 23% a second course of isotretinoin. In a complementary study, 299 patients treated 5–10 years previously with isotretinoin were followed for 5 years post-treatment. Of these, 22.7% required further courses of isotretinoin, 17% requiring only one further course. This study showed that low initial doses, particularly 0.1 mg/kg per day, were associated with the need for repeat courses: this dose must be considered subtherapeutic. Among the 88 patients studied over 10 years, those receiving isotretinoin 1.0 mg/kg per day or a cumulative dose exceeding 120 mg/kg showed relatively low rates of relapse. Thus cumulative dose was a major factor in influencing long-term outcome. Overall, age, sex and duration of acne did not influence long-term response, although in the 5-year study female patients over the age of 25 years at the onset of treatment required more repeat courses. The initial severity of acne also influence long-term outcome. Severe, predominantly truncal, acne was found to relapse more frequently in the 10-year study but facial acne tended to be the more frequent reason for repeat courses of isotretinoin in the 5-year study. Initial, but not long-term, suppression of sebum secretion was correlated with a good long-term response to isotretinoin. In both studies, no long-term side-effects or biochemical alterations were noted and repeat courses did not result in cumulative side-effects. Isotretinoin is a safe and effective therapy producing long-term remission in the majority of patients with acne, especially if given in a daily dose of 1.0 mg/kg or cumulative doses greater than 120 mg/kg.
Topical retinoids are important tools in the management of acne because they act against comedones and microcomedones and have direct anti-inflammatory effects. The substances approved for acne treatment comprise tretinoin (all-trans-retinoic acid), isotretinoin (13-cis retinoic acid) as well as the synthetic third-generation polyaromatic retinoids adapalene and tazarotene, the latter being approved for acne treatment in the US only. Retinaldehyde is used in cosmetic preparations against acne. All topical retinoids are effective as single agents in mild to moderate acne but differ in efficacy and tolerability. Tazarotene 0.1 % is more effective than tretinoin 0.025 % or 0.1 % microsphere gel or adapalene 0.1 % gel or cream (EBM-level 2c). Adapalene 0.1 % is equally effective to tretinoin 0.025 % or tretinoin microsphere 0.1 % gel or tretinoin 0.05 % cream or isotretinoin 0.05 % gel (EBM-level 2c). Adapalene 0.1 % gel is significantly better tolerated than tazarotene 0.1 % gel, tretinoin 0.025 % and tretinoin 0.05 % gel, tretinoin 0.05% cream, tretinoin microsphere 0.1 % gel or isotretinoin 0.05 % gel (EBM-level 2c).The safety profile of topical retinoids differs from their systemic counterparts and is related mainly to local adverse effects, such as erythema, dryness, itching and stinging. The currently available evidence justifies the use of topical retinoids in most types of acne and during maintenance treatment.
Standard systemic therapeutic agents used in acne include oral antimicrobials, isotretinoin, and hormonal agents. Appropriate patient selection is the key to decide when to use hormonal agents as first-line therapy as well as to achieve optimal results. Indications of hormonal therapy in acne in girls and women include proven ovarian or adrenal hyperandrogenism, recalcitrant acne, acne not responding to repeated courses of oral isotretinoin, acne tarda, polycystic ovary syndrome, or the presence of clinical signs of hyperandrogenism such as androgenic alopecia or the presence of the seborrhea, acne, hirsutism, alopecia syndrome. We describe the hormonal agents currently available for acne treatment, discuss their indications and contraindications, and address the question of whether they may be used as a first-line therapy in acne.
The Global Alliance to Improve Outcomes in Acne published recommendations for the management of acne as a supplement to the Journal of the American Academy of Dermatology in 2003. The recommendations incorporated evidence-based strategies when possible and the collective clinical experience of the group when evidence was lacking. This update reviews new information about acne pathophysiology and treatment-such as lasers and light therapy-and relevant topics where published data were sparse in 2003 but are now available including combination therapy, revision of acne scarring, and maintenance therapy. The update also includes a new way of looking at acne as a chronic disease, a discussion of the changing role of antibiotics in acne management as a result of concerns about microbial resistance, and factors that affect adherence to acne treatments. Summary statements and recommendations are provided throughout the update along with an indication of the level of evidence that currently supports each finding. As in the original supplement, the authors have based recommendations on published evidence as much as possible.
Acne is common and can lead to scarring of the skin, as well as to psychological distress and reduced self-esteem. Most topical or oral treatments for acne are inconvenient and have side-effects. Laser and other light therapies have been reported to be convenient, safe and effective in treating acne. To carry out a systematic review of randomized controlled trials of light and laser therapies for acne vulgaris. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycInfo, LILACS, ISI Science Citation Index and Dissertation Abstracts International for relevant published trials. We identified 25 trials (694 patients), 13 of light therapy and 12 of light therapy plus light-activated topical cream (photodynamic therapy, PDT). Overall, the results from trials of light alone were disappointing, but the trials of blue light, blue-red light and infrared radiation were more successful, particularly those using multiple treatments. Red-blue light was more effective than topical 5% benzoyl peroxide cream in the short term. Most trials of PDT showed some benefit, which was greater with multiple treatments, and better for noninflammatory acne lesions. However, the improvements in inflammatory acne lesions were not better than with topical 1% adapalene gel, and the side-effects of therapy were unacceptable to many participants. Some forms of light therapy were of short-term benefit. Patients may find it easier to comply with these treatments, despite the initial discomfort, because of their short duration. However, very few trials compared light therapy with conventional acne treatments, were conducted in patients with severe acne or examined long-term benefits of treatment.
We sought to evaluate efficacy, safety, and tolerability of a combination of clindamycin phosphate 1.2% and benzoyl peroxide 2.5% (clindamycin-BPO 2.5%) aqueous gel in moderate to severe acne vulgaris. A total of 2813 patients, aged 12 years or older, were randomized to receive clindamycin-BPO 2.5%, individual active ingredients, or vehicle in two identical, double-blind, controlled 12-week, 4-arm studies evaluating safety and efficacy (inflammatory and noninflammatory lesion counts) using Evaluator Global Severity Score and subject self-assessment. Clindamycin-BPO 2.5% demonstrated statistical superiority to individual active ingredients and vehicle in reducing both inflammatory and noninflammatory lesions and acne severity. Visibly greater improvement was observed by patients with clindamycin-BPO 2.5% as early as week 2. No substantive differences were seen in cutaneous tolerability among treatment groups and less than 1% of patients discontinued treatment because of adverse events. Data from controlled studies may differ from clinical practice. Clindamycin-BPO 2.5% provides statistically significant greater efficacy than individual active ingredients and vehicle with a highly favorable safety and tolerability profile.
Acne affects between 40 to 50 million individuals in the United States. Recent findings regarding the multifactorial pathogenesis of acne have facilitated a reexamination of the classification of acne and acne-related disorders. Disorders without a microcomedo as the initial pathologic condition are no longer classified as "acne." Research has also identified that the clinical characteristics of acne vary with age, pubertal status, gender, and race. These findings may have implications for the clinical management of acne and acne-related disorders.
Lay perceptions that diet, hygiene and sunlight exposure are strongly associated with acne causation and exacerbation are common but at variance with the consensus of current dermatological opinion. The objective of this study was to carry out a review of the literature to assess the evidence for diet, face-washing and sunlight exposure in acne management. Original studies were identified by searches of the Medline, EMBASE, AMED (Allied and Complementary Medicine), CINAHL, Cochrane, and DARE databases. Methodological information was extracted from identified articles but, given the paucity of high quality studies found, no studies were excluded from the review on methodological grounds. Given the prevalence of lay perceptions, and the confidence of dermatological opinion in rebutting these perceptions as myths and misconceptions, surprisingly little evidence exists for the efficacy or lack of efficacy of dietary factors, face-washing and sunlight exposure in the management of acne. Much of the available evidence has methodological limitations. Based on the present state of evidence, clinicians cannot be didactic in their recommendations regarding diet, hygiene and face-washing, and sunlight to patients with acne. Advice should be individualized, and both clinician and patient cognizant of its limitations.