Acne scarringThis article on Acne scarring was found at Westside Dermatology Group as a PDF file. What I have tryed to do is put it into a web page form.
This is a technical kind of an article that I think is worth reading through. When you do talk to your Doctor about your Acne scarring you will have a good idea what the Doc is saying.
The whole article is 17 pages and I hope that you fin it easer to read this way. the PDF file can be found hear
Look for the Downloadable Resources on the bottom left of the page.
A review and current treatment modalities
By Albert E. Rivera, DO
Acne is a prevalent condition in society and often results in secondary damage in the form of scarring. Of course, prevention is the optimal method to avoid having to correct the physically or emotionally troublesome scars. However, even with the best efforts, scars will certainly arise. This article attempts to give a broad overview of multiple management options, whether medically, surgically, or procedurally based. The hope is that a general knowledge of the current available alternatives will be of value to the physician when confronted with the difficult task of developing a treatment plan for acne-scarred individuals, even in challenging cases. ( J Am Acad Dermatol 2008;59:659-76.)
ACNE
Acne is caused and characterized by multiple factors, including: Propionibacterium acnes activity; increased sebum production; androgenic stimulation; follicular hypercornification; lymphocyte, macrophage, and neutrophil inflammatory response; and cytokine activation. Multiple surveys and studies have attempted to determine the prevalence of acne within various groups. None of these are without shortcoming but all have done well with targeted, representative groups. A good review, too extensive to be included in this work, containing tables (consisting of 15 general population or schoolchildren-based cross-sectional surveys along with 3 separate case-control studies) and discussions of several of these publications has been compiled and published by a group of Australian authors.
In 1978, the most comprehensive study to date, HANES-1,
Established the prevalence of acne vulgaris within 20,749 US citizens aged 1 to 74 years (excluding those hospitalized for another dermatologic condition and those with the disease in remission) to be 68 per 1000 for both sexes, 70.4 per 1000 for men and boys and 65.8 per 1000 for women and girls. Cystic acne was present in 1.9 per 1000 for both sexes, 3.3 per 1000 in men and boys and 0.6 per 1000 in women and girls. The common complication of acne scarring was found in 1.7 per 1000 for both sexes, 2.0 per 1000 in men and boys and 1.3 per 1000 in women and girls. Approximately 80% of girls and 90% of boys develop acne in their adolescent years. The peak incidence for girls is age 14 to 17 years and age 16 to 19 years for boys and men. Furthermore, of individuals aged 11 to 30 years, 80% have some degree of active acne.
More recently, a community-based study, using the Leeds grading technique for acne3 and including 749 patients, all older than 25 years (range 25-58 years, mean age 39.5 years), was used to determine overall acne prevalence as 58% of women and 40% of men. ‘‘Clinical’’ ([0.75 on the Leeds scale) acne was present in 3% of men and 12% of women. The prevalence of clinical acne decreased significantly only after age 45 years. Their definition of scarring was noted in 14% of the women and 11% of the men in the study.4 However, even in the two examples above, statistics are often inaccurate because most estimations are based on patients who seek treatment, physician diagnoses, hospital records, compensation claims, medication purchases, or various exclusion or inclusion criteria, rather than a full cross-population sample.
From the Department of Dermatology, Northeast Regional Medical
Center.
Reprint requests: Albert E. Rivera, DO, Department of Dermatology,
|