Acne - Skin Care IV Lecture Review

This set of 100 flashcards covers anatomy, causes, symptoms, grading, treatment options, and skin care guidance for acne based on the Skin Care IV lecture.

What is the location of the sebaceous glands in the skin?

They are located around the hair follicle.

What specific structures combine to form the pilosebaceous unit?

The sebaceous gland and the hair follicle.

On which three body areas are the pilosebaceous units the largest?

The face, upper back, and chest.

Define acne as described in the notes.

A disorder of the skin’s sebaceous gland that results in clogged pores and lesions.

What causes the formation of bacteria-friendly clumps in the follicles?

Sebum that cannot pass through the follicle mixed with shedding cells that clump together.

Which specific bacterium grows within plugged follicles in acne?

Propionibacterium acnes

How do Propionibacterium acnes contribute to skin inflammation?

They produce chemicals and enzymes that cause inflammation.

What percentage of individuals between the ages of $12-24$ develop acne?

$$85\%$$

What effect do male androgens have on sebaceous glands during puberty?

They cause the glands to enlarge.

When do hormonal changes typically trigger acne in relation to the menstrual cycle?

$2-7$ days before the menstrual period.

Which conditions related to pregnancy can trigger hormonal acne?

Hormonal changes related to pregnancy.

Name a psychological factor that can contribute to the cause of acne.

Prolonged emotional tension.

Which two psychiatric medications are noted as drug-induced causes of acne?

Lithium and Barbiturates.

Name two physical items that can cause acne due to pressure on the skin.

Bike helmets and backpacks.

Which two environmental factors are listed as irritants that can cause acne?

Pollution and high humidity.

What are comedones?

Enlarged hair follicles plugged with oil and bacteria.

What is the common name for closed comedones?

Whiteheads

How are whiteheads visually described?

Small, white bumps on the skin.

What is the common name for open comedones?

Blackheads

What cause the dark color observed in blackheads?

Direct contact with the air causes the sebum to oxidize.

How are papules described in terms of appearance and sensation?

Inflamed, small pink bumps that can be tender to touch.

What characterizes a pustule?

An inflamed, pus-filled lesion that may have a red base.

What are nodules?

Large, painful, solids lodged deep within the skin.

Describe the characteristics and consequences of acne cysts.

Deep, inflamed, pus-filled lesions that cause pain and scarring.

What is the initial step in the pathophysiology of acne regarding cell shedding?

Abnormal keratinization of cells shed in the duct.

What occurs when a follicle is obstructed with impacted cells and sebum?

The follicle distends, creating a microcomedo.

How does a microcomedo progress into a whitehead?

More cells and sebum accumulate, causing the microcomedo to enlarge.

In pathophysiology, what causes the darkening of the tip of a blackhead plug?

Deposition of melanin.

What enzyme from bacteria breaks down sebum into irritating free fatty acids?

Lipase

What is the inflammatory result of P. acnes colonizing the pilosebaceous duct?

Local tissue destruction and disruption of follicle epithelium lining.

What immune cells infiltrate the area during the disruption of the follicle lining?

Lymphocytes

What two physical actions can cause a follicle wall to rupture?

Picking or squeezing.

How many comedones are found on the face in Grade I acne?

<10

Describe the presence of lesions on the trunk in Grade I Comedonal Acne.

None

What are the quantitative requirements for Grade II Papular Acne?

$10-25$ papules on the face and trunk.

What is the maximum diameter of inflammatory lesions in Grade II acne?

<5\,mm

How many pustules are present in Grade III Pustular Acne?

More than $25$ pustules.

What is the qualitative description of scarring in Grade III acne?

Moderate scarring.

What type of lesions define Grade IV Severe/persistent Pustolcystic Acne?

Nodules or cysts.

What is the diameter of inflammatory lesions in Grade IV acne?

>5\,mm

How is recalcitrant severe cystic acne quantitatively described?

Extensive nodules/cysts.

What are the four primary purposes of acne treatment?

Prevent scars, reduce number of lesions, minimize embarrassment, and reduce cell clumps/oil/bacteria/inflammation.

What four OTC topical products are listed for acne treatment?

Benzoyl peroxide, Salicylic acid, Sulfur, and Sulfur & resorcinol.

What are the three common concentrations of Benzoyl Peroxide?

$2.5\%$, $5\%$, and $10\%$

What are the two Mechanisms of Action (MOA) for Benzoyl Peroxide?

Keratolytic/Comedolytic and Antibacterial activity.

How does Benzoyl Peroxide's keratolytic action work on the skin?

It causes desquamation of epithelial cells and prevents closure of the pilosebaceous duct.

Which strength of Benzac AC is indicated for mild acne?

$$2.5\%$$

Which strength of Benzac AC is indicated for moderate acne?

$$5\%$$

Which strength of Benzac AC is indicated for high-grade acne?

$$10\%$$

What is the base of Benzac AC water-based gel?

Water-based.

List five adverse effects of Benzoyl Peroxide.

Excessive drying, peeling, erythema, edema, and transient stinging/burning.

How many times daily can Benzoyl Peroxide be applied?

Twice daily (less for sensitive skin).

What is the expected timeframe to observe the effects of Benzoyl Peroxide?

Around $4\,weeks$

What warning should be given regarding Benzoyl Peroxide and fabrics?

It may bleach hair, clothing, and bed linens.

What environmental factor should be avoided when using Benzoyl Peroxide?

Excessive sun exposure.

Why should alcohol-based products be avoided with Benzoyl Peroxide use?

They may exacerbate stinging and burning.

What is the concentration range for OTC Salicylic Acid?

$$0.5-2\%$$

What is the Mechanism of Action for Salicylic Acid?

Mild comedolytic and surface keratolytic agent.

What is the concentration range for OTC Sulphur?

$$3-10\%$$

What is the MOA of Sulphur?

Keratolytic agent and antibacterial activity.

What substance is added to Sulphur in a $2\%$ concentration to enhance its effect?

Resorcinol

List the prescription (P & POM) topical and systemic items for acne.

Clindamycin, Erythromycin, Adapalene, Azelaic acid, Tretinoin, and Tetracyclines.

How do topical antibiotics treat acne?

By decreasing the number of P. acnes and reducing inflammation.

What is the standard concentration for topical Clindamycin?

$$1\%$$

Name two brand names for Clindamycin topical products.

Dalacin T and 3mycin.

What is the recommended dosing frequency for Clindamycin gel/lotion?

Thin layer bd (twice daily).

When is improvement expected after starting topical Clindamycin?

After $6-8\,weeks$

What are the concentrations for Akne-mycin solution and Eryacne gel?

Akne-mycin is $2\%$ and Eryacne is $4\%$.

What can exacerbate the burning and irritation of antibiotic solutions?

An alcohol base.

How long is the minimum duration of treatment for systemic antibiotics?

$$6\,months$$

When is improvement typically evident for systemic antibiotics?

After $3\,months$

List three specific types of Tetracyclines used for systemic acne treatment.

Tetracycline, minocycline, and doxycycline.

What is Adapalene?

A topical retinoid useful as first-line or maintenance therapy.

What is the MOA of Adapalene?

Normalize follicular hyperproliferation and hyperkeratinisation, and provides anti-inflammatory effects.

How should Adapalene be applied?

A small amount as a thin film once a day, at least one hour before bedtime.

What might happen to acne in the first $1-3\,weeks$ of Adapalene treatment?

Acne may worsen initially.

How long does it take to see improvement with Adapalene?

About $6-8\,weeks$

List five side effects of Adapalene.

Burning/stinging, dryness/peeling, itching, redness, and photosensitivity.

Where is Tretinoin usually administered?

Topically

Where is Isotretinoin usually administered?

Orally

What are the general Mechanisms of Action for retinoids?

Reduces oil production, unclogs pores, and promotes peeling of affected skin.

Which groups of women should strictly avoid taking oral Isotretinoin?

Those who are pregnant, of child-bearing age, planning pregnancy, or breast feeding.

Why is Isotretinoin contraindicated in pregnancy?

There is an extremely high risk of a deformed infant even with small amounts.

What oral retinoid brand name was associated with missing ears and heart defects in infants?

Accutane

List four birth defects associated with Isotretinoin exposure during pregnancy.

Cleft lip/palate, small head, heart defects, and central nervous system malformations.

How often should skin be washed according to skin care tips?

Twice daily with a mild cleanser.

When is an additional wash recommended beyond the daily routine?

After heavy exercise.

How should hair be cared for to manage acne?

Wash hair regularly.

What type of cosmetics should be chosen by acne-prone individuals?

Non-comedogenic, oil-free cosmetics.

Which hormone causes enlargement of the sebaceous glands according to the questions?

Androgens

True or False: Barbiturates may cause acne.

True

Are blackheads open or closed comedones?

They are open comedones.

Name the types of scars listed in the lecture questions.

Keloid, stretched scar, hypertrophic scar, and sunken scar.

Which treatment mentioned DOES NOT have anti-bacterial properties?

Adapalene

What skin lesion is described as 'flat, reddish spots'?

Macules

Which medication is listed as a potential first-line treatment for comedonal acne illustrated in the transcript?

Adapalene

Which product is used specifically to treat scars?

Allantoin gel

What is the qualitative quantitative threshold for Grade II papules?

$$10-25$$

What is the Qualitative Description for Grade IV acne?

Severe/persistent Pustolcystic Acne

What can deposition of melanin cause in the pathophysiology of acne?

Darkening of the tip of the plug (forming a blackhead).