An individual with
acne vulgaris usually presents with a history of difficult spots, most commonly affecting the face, shoulders, back, and chest. The individual is most commonly a teen or young adult, however acne can occur for the first time in later life, for which an effective acne vulgaris treatment is going to be essential.
The doctor will examine all impacted areas of skin including the shoulders and back. The skin as well as hair may have an oily texture and appearance. With regards to the severity of the acne, there may be non-inflammatory comedones, inflamed papules or pustules, or a combination of both. For all of these a completely different acne vulgaris treatment is going to be required.
- Closed comedones (whiteheads) appear as raised bumps on the skins surface, and are skin-coloured or somewhat reddened.
- Open comedones (blackheads) have a characteristic black 'plug' caused by oxidised oil and dead skin cells.
- Papules are small, circular or oval, inflamed (red), raised elevations of the epidermis.
- Pustules appear like papules, but have a central pocket of pus.
- Nodules are poorly demarcated swellings which are usually red and tender. They may be fluctuant on palpation. In extremely severe acne, nodules may track together as well as create large, deep sinuses (acne conglobata).
- Haemorrhagic acne is caused by bleeding inflammatory lesions, and could be very painful and distressing.
The physician will look for proof of scarring as well as hyperpigmentation.
Scarring may occur when acne heals, specially when nodules have been present. It is most commonly atrophic in nature, leading to the formation of 'ice-pick' scars or 'pock marks'. Hyperpigmentation might occur after acne resolves, especially in those with darker complexions. When the features are atypical of acne vulgaris, consider the possibility of a serious form or clinical variant of acne.
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