Acne is a condition in which the oil (sebaceous) glands are enlarged or active, resulting in the proliferation of the normal bacteria (Propionibacterium Acnes) in the glands. Acne can present in many forms: comedones (blackheads or whiteheads), papules, pustules, nodules, or cysts. It may occur on the face, neck, chest, back, shoulders and arms. It typically affects teenagers, but is not limited to any age groups.
The causes of acne are mostly hormonal, familial, or stress-based. Treatment may include topical lotions/gels or creams containing benzoyl peroxide, antibiotics, or Vitamin A derivatives. Oral antibiotics may be prescribed to suppress the excessive bacterial count. Cortisone may be injected into a deep cystic pimple to help them go away more quickly. Birth control pills or hormones may also be used. Blue/Red Light and photodynamic therapy are also an option. Most severe cases of acne may respond to isotretinoin, however this requires frequent follow up and blood tests to monitor many of its potential side effects.
Psoriasis is immune-mediated, involving the infiltration of T lymphocytes stimulating the skin to proliferate. Numerous cytokines such as tumor necrosis factor (TNF) and certain interleukins are thought to be involved in the inflammation seen in psoriasis.
Systemic therapy for psoriasis include methotrexate, acitretin, cyclosporine, tumor necrosis factor (TNF) blockers, interleukin (IL)-12/23 inhibitors. These can be associated with side effects mainly decreased immunity related to their immunomodulating activity. There are 3 TNF blockers approved for psoriasis and psoriatic arthritis: Etanercept (Enbrel), infliximab (Remicade) Humira,and Adalimumab (Humira). Golimumab (Simponi) is only approved for psoriatic arthritis. Ustekinumab (Stelara) is IL 12/23 inhibitor.
Seborrheic keratoses (SK’s) are very common benign superficial skin growths that can get more numerous with age. They are not contagious or sun-related and they cannot be prevented. They can appear waxy or warty, the color can vary from light tan to black, and the size can be a few millimeters to more than an inch. Treatment options may include cryotherapy or freezing with liquid nitrogen, curettage or scraping, and electrosurgery or burning using an electric current.
Rosacea, commonly known as “adult acne”, often begins as the tendency to flush and blush, leading to persistent redness, then broken blood vessels or telangiectasia and tiny bumps. It’s occurring more often on the face, but may affect the ears, chest and back. Ocular involvement can occur is as many as 50% of the people affected with rosacea and can present as burning of the eye or symptoms of conjunctivitis.
The cause of rosacea is unknown. Treatment may include a gel or creams. Oral antibiotics maybe needed. Persistent broken blood vessels maybe treated with laser or intense pulse light (IPL). It’s best to avoid factors that tend to make the face red, therefore rosacea worse: hot or spicy food or drinks, heat, cold or sun (wear sunscreen, avoid exercise in the heat), scrubbing the face or using irritating facial products.