Acne
(Pimples)
Occurs
commonly between the age group of 12 to 30 years. It has a lot of
psychological consequences.
Aetiology and pathophysiology
Causes
may be
1)
Increased sebum
production due to following
hormonal disorders as:
|
Adrenal: |
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Ovarian: |
|
Other: |
|
Cushing syndrome, disease
, androgen production) Tumor (adenoma, carcinoma) ,
Androgen-producing adrenal, Late-onset genetic defects in
steroidogenesis, 21-Hydroxylase deficiency, 11ß-Hydroxylase
deficiency |
|
Primary
polycystic ovaries , Secondary polycystic
ovaries Androgen-producing
ovarian cell tumor, stromal Tumor (adenoma, carcinoma), Hilar
cell hyperplasia |
|
Idiopathic
Hirsutism , ingestion, injection of androgen or or androgenic
substance, |
3) ductal
hypercornification so that blockade of duct & infection of the duct
with Propionibacterium acnes bacteria leading to inflammation followed by scarring if not
treated properly.
DIAGNOSIS
OF CAUSE OF ACNE PROBLEM
First step in proper treatment of acne is
accurate diagnosis of cause of this problem. So we first try to find out
cause. We take detailed history, thorough nutritional counseling, physical
examination, and examination of hormonal system. After that depending on
likelihood of particular cause relevant tests are done. At our centre we
have the facility for all the diagnostic tests needed for the diagnosis of
the cause of acne problems,. Thus you may consult us at our centre &
at same time you may get all test done also. The time taken in getting all
the reports ready is 36 hours. So if you are from out of Delhi, you may
come here for two days.
DETAILED HISTORY
Onset:
Sudden/gradual,
Primary or Secondary, Response
to previous therapy, Stress (physical or mental), H/O precipitation by
some drugs, HT, trauma,
Hypothyroidism / Hyperthyroidism .
INVESTIGATIONS i.e. DIAGNOSTIC TESTS
At our centre we have all the facility for
complete investigation of cause of acne & other
problems. So we perform following tests, step by step depending on
their need based on history & examination.
The various diagnostic tests
needed/performed are as follows: -
Step-
I: Hormone Testing: Hormones are tested by latest-immunoassay techniques. These
hormones includes total Testosterone, free testosterone, Prolactin, LH,
FSH, T3, T4, TSH, others as Cortisol, E2,
Free testosterone SHBG etc.. Among above tests relevant hormones are
tested in that particular patient depending on history & examination
Results are available in 36 hours. When we find out any of above hormone
disorder simply correction of these hormone disorder corrects the acne
problem in three to six months time.
Blood
glucose & other systemic test as test for kidney, liver etc. are done.
TREATMENT OF ACNE
After
diagnosing the cause of acne we prescribe medicines. The success of
various drugs we use in acne problems depends on accurate diagnosis of
cause. If empirical treatment is prescribed as most doctors do, it often
does not achieves permanent cure. These acne tonics & ayurvedic
medicines can improve your acne problem temporarily but they cannot give
permanent cure.
We
provide specific treatment for Recurrent
acne.
Similarly
Permanent cure provided for Resistant acne.
We also give
certain Newer treatments in very Difficult cases.
Our treatment also takes care of Scars left
over of previous acne.
The various treatment
provided are:
alpha-hydroxy acids as benzoyl peroxide
antibiotics
azelaic acid and retiniods
combination of sulphur, imidazole, hydroxyquinolone, glycolic acid or zinc lactateoral therapy
antibiotics to cure infection
Hormone Therapy: Hormone
therapy is given to cure the problem whatever defect is found. Depending
on the type of hormone disorder i.e. whether hormones are decreased or
increased, Hormone therapy is directed towards that. Hormone therapy
usually cures the Acne problem in 3 to 6 months time and they do not have
any adverse effects.
Antiandrogens
cyproterone acetate (CPA)
spironolactone
Isotertinoin
Newer Treatments:
Laser and Light Therapy
Response to Treatment: As we have fully
dedicated team of highly qualified, experienced, doctors, who are expert
in field of acne treatment Response to treatment is very good. After
finding the cause of acne by above tests it is cured in most patients in
three months treatment.
Acne is cured in most
cases after correct diagnosis & treatment.
For consultation & treatment (by appointment / or online) click
How
to Consult Us
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