Dvu¥s uSed in Treatment of _ Aene ht hed Peg aioe alg DN cobgal csale Spe any i — 7 one GID otal cal b yoat ~ “sof Pu mast Common shin dseese Sos GOsaid Ge pls cell eas Cems & - Almet every one have @eny ies ocCuran, ? —> more than 90x of Adolescents io HostesStwis ails > Neorly Gor ef at) adult C7 yas Ae SL ols tyne at Se SS ct lis ans far gpoTeiSitus +] prey A Clee we _» Ptme con presist Cor yeovs ond Result in dsEiQurement ond pYemene ay Scorn _ne a eee Gray spo ss all ns Jo-—93 + ee Sal Liga pgll ard! sll abd | Ried Bole ByS aay ¢—_ Sul B +154 Ain dB, — Bee se Db vis —y Both men’s ond Women’s lo dies Produce andvogens - = testosterone - Andyostenedione - Dihydretestoste Youe DUT - Deby dvoepion drostevone DHE A - QHEA sulfate QHEAS gh oS pls FNS Andrei 3 cel CV Slas Laser gy? asi OT ba j= als B.—e Excess amounts of Andyotens Can Pose apreblem yesulling im clQie= Acne ae xne en cal = Wvsutism uve - alding roll Acne spitz Andvojens st 2 bg aC lal BME © Ani yyevs> St = — Vind j hol sob j Sebaceous glands — =nxHN) sues oR aS, Sebaceoud ancdb gland a NV Nom ated) B2u 3 a5) Epiep 246 oA (BN) Gebum) eo @) yi babs patsy ed aysiy eb «Geb 1 gy gee Ge Lace = Wy oO y chest Noy ( tir Yous 5 Nou Fellicle sebum —>eily —> Rich ow triglycerides goy Ser Production of Androgens) Duving Ps. Puberty Petar ~ pregnancy deal - Female menstrual cycle ays BoA 4 (Androgens > stimulates _sebscmus glands to produce excess sebum CG sebus leads te Carp “> _ Bry skin G So Novmal production of Seloum is necessory, For \ntoltes sky — madden ond grotect skm dead cells thet andl waits sss de Pollicles accumulate im the —> the empties onte the skim thvoush timy Penny Ww the Coltcles called Pores ceosall ded WIN 3 Toe ey Sebs 3) ssl as LSall sd ar sebum a”T Andygens {sebum | Follow of sebiom Aodizbe 9 ee : sebym Js Py> ole sebum J! Fpiap ais Ps ote sebence ors glav) sebum s1 29 | over Production of And vsgns) ehimu lates sebaceous glands to produce excess sebum 4 azine QD WF Lo 30 EN Call sh sebum Maud 2 Wyo | gab 9 pve WN shoal as Ube _Vs@ sebum 1 dyes uw c * pe IS Stsnde aad a ae sao? © ~ sebum ~ Dead calls ,.8—» Accumulation of dead cells and Sebum Gy Form sticky plugs that lock the Poves 4 PYeventiny sebum From reaching the surface of the skin | Skin drieh 4 skim Feel oily yan mechanism Mt Ol. La J\'s—all sebum —_sijyol sob py Andojens osc The king 0f An dvojensg testosterone 34 cay teshosterone ss Suh fay posed IUDUH Dilylvotestostevond) OAT < 22 aS ah clap p38 de IS — ONT aA boul do ppg _ Development of male chovacteristics ~ Development of Genvtals tr - testes = Growth of Pubic and body hoi = fb mole sexual behoviour 4s+G61D mnore Potent than fesfostevone testosterone dib ou + IF 2 1d BY! SUD type SA-reducase enZyme 9a. OHT 4 ; sebum Ji sabi cz DHT Sy. e aweulatng testosterone DAT Glee — gsm wel Salyps us GHD —+ Binds te Receptors in Stbateous Sealy glan}s t Sebaceous glow) srZe t sebum production gtbum 31 SySe asp Ce—§ale 223 2 NS 9 —Pores Sos Lope te a3 45 middle ged women a_i Ce ato with recurrent premenstrual acne testosTerone)\ 090,28 8 ACne J) t9.5 aria Loge su Ovories> II Ab ty yay esl Tutiation of menses aya Sol Ae epee wlg Alauloall Os Acne) CL sas jphi be! Cen) 22 ts, U5 Gebund (Cal s>e+ 3 Androgens J] > dd oi Sslee J Dossy Isle Od} Ih qs, follicles _w cg aaa mma fene csleuly e_——— —» it isthe Precurser lesions fe acne 1 sebum production + * Growth of Kerstin profes m3) calls Jing the Pere cells - sticky elu tog > ctl £5 059 Pores ese eh Ly97 spy dst 58 micyocomeda = ¢_ at Acme Ih es A Cision 5 Jt Gy ains CC» Comedonal acne dypaale — @ * oeOD Cometonal acne) ob 9 sho —t——___ closed open = Whi Cos ones = Black oe Cometones (closed comesones = white comedones } 2! aa oe = S saul — Forms when Traped sebum Pushes ue aganist the non- dilated opening 2 the Pore — Reyrwan below the surface of the skin > produced uthitish Pump sgabele Ae Gad ain slp vs) a> axl oS _ ema Ope 4S HI SS Sopp POW — CREE Aol — sop ll — RAI tag) Sihio & 35 teal OPen Comedones = Black Comedones Hol de — det Py GN gaat clsed 51 eps a» Forms when the pore Wall is able to dilote am vesPonse te increased Pressure crecte) loy the Trapped sebum @ «.—> Black colby 15K La adds 1 whit color 34th (caus oat) cpa ars dang osc Sebium Sie closed Sproat lll bal ded od Come done Gen comeeap sot Selium ¢ Dead cells SM Sys walle pics! pove Iys bese Vee Giedetiod ated acd orygin J lieve Dye oo BI og AN pen Qlaoks heads. ey cakst heals Acne Sos alzysl osgdorsll “iw cs ub Fs» Jt esl Loy shi PoPulopustuler Acne Low, Ga ob pall upacall 5 Gls 45 WO q al « OF3 eae Acne sos galt (8 poy osOcs ACHE tga Tnf mations yo@hdsl Bene 1 SP IPPM 16D Doge A wodl Ged waisslace eed one oo sebaceous gland Vos Rebus pis one eo Fay) Dead celle _st dips a Yl gs 51 SdUall AL Lal fae Od G& when closes Comedones burst Ly ther covtenlls get info Survor ndina Tes ues ” Lmmune system J gts opr ye isles « surrountiny 3 see dy Tass ues rove Blood te the area - Le couse inflammation —» Se the closed come done G amd the oven Surv ounding ot become Qe) ond Suiallen”Small, inf lemme) ¢—PaPures pas 5 Nal Rung Papules = Comedones + Tnf lammatio a Warr Pallicle cabo (g Soul acest Lp Iba Sen eS emcee Propionibadierim 4 casi acne 7% Normal Flea aithin ps_anit shad caseaSyig sebum 1 jl dob jute Cedouyp ct oscil) alia Arpeall Lf 08 25 Triglycerides ile Sedum stot JS uo USs <— Triglycerides ap Ss Peacne LySd 02d esi Lidase eet lel Cuppis Free Falty Acs ll Trrifaut substances Coube \ CInFlmmation>258 spel Acne JL clpsllopscal aan — Sis she apsl Pacne — LS sb pel ovsSpll aid9 & Loy Pustules = Comedones + Stee + Pus nf bowmation Tae CsB9m yooh Pacnes Lg Acne Jb vlpyl oli & Acne los = all eg} wJeee 9 G a 3 )Nodulocystic Acne sebum PACNE Cree Fatty Acids Triglycerites Lipase 4 Gay 25 Saal) Free Patty ocds 41 as Pro-inP lammatfery chemical signals i stimulate higher eae > keratinocyte _ LTBY actiuity ond Re Production ‘i Tnflammotion f Pus 2 csyasre wo Saran pSiy PSA all 4p —S dbs : _. adn Cyst — ft Tnf lammation extends inte deeper layers ~ of the skin ~ (eyst}—+ very Pamful and dis Figuring lbs Dt ~hot — Heat “ -Red -suollen Cyst) — The met serious type of acne [esions Comedenes + papules Pusfules + cysts a Nodules 11 B59 sg wall olay Lov4 gold PonPul \umos. beneath the suvFoce of the skim Plas WF Acne JIC 91 (9 ap Meal Comedonal acme = mild white heals + Slack heals LO papulopustuley acne = mode rate ~ papules * pustules ? DS setlocses acne aNormal Skin Blackhead Whitehead Opens tothesurface Stays below the ‘and tums black skinsuface | sin sutoce ‘Sebum_ Folicle Giand Papule Pustule Cyst / Nodule Smal, inflamedbump- KnownasPimple inflamed painful pimples Red inflamed with pus on top deep in the skinea met Rell lame Cal}Severe Inflammatory Acne is Tete Comat it CalgFo eared oman Roca ft face os papules (acieade sod whee). ‘comdones, neu use. ‘ey trypan comedones dion konae “ow onetouthoftetae~ Comedonal acne _ 2 pay lo Sons — Qapulopusiuler scree Acne vulgaris ~ Nodulocystic ene common acne : Onl dis ep Sal af ted, of of atl People with ache Byob WM Acne Some sei Cigt + She — 44 Neonatal acne > Infontile acne _ > Acne conglobate > Acne Plumimans SAP He Syndrome “3 PAPA Syndyome fen Jig rigs L—S 5h as spiel ye 2D < +Gired) —> stress Cause acne 23m OA Sy pytaall AUaall 048 M5 rlale anh ¥ tyes SN) ey AGE ol iy Os F Projuction of Covtice ferords Coy heh stimulates scbum produdion Se 4 worsen the Acne ee Cspot oly Ata ~Tyestment of Acre Gools of t yeot ment ae _@ Decrease sebum production _® Reduce P-acnes Gaderia _@ Reduce Keratini Zation -@ Elimmate ain lammation Types of treotment Topical treatment systemic trestment Topical tresfment of Acne QE Ancor oh tepid ges Sigh Iba Acne Feat ment moderate thy rm) 3 cath Ga Seuene |) auc = le Yes Combretion Bol boy pisos bya uso vy apls yaw : col uso ZplS mechanism io ee JTe- topra\ _)\ di yt ou — apis) AoRenZoy\ Peroride tS tee Lae Yos'yl Dion combnotions Gopi ged —> itis, the min Ingredient in mast over the Counter ocne PrePorotion —> Tret mild aC lam matory ache Wechanism of Action Benzoyl pevoxite ——> OxidiZing agent $ Release 0 xy9¢% (02) abled VA jad — P.acnes NN of Casper ~ Bacfervin Anserobic Bacteria oxygen Pree enviroment Boer Qtadlo so pod Wine Cue S91 2909 AL OWI LAT! 0 28 (oS cpl o Kids Benzoyl perexde 1 Glgs te «- C5 (Pentvates how Foltrele Re leose_ 0 KY Qe + Racharia deod pone A ae 4 oP now pustules Frpm FormnsCRAP pay sas Fst line tyeal mild ~ Latent Eo <— “ube S Genzey) RD AIS Coe Bd) gn) Us Line abd ges ot! ¥ sensitivity to the sun Cos Spy Aus 528) eats at) 2 Casal | mata e's CP! Sungcreen — Cyeom, SD 3 Wael APH <— - lotie 25 ‘ - Gel ae aN Sa -je % Scliculic Acid eb Nes yy 24 paisa —» ofc _ pop uley Topical tyeolment _y pet treet TnCeckow ov Taf Ismmnstion Mechanism of Action Salicylic acd 4 GL pall All o> we aes Soo Pores JI 9 Sb) a get msde clogged hoy Follicles Next aay cs Jha ey Isla Amclogged hooy Fol} icles Si) jis 1g Deod cells 3 Ais) cea cs. Salicylic acy Couges the Deal .skin cells inside the Fellicles to dissolve Sal sebum Ji yp Galen dls Pores ite Folhieles ioe swe dpe? Ble AY Solicylre ocd Ne we, A month pps So¥lek COaG conceal vation YO ewe uy eH - 9a aaa hog hey Ale ea) Bie does ay¥itont — AAPA Cancentvaton + Benzoyl Perorrde coadF Dosing Te sv > sol: cybe ack ° . cap) ce leks eVLul ww VQ - moderate = ‘ Azelic Aw3 9 toe - comedelytic — Arti becleyial = ComPefative inlubster of Ay Voss nade SR CL let oe fh py montation wa Coe . Bo tt weam fpsny = Salicylic Acid & Acne SALICOYLIC-— =p". Re 29 781 Lips Ty peel Go Topical Hie ds) aula ae —» The mst Peover Ful Comedolyfic agents s They ove metobolities of vitamin A => Thy wore 05 hormones Topical Nes Refnors SI pial prePowations -Trainan - AdoPolene -TeZovelene ‘ame duper es boseelee Zils Yas otoF 28 Vtomin A —~e | Qrouth of skim cells D\ on i Gains 9 § Dead Skin cells R eb nords accumulation \ TnleRon —» Slowira the greuth o@ Stim cells So Keeping dead Skin cells Prom Bulding ug mare the hoy Follicle comedones I so cola Ci pag pes Comelonsy = T sebum + 1 kertinizoton wa y Keratinizotion —— Retinoids suaRetinorts Aa, vitamin A gt od, eas 4 sebum production Lm shrinking sebanens lands & production of Collagen ™ a IiSi bs aes) pool te cS 30-025 I + |ipreinn Sys 9 x o.05 Ve = Cream >o-l wv - Gel Jy lool (8 OPA! oD EP a thctosensiiity <— AUS + terotegenic —m Jovld tein) > Moye writeting Byles 2 ybp Atha Gd> ole | uly is dO) alalloags ora ai} fd aul £45 Bed time by asl ect faa phelosensitwity ay oi'y + OR ETO YS mel a_i pts ( ees ed (peer) SW eM OD w¥ (> 2s 8B pt jae dell Wess gos Aled ane Set 2) seother Topical Retinorts fezavatin’) _ move exPensine than tetonsin the mest potent — less ivritanh than trefmon “= less photo sensitivity JDGNG eet —2 Yo 1s Luda of pes voS ~0.95 Yeo ~ ol te - Cytam Cone , -Gel wwe than tretinoin Ad ene = more enensiie = less ivritant then tyetinsn | - less Phetesanstracty than looth < teza retcne —~ Cveam Tretinan - Gel Cenc Ol fee Os ds Topical Antibisics} AMO AHS ant modeyale ~Seveve eisega ACNE Baderin'p Cus 3b; A5ed eG oes? rs a4 1 is sd) te pe ae Topical CF iod) ge caval! Retinords gues applied at the Morning lees cis 4 Topical ovihibiitics, sopplieh at Red tine jst. Aad <—., Topical RehinetdsTopical antibiotics 1 f7isy ul as Lins Yio Cpa asl 0 Ol ji eal aad BenZoy\ Peroxide or Salreytic ons) Cea asax SENZOS\ Peroxide = i De —> (Developing antibtetic Resistance -Renzoyl Pervoxite on f04 st GD - ~ Salreytic acd , d= 1) Topical antibraticstt d32> dp BIS > Clogged hair Pallicles 2) Srl phos % topical oubbrstes _y ox Drpaas clogged Follicls _ 4 Sore Nda89 pall ako _6 4 auy7¥| OLD Oy w SNS) Oral treet met of Acne > USed in treatment of severe acne > 3 Tipes_ @ Antibicfics OTe ireares severe i gv inom acne ® Ise ve CEOval Antibiotics) For severe acne ~ Tetracycline to curb the — Erythvomy cn Jrouth o& Racteria - Co-tyim oXaZo\ and yveduce - Dovycycline Taf lammoation -Vimecyc ling Topical Jt ot wo Ty . thevapy Ty’ methoprim hak title chance of sulfometh oxaZele Guccess) systemic anti biti ail SYS bfoe jel bs 6 weeks Gs 5 YS de aad lids cis lSes sn Sayan Zpeph va Styl sesbel y peer + testa PE yawtt Davoren of oral oostibiatic pp e459 thevedy fe 3 months hale montervcnny Jepreal theregy Tap 2nd Ae shan o\ Foprcally claw erythromy cn Cy The mest commonly preseviged anthiche Fey acne During} Pregnancy Se ° ols hoMinocy cline 2nd- orc trmefer of _ Pregnancy why... 2 —> They couse Qenfal staming) ond Cocrmal TyPSPLESB «Gale —> Livery Toxicity im mother Ceara PrP dat tg Trimetho Pv ms ——v+ owt alate tevote jenicsty satfamethoxa Zol)—» * Rok of “Kernicterus hyperbilivubinemic neonetes Dosing of oval owt bitic) tetracycline —— + 5oo my 3B times aly ty ph A months cfs ¥s as Doky cy cline —y Jooe mg 2 times gaily Qrroths os JHB soe) Minocycline ——¥ loa my ence dosly Qmorths Os SH YI Ae Tebyacyctine [ att oF them owe Dovyeyeline Contya-in ticated imTsotvetinoin least Yasbteady sa Aull IA Cae dbig —® systemic Retinoids — © -® The mak Powerful ant - acne agent used im Severe Cose —» Severe Cystic used m Severe Case -B USed when there is Resistance to oral oantbiot, a) The only medication that effectively controls Severe cystic acne —® IT is mM extremel hp aimels Rewer Fal drug Ta stops aLl_changic_in the thet couse oye. Mechanism of Action teh 21a > KW bacteria ond yeduces inf bimmetion au aaa the Sebaceous ail glands Reducing sebum Production by up te Io” a slow uf the growth of skin cells GES siz JS aul Jxi__al Jhon ogi “W/t Lsot retinoin +r fevatogenis ufo aoAs Tsotvefinoin Cause - physical deformities — UngeveloPes OYFOnS - Blindness — mental Relerdation iat Reawt ~~ The Death of Fetus before Birth - Premofure Birth -Deoth of newborn Roby Sike effects of Tsefretinom ulcerolive colitis - Risk of DePyession -TRekef Quid juss! | seretonin levels in - Mucosa Ovyness Groin — Phofoseng iti sity - Ay Thyal gies Alf evetion of liver @rZy me Hype ceri demia aia cole ss Tsofrdbinenn 41 ot coyyan Tsotvetinoin dries out the skin SLY) 048 ple : Polms oR Han} suttl ond bleed hoTsotyefinoin ae B ISL ino &y Sw Topical gO 3 Cy couse WritdtiaoF the skin switiol dose [oS mall dey [ Pov : aes and in Cy cose os Tolerate _we Recommended Course theraPy is ZS maths 2 months after cleatone ¢ Jl zal wrth avert 7 mowths Tsobretinein gol Jn Tsetvetinoin obbsorphen a increane Oe Co-odmmsterstion with Ligids S Ce so Potients ave mstructed te take they dose with small Fatty meals, —e Turce Daly LIsctretinoin 22a ain & Roy aude 2S las $M sg 5 AIL) 6 ape alate pa Ta yeebd LO) oDe ads R—sal o 563Hormonal therapy cladlysd 2US ove contraceptives =~ Works “hy Regulativrs the - Andregens - Progest fone Ge Blocking the ePech of andreqen on the Skin ond thus reducny sebum Production Seti hormones — Estrogen —» oral Cont racephues aa othe ww Females ond Female sex herman s A \ aa Sb Qe y yoda] 423 _ oS D esty oytn PY HK Krone Ce BsUs the Producten of Androgens G \ sebum Production al) pie Gey) Bek ales apa) 6A BHO Lee SQL g Yd) GN al sb fie—= Drury that Block the ef Fe of andyoyen hoy menes on the sebaceous ghnds —e used for Women vith Severe acne —> Not Used For men Mechanism = Blods Aw dvogen vecegt ors = Rejuce adrenal andyoqen production - yeduce ovarian ondvosen Production — yeduce Ptfuitory Production oC Proladin - Inlobst G-d vedudlase DHT — 3 teshosterone te 96 od 4} Cc. strmulotes Sebum produckson E yomples : cantons = Ethmnyest vobse\ — PYoye Ky one — cypKolerone acetate =— Dros Prenone - Geto dene Zprenoladon®) eb Liar 5¥ Zo J) oy sal acetate ft ta‘incall y, Jee Uy ye Bae Ct Secsd yl poll SW fat cus dips Atne seplrapi edhe ib Iyletlels Yo Cy Teo mad Washing vill only ivritate the skin Further oh uloysen they acne Cos pela vilite heads stn \ ns biopic 7 _ wv 5 as YP woes fee teil a ‘ Tp Bin Cotati oddtianal mp amMotien ond Trlechan Sooks. Defergerts -Asfragent oy ae al ee A Sad (p Shall sebum Sadly) ges Lew _ Sedum Sat CaS wiottey- Qosed Cosmetics WG yet al ee ori_bosed Cosmehics 3) Fust | ea end! EE... withers gla lacsl ae? Yel © el Peri He Aah igs past ces poll Course of treatment se apo sly ol2 8719493 BY cst Gla on fo