Fernanda Horrillo ISM- Period 7

Jorizzo, Joseph L., and Ronald P. Rapini. "Acne Vulgaris." Dermatology. By Jean L. Bolognia. Second
ed. Vol. 1. Spain: Elsevier, 2008. 495-547. Print.

About 85% of young people ages 12-24 are affected by acne vulgaris.

Sebum production is relatively high the first 6 months of life, then decreases and remains
stable throughout childhood until adrenarche.

The activity, size, and number of sebaceous glands is inherited.

Comedo formation occurs when the corneocytes, which are normally shed into the
lumen of the follicle and extruded through the follicular ostium, are retained and accumulate,
leading to hyperkeratosis (Bolognia, Jorizzo, Rapini 495).

An important role is the development of scarring is the specific type of inflammatory

response

Any estrogen given systematically will decreases sebum production.

Resolved inflammatory acne often leaves lasting cosmetic disfigurement associated with
scarring

Acne fulminans is a severe cystic acne consisting of abrupt onsets of nodular and
suppurative acne associated with variable systemic manifestations.

Acne conglobate is the same except without systemic manifestation.

Drug induced acne is acne formation as a side effect of medications like anabolic
steroids, corticosteroids, corticotrophin, phenytoin, etc.

Occupational acne is formed by exposure to insoluble, follicle-occluding substances in

the workplace (Bolognia, Jorizzo, Rapini 495).

Chloracne is a term used to define occupational acne cause by exposure to chlorinated

aromatic hydrocarbons such as polychlornaphthalenes, polychlorinated biphenyls,
polybrominated biphenyls, etc.

Neonatal acne consists of small, inflamed papules and is currently under debate in
regards to pathogenesis.

Infantile acne is cause by hormonal imbalances and presents itself in babies 3-6 months
of age

Tropical acne is an acneiform, follicular eruption that results from exposure to extreme
heat (Bolognia, Jorizzo, Rapini 501).

Radiation acne is characterized by comedo-like papules occurring at sites of pervious

exposure to therapeutic ionizing radiation (Bolognia, Jorizzo, Rapini 501).
This source was very descriptive in all the different specific types of acne and their causes. It listed a lot
of uncommon conditions in which acne can form that I was very unaware of. It also demonstrated the
biochemical and biological processes in which they are formed which was helpful to my understanding
of the content

Fernanda Horrillo ISM- Period 7

"Excellence in Dermatology Excellence in Dermatologic Surgery Excellence in Medical
Dermatology Excellence in Dermatopathology." Learning Module: Acne and Rosacea. American
Academy of Dermatology, Jan. 2015|. Web. 17 Oct. 2015. <https://www.aad.org/education/basicdermatology-curriculum/suggested-order-of-modules/two-week-rotation/week-1/acne-and-rosacea>.

Acne vulgaris is a skin condition characterized by blockage and/or inflammation of

pilosebaceous units.

There are three classifications of acne based of morphology: comedonal, inflammatory,

and nodulocystic.

There are three subtypes of acne: mild, moderate, and severe.

Comedonal acne consists of opened and closed comedones, inflammatory acne consists
of papules and pustules, and nodulocystic acne consists of nodules and cysts.

Mild acne is characterized by comedones and a few inflammatory lesions.

Moderate acne is characterized by comedones and a marked number of inflammatory

lesions.

Severe acne is characterized by extensive inflammatory lesions and diffuse scarring.

Increased sebum production can influence the formation of acne by androgens.

Keratin and sebum clogging the follicle lead to abnormal desquamation of follicular
epithelium and results in hyperkeratosis.

Hyperkeratinization is the excess of keratin in the hair follicle influenced by genetics or

androgens; leads to cohesiveness of the follicular epithelial cells which results in follicle
blockage.

P. Acnes proliferate and release enzymes which stimulate the release of inflammatory
cytokines, resulting in breakage of the follicular wall and inflammation.

Topical Retinoid is a common treatment of acne. It is a vitamin A derivative that

normalizes the desquamation of follicular epithelium and promotes cell growth.

Benzoyl Peroxide is an antibacterial and comedolytic. It targets P. acnes and reduce

inflammation.

Oral Antibiotics target P. acnes and reduces inflammation.

Oral Isotretinoin is a retinoic acid derivative that targets all four factors of acne development. This
source was very informative with the basic concept of acne. It covered everything very broadly and
generally. This was the main source I used for the production of my PowerPoint because it provides me

with all the basic concepts and understanding of acne without getting too complicated and scientific with
the details.

Fernanda Horrillo ISM 7th

Cordain, Loren, PhD, Staffan Lindeberg, PhD, and Kim Hill, PhD. "Acne Vugaris: A Disease of Western
Civilization." Arch Dematology (2002): n. pag. JAMA Network. Web. Nov.-Dec. 2015.
<http://archderm.jamanetwork.com/article.aspx?articleid=479093>.

In the Western world, acne commonly affects primarily adolescents but also a significant portion of
adults older than 25 years.
There is suggestive evidence in non-industrialized societies that the incidence of acne is lower than
in westernized populations.
Kitava is an island in the Trobriand Island group located in Milne Bay Province, Papua New Guinea;
in the 1990s development was limited (no electricity, telephones, automobiles, etc).
Food diet includes Tubers, fish, fruits, and vegetables.
All subjects were examined specifically for skin disorders, including acne; there were 1200 subjects
10 years or older.
Not a single papule, pustule, or open comedone was observed in the entire population examined
A general practitioner who spent almost 30 years treating Inuit people as they made the transition to
modern life, reported that acne was absent in the Eskimo population when living and eating in
traditionally, however upon westernization, acne prevalence became similar to that in Western
societies.
In Western populations the development of acne has hereditary and environmental components.
Familial studies have demonstrated that hereditary factors can determine susceptibility to acne,
whereas twin studies have suggested that although sebum secretion is under genetic control, the
development of clinical lesions is modified by environmental factors.
Diet represents a well-recognized factor in acute and chronic hyperinsulinemia. Recent evidence
showed that the hormonal cascade triggered by diet-induced hyperinsulinemia promotes unregulated
tissue growth and enhanced androgen synthesis.
Hence, hyperinsulinemic diets may represent a previously unrecognized environmental factor in the
development of acne via their influence on follicular epithelial growth and keratinization and on
androgen-mediated sebum secretion.

This article was very intriguing, identifying possible causes for the differences in acne vulgaris
prevalence among western and nonwestern environments. I admire the researchers critical thinking
skills and analysis in finding an explanation for the differences. Diet is a very hazy and unaccepted
cause of acne among dermatologists. However, the researchers concluded that diet does not directly
cause acne, but influences the factors that cause acne such as hyper keratinization and androgens.

Fernanda Horrillo ISM 7th

Jaliman, Debra, MD. "Skin Types and Care: Normal, Dry, Oily, Combination, Sensitive." WebMD.
WebMD, May-June 2015. Web. 03 Nov. 2015. <http://www.webmd.com/beauty/face/whats-your-skintype>.
Skin types vary depending upon factors such as: water content, which affects your skin's comfort and
elasticity, oil (lipid) content, which affects your skin's softness, and sensitivity level
Normal skin is not too dry and not too oily and is characterized by no or few imperfections, no
severe sensitivity, and barely visible pores.
A combination skin type can be dry or normal in some areas and oily in others, such as the T-zone
(nose, forehead, and chin).
Combination skin can produce overly dilated pores, blackheads, and shiny skin.
Dry skin is characterized by almost invisible pores, dull, rough complexion, red patches, less
elasticity, more visible lines
When exposed to drying factors, skin can crack, peel, or become itchy, irritated, or inflamed. If
your skin is very dry, it can become rough and scaly, especially on the backs of your hands, arms,
and legs.
Genetic factors, aging or hormonal changes, weather, ultraviolet (UV) radiation, indoor heating, hot
baths and showers, cosmetic ingredient, and medications can all contribute to making dry skin worse
Oily skin can consist of enlarged pores, dull or shiny complexion, blackhead, pimples, or other
blemishes
Oily skin can be affected by the weather/ seasons and can be made worse by stress, puberty or
hormone imbalance, or exposure to heat/ humidity
Sensitive skin can be characterized by redness, itching, burning, and dryness
All skin types should use a broad spectrum sunscreen that blocks both UVA and UVB rays, avoid
direct sunlight and wear a hat and sunglasses, avoid smoking, stay hydrated, wash skin regularly, and
moisturize.
This source contains general skin type information including the type, characteristics or the type, and
conditions/ environmental factors that can specifically effect each type. It is comprised of mostly basic
information, and I was personally looking for something deeper. The information given was not
enforced by biological/ biochemical reason, only simply stated. Although, it did provide me with general
information useful to my further research.

Fernanda Horrillo ISM 7th

"Acne Alternative Remedies: Manuka Honey, Tea Tree Oil, Zinc, Yeast, and More." WebMD. WebMD,
18 Feb. 2012. Web. 02 Nov. 2015. <http://www.webmd.com/skin-problems-and-treatments/acne/acnealternative-treatments>.
Conventional acne treatments don't always work for some people, causing side effects (skin irritation
to birth defects) and development of antibiotic resistance.
A study in the U.K. reported that more than one out of every two acne patients treated
with antibiotics carried resistant strains of two different bacteria often found on the skin.
The American Academy of Dermatology (AAD) says that "all-natural supplements" have not been
shown to be effective, and some may even be harmful.
The AAD also states that there is no evidence that any dietary regimen has an effect on acne.
Proponents of alternative treatments point out that acne is unknown in so-called "Stone Age"
societies. On the other hand, it affects up to 95% of adolescents in industrialized societies. This
suggests, they say, that a Western diet may be a major factor in the development of acne.
Manuka Honey is promoted an acne remedy because studies suggest it has significant antibacterial
and wound-healing properties.
Manuka honey is thought of as a reliable and effective treatment because honey-impregnated wound
dressings have gained increasing acceptance in hospitals and clinics worldwide.
Studies have proved that Manuka honey is effective in quenching free radicals.
There have been no studies that disprove the effectiveness of Manuka honey on acne.
A study conducted with Tea Tree Oil, an essential oil extracted from the leaves of a small tree native
to Australia, resulted in a reduction in acne lesions in participants after three months and less side
effects compared to benzoyl peroxide.
Vitex, a whole-fruit extract for treating premenstrual acne is thought to act on follicle-stimulating
hormone and luteinizing hormone levels in the pituitary and said to increase progesterone levels and
reduce estrogen levels.
Vitex is approved as an acne treatment by the German Commission E, a European agency that
studies herbal remedies.
German Commission E, also supports the use of brewer's yeast, which has antimicrobial effects.
This source was personally intriguing because of its scientific perspective on alternative acne treatments.
Believed home remedy cures for ace are often seen on the internet. However, their credibility is often
questionable. I felt this article was informative, realistic, and unbiased, covering the topic of alternative,
natural-based acne treatments. It did so in an efficient manner, referencing studies and biological
aspects.