ARTICLES

Acne Disaster

Acne Vulgaris is an inflammatory disease of the skin caused by the bacterium Propionibacterium acnes. The bacterium is an aerotolerant, nonsporeforming, slow growing anaerobic gram positive bacterium that is linked to the skin condition acne. It can also cause chronic blepharitis and endophthalmitis, the latter particularly following intraocular surgery. Acne lesions are called 'pimples' in laymen language.These pimples may range from dark brown to reddish brown due to oxidation of keratin or even red color in fairer people.The bacteria thrive on oil secreated by the sebaceous glands which is known as sebum. It is rich in different types of fatty acids. As the bacterium is a commensal, it commonly thrives on healthy mans skin.The bacterium derives its name on its ability to produce propionic acid. They also produce lactic acid and acetic acid from glucose.

Acne causes may be due to family history,Hormonal activity, such as menstrual cycles and puberty. During puberty, an increase in male sex hormones called androgens cause the glands to get larger and make more sebum, through increased output of hormones from the adrenal (stress) glands due to stress, hyperactive sebaceous glands, accumulation of dead skin cells

Acne can also be caused due external factors such as

Use of anabolic steroids.

Any medication containing halogens (iodides, chlorides, bromides), lithium, barbiturates, or androgens.

Exposure to high levels of chlorine compounds, particularly chlorinated dioxins, can cause severe, long-lasting acne, known as Chloracne. Exposure to certain drugs and chemical compounds, including narcotics (opiates and opioids), especially when taken intravenously.

Seafood can cause acne as it is rich in iodine. Milk is linked to acne as it may contain sex hormones of bovine origin.Foods rich in carbohydrates can easily be converted to fats which can be deposited in sebaceous glands.

When a pore is blocked this anaerobic bacteria overgrows and secretes chemicals that break down the wall of the pore, spilling bacteria such as Staphylococcus aureus into the skin, and forming an acne lesion (folliculitis ie inflammation of the follicles).It lead to pus formation and the exudate is rich in pus cells or neutrophils as they have a protective function in destroying the bacteria.The pus filled area should not be touched by hands as there can always be a spread of infection to other part of skin.Skin irritation or scratching of any sort will activate inflammation.This may lead to scar formation.It has also been found in corneal ulcers, and on very few occasions damaging heart valves leading to endocarditis, and infections of joints (septic arthritis) have been reported.

The face should be washed with soap containing azelaic acid which is a dicarboxylic acid naturally present in wheat,rye and barley. Azelaic acid may be used for reducing skin pigmentation.It is naturally produced by the yeast Pityrosporum ovale. P. acnes can be killed by 5% benzoyl peroxide, tetracycline group and other antibiotics. However, tetracycline-resistant P. acnes is now quite common. Clindamycin and erythromycin is also frequently used but may be ineffective or less effective at times. Triclosan or chlorhexidine gluconate are less effective.New facts show,that P.acnes are sensitive to some macrolides such as Azithromycin, which has a wide spectrum of action. It is normally prescribed 500 mg by mouth, three times weekly for 4 to 6 weeks. Azithromycin exhibits post-antibiotic effect by concentrating in the lung tissue for approximately 5 days. Another antibiotic is Nadifloxacin from the group of so called 4-fluoroquinolones (such as Ciprofloxacin, Ofloxacin, Levofloxacin).

It has action against P. acnes and some other microorganisms that also take part of the poly-infection. New evidence and research also suggests that increase in vitamin A and E can reduce the risk of acne. Other therapies which can be use are phototherapy [blue and red light treatment],photodynamic therapy or laser therapy. Besides that conventional ayurvedic methods using Azadirachta indica/Marrango tree[antibacterial],Curcuma longa/turmeric [antibacterial], Aloe vera[coolant], Rubia cordifolia/Himalayan madder [antibacterial and astringent] can also be used.

BRUNO LOPES is an MSc-2 student of T.N.Medical College and B.Y.L.Nair Charitable Hospital [MUMBAI UNIVERSITY] and likes to do research on Herbs and fruits and study their medicinal properties. He has graduated in Microbiology and Biochemistry[co-curricular honors in microbiology] from ST.XAVIERS COLLEGE, Mumbai [MUMBAI UNIVERSITY]. Currently he is researching on his dissertation topic, 'Role of Sodium potassium ATPase,Glucose and glycosylated hemoglobin in Diabetes mellitus' as a part of MSc-2.

His aim in life is to do something for betterment of mankind which he describes by a simple adage, which is,''Knowledge is education for oneself but wisdom for the sake of others'' His interests are Microbiology, Biochemistry, Oncology, Nutrition, Botany, Immunology, Virology and many more. He has a vast knowledge on scientific names of different plants and microbes of course as he had graduated in Microbiology and Biochemistry.