About the author
Joseph Ezie Efoghor is a Registered Nurse, Safety Officer, Christian author and prolific writer (Platinum author on He has been touching several lives through his positive style of writing.
He is the administrator of the African Nurses Forum, a site for professional nurses in Africa and for those looking for health information. To join the forum, click on this link to get registered http://www.africannursesforum.comTo http://bloodpressureandmore.blogspot.com WHY I CREATED THIS E-BOOK
I discovered as a health professional, that a lot of people are suffering in silence because of the health challenges they are facing. Why some are too embarrassed to talk about their problems, others have complained without getting the needed help either because they are complaining to the wrong people or because the information they get is not good enough to help them.
One of the health problems teenagers and some adults are faced with is the problem of Acne or Pimples (Acne Vulgaris). This problem has actually destroyed the beauty of some young ladies by leaving nasty scars on their faces. Some are battling with cases of acne that just refused to go after series of medical treatments.
I believe this e-book would be of immense help to everyone who would read it, because the information contained herein are very useful. Following the advice in this e-book would do you a whole lot of good. You should not take your acne for granted; otherwise it would deal a considerable damage to your beauty.
You have been granted the give-away right to this e-book; therefore you can give it out as a free gift to your friends, use it to promote your sales, give it out as a bonus to your product or membership site, or simply duplicate it so long as you do not re-edit or alter any part of the book whatsoever.
ALL RIGHTS RESERVED. No part of this e-book may be reproduced or transmitted in
any form whatsoever, electronic, or mechanical, including photocopying, recording, or by
any informational storage or retrieval system without express written, dated and signed
permission from the author.
Copy right Joseph Ezie Efoghor, all rights reserved worldwide (October 2010).
Definition: Medical dictionary defines acne as ‘a disorder of the skin caused by inflammation of the skin glands and hair follicles specifically: a form found chiefly in adolescents and marked by pimples especially on the face’.
According to the science dictionary, it is ‘an inflammatory disease of the skin in which the sebaceous glands become clogged and infected, often causing the formation of pimples, especially on the face. It is most common during adolescence, but also occurs in infants and adults’.
Acne or acne vulgaris is brought about by several different causes:
1. Hormones: Increase in Androgen production at puberty causes the sebaceous glands to enlarge. The sebaceous glands become over stimulated by androgen production for years. This leads to the formation of acne.
2. Follicle shedding: Dead cells within the follicle are supposed to be shed gradually and expelled onto the skin’s surface. The follicles shed cells rapidly if you have an overactive sebaceous gland. These cells mixed with excess sebum, form a plug in the follicle and prevent the skin from completing its renewal process. The clogging of the pores, coupled with excess sebum, encourages bacteria to grow and form acne.
3. Bacteria: (Propionibacterium acnes) or P.acnes is a commensal bacterium which helps to normally maintain the skin’s sebum. But they proliferate rapidly when a follicle is plugged, leading to inflammation in the follicle and the surrounding skin.
4. Excessive sebum: Androgen stimulates the release of excess sebum which combines with dead skin from the lining of the follicles and bacteria from the skin. When excess of the sebum is produced, the chances of clogging/plugging the pores increases and results in acne.
5. Inflammation: This is the process which the body uses to defend itself against any external assault. White blood cells attack the bacteria which they perceive as intruders, resulting in inflammatory response. The outcome is redness, heat, swelling and pain or tenderness. It is usually higher in adult women.
Predisposing factors
Some factors that can trigger off acne or make already existing ones worse include:
a. Heredity/Geneticsb. Emotional stressc. Menstruation – Usually worse during mensesd. Hormones – Androgen is known to exacerbate acne Psychological effects
Acne has both psychological and emotional effects on the sufferer. There is usually loss
of self esteem as the patient’s aesthetics is affected – patients feel they are ugly,
unattractive, dirty, etc. It also causes anxiety, depression, etc. The patient’s emotional
upset create more negative impact on them than the acne creates.
Acne and stress can become interrelated – more acne causes more stress and the stress could cause the condition to worsen. It is more of a vicious cycle. Reduction in emotional stress could significantly reduce acne.
The patients should understand that the condition is treatable and should therefore see a medical doctor or talk to someone about their fears.
1. Hygiene: Personal hygiene is one of the ways to prevent acne from breaking out on your skin from time to time. Some dead skin, bacteria and excess sebum are known to contribute to acne. It is therefore advisable to keep your skin clean all the time to get rid of the dead cells and bacteria. By so doing you will reduce the possibility of acne breaking out on your skin. But excessive washing has to be avoided in order to prevent the skin from becoming over dry and irritated. Excessive dryness can provoke the skin to produce more oil which eventually leads to more acne.
2. Skin care: You have to find out the skin care regimen that is best for your skin type and adhere to it. You should not keep changing skin care regimen as this may likely cause more acne to break out. The most reliable treatment and prevention is to combine acne fighting drugs with gentle cleansers and exfoliants, which help to open up the pores as well as heal the blemishes.
You could use an oil-free moisturizer and salicylic acid or benzoyl peroxide. If applied daily, you could minimize its breakout. 3. Changes in seasons: Acne could get worse or milder depending on the weather. It is believed to be worse when the weather is hot, because of excessive sweating which leads to more oil secretion and subsequently clogging of more sweat pores.
4. Avoid Chlorinated water: Swimming in the swimming pool could expose your skin to chlorine, leading to excessive skin dryness. This could cause a chlorine-provoked type of acne known as chloracne to break out.
5. Avoid certain Sunscreens: Sunscreens with oily base can also worsen your condition. If you must use sunscreen, you have to use the oil-free ones.
6. Avoid pressing, scratching, squeezing and popping, as they tend to worsen acne How you can help yourself
In as much as you need the help of the doctor or dermatologist to get rid of your
troublesome acne, there are things you could do yourself to lessen the effect of the
1. Pore strips: Some pore strips are now available in the pharmacies which you could put on your forehead, chin, nose, etc. to help bring out the oil from the pores on your face and nose. They are safe and inexpensive; and should be done by yourself at home.
2. Cosmetics: Some flesh-tinted cover-ups are also available to camouflage your blemishes or blackheads. The water-based ones are recommended since they do not in any way block the pores. They should also be non-comedogenic and non-acnegenic.
3. Facials: Steaming and deep-cleaning the pores may also help to relieve the discomfort for those with ‘whiteheads’ or ‘blackheads’. They can be done alone or in conjunction with other medical treatments.
For more information on how you can take care of your health, visit our forum and register to get our resources at Treatments
Acnes don’t go away so easily; so when choosing your regimen you have to look for
treatments that take care of both your current blemishes and the ones that are forming
inside the pores. When you start your regimen, you must be patient and give it some time
to work.
Some of the products used in the treatment help to destroy the bacteria; some help to
reduce the inflammatory process, while others help to remove blockages and keep the
pores open.
Some of the regimens used include Tetracycline, Benzoyl peroxide, Salicylic acid,
Isotretinoin, Adapalene (Differin), Contraceptive pills, Laser acne treatment, Sulphur
treatment, Tretinoin, etc.
Tetracycline is one of the oral antibiotics that could be prescribed by your dermatologist
for the management of acne. Others include Erythromycin, Minocycline and doxycycline.
Other antibiotics like Amoxillin and Cefadroxil are also useful. They target the bacterium
(Propionibacterium Acne) which is responsible for acne development. These could either
be successful as single treatment, or combined with benzoyl peroxide for a better result.
Combine therapy is favoured because they help to reduce the incidence of bacterial
resistance. It is advisable not to take the antibiotics for a very log time. Tetracycline
therapy is usually for several weeks; stopping it without consulting your doctor could
make your condition get worse.
Benzoyl peroxide is one of the oldest, trusted and most commonly used remedies for mild
to moderate acne. It is very safe especially for teens and adults. Its result is best when
usually combined with topical prescriptions. It has multiple actions on the problem by
helping to prevent and treat acne breakouts – it actually targets the P. acnes living on the
skin and inside the pores. It also reduces inflammatory lesions and oil secretion.
Resistance is usually not a problem with benzoyl peroxide. It takes up to about 3 weeks
before results are usually noticeable. You have to start slowly on alternate days until your
skin adjusts to treatment; this helps to prevent irritation. Mild concentration of about
2.5% or 10% of benzoyl peroxide is usually okay, and they are less irritating to your skin.
Salicylic acid is useful for the treatment of mild acne, oily skin and post-inflammatory
hyperpigmentation which makes those acne areas darker than other skin after recovery. It
is a mild form of acne treatment which can be found over-the-counter; usually at a
concentration of 2%. It is chemically related to Aspirin and it works by penetrating the follicle and dislodging the comedomal plug that is on the lining of the follicle. It works majorly by promoting the sloughing off of dead skin cells (Keratolytic agent). It also helps prevent lesions. Salicylic acid is to be continued for a long time even when the acne lesions have healed; this helps to prevent clogging of the pores. The side effects are usually mild and less irritating than benzoyl peroxide. Some of the side effects include dryness and skin irritation. If dryness occurs, use a light oil-free moisturizer to reduce the scaly skin. Decrease the frequency of application if irritation occurs; but if irritation increases, discontinue its use.
Some of the ways to reduce irritation is to avoid using salicylic acid with alcohol-containing products, abrasive soaps, soaps that dry the skin, topical skin medicines, medicated cosmetics and other topical acne remedies which contain sloughing agent e.g. benzoyl peroxide, tretinoin, sulphur or resorcinol.
Caution should be applied in pregnancy since it may be potentially harmful to the baby. It is best to see the doctor before commencing treatment if you are pregnant since its safety is not fully guaranteed.
Salicylic acid could come in the form of creams, lotions, medicated pads or alcohol-based solutions. You need to be sure which is best for your skin before employing it for your treatment.
Isotretinoin is a retinoid or a derivative of vitamin A, which is used in the treatment of
cystic acne or acne that is poorly responding to other treatments. It is used in the
treatment of severe forms of acne when other treatments employed have failed to control
the condition.
It works by inhibiting the function of the sebaceous gland thereby preventing it from producing more oil. It prevents the formation of comedone by evening the process of sloughing off of old skin cells.
It can only be obtained through the prescription of a dermatologist, and is usually not available over the counter because of its severe side effects. Isotretinoin was usually sold as Accutane ®, but that has now been taken out of the market by the manufacturer. Other generic names now include Amnesteein ®, Claravis TM or Sotret ®.
Side effects of isotretinoin include: Headache, fever, dry skin, bone pain, hair loss, itching, tiredness, sweating, nausea and vomiting. Some severe side effects may be caused by allergic reaction to the drugs; and they include Hives, rashes, swelling of the lips; hearing loss, bleeding, visual changes, heart attack, voice changes, dizziness, etc. Should any of these side effects occur, the drug should be discontinued immediately and your doctor should be contacted.
Warning: Isotretinoin is not suitable for pregnant or breastfeeding mothers, and for those
planning to become pregnant soon. It increases the chances of spontaneous abortion,
congenital abnormalities and premature births. The doctor must be consulted before
treatment is commenced.
Note: Isotretinoin is usually prescribed for about 5-6 months. Therefore, hepatic function
tests should be carried out monthly to help monitor the liver function and the triglycerides
level to ensure they are not on the rise during treatment.
ADAPALENE (Differin)
Adapalene is a topical retinoid which is similar to vitamin A; it is useful in the treatment
of acne. Its mode of action is not well understood; though it is believed to alter the
growth of skin cells thereby reducing the possibility of acne breakouts. It is only
obtainable on doctor’s prescription.
Adapalene comes in the form of gel or cream, and is sold as Differin ®. Some of its notable side effects are dryness, itchy skin, irritation, sensitivity to the sun (ultra-violetrays) and more acne flare-ups.
Caution: There is no conclusive evidence that Differin is teratogenic. However, its safety
during pregnancy is not guaranteed; it is best to consult your doctor before using it if you
are pregnant. Differin must not be used in combination with other acne medications
except you are instructed by the doctor to do so.
A combination therapy of adapalene and benzoyl peroxide (Epiduo gel) is also very effective. It’s approved by the FDA for once daily treatment of patients that are 12 years old and above.
Excessive production of the male hormone Androgen could cause acne in some females.
With excess androgen produced by the ovaries, the production of oil by the sebaceous
glands increases, thereby leading to increase acne break-outs.
Most times, androgen-induced acnes are usually resistant to treatments. When this is the
case, it would be important for your doctor to determine the root cause of the problem.
Some of the questions your doctor might want to answer include:
 If your acne started with puberty.
 If you suffer from irregular menstrual cycles.
 If there is increase in your acne flare-ups prior to your menstrual cycle.
 If you have hairs in unusual places or if you have excessive hair growth  If your blood test reveals you have too much androgen.
The doctor would suspect your acne is related to excess androgen if you have one or more of the above symptoms. If that is the case, your doctor may prescribe a birth control (oral contraceptive) pill for you. The oral contraceptive pills taken in low doses help to reduce the effect of androgen that is produced by your ovaries.
Though Ortho Tri-cyclen ®, Estrostep ® and Yaz are already approved by the FDA for the treatment of acne, newer progestin agents which include Desogestrel and Norgestimate are known to be effective; and also less androgenic. Medical experts believe that low-dose contraceptives are helpful in improving acne.
While oral contraceptives help to suppress the androgen produced by the ovaries, anti-
androgen drugs actually inhibit or prevent your ovaries and adrenal glands from
producing androgen. They also check existing androgen from stimulating the sebaceous
glands to produce excess oil.
One of the drugs with anti-androgen properties is Spironolactone, a drug commonly employed in the management of hypertension. Spironolactone helps to control androgen-induced acne by blocking androgen receptors. However, it also has some side effects which include menstrual irregularities (if you are not on oral contraceptive pills), breast tenderness, fatigue, headaches, and increase potassium levels in the blood stream. Patient may also experience excessive or frequent urination since spironolactone is a diuretic.
Caution: Spironolactone is a known teratogenic agent which is able to disturb the growth
and development of the foetus. It can also cause feminization of a male foetus. It is
therefore important to consult your doctor or gynaecologist before taking the drug if you
are a woman within the child-bearing age.
Some corticosteroids are able to suppress androgen produced by the adrenal glands and
also reduce inflammation when taken in small doses. Some of them include prednisolone
and dexamethasone. Better result could be achieved if they are combined with oral
contraceptive pills for the treatment of hormone or androgen-induced acne. However,
some of the patients have actually noticed an aggravation in their condition with the use
of corticosteroids. It should therefore be used under medical supervision. Doctors also
inject some forms of cortisone into large pimples and cysts in order to flatten them out.
Sulphur is used in the treatment of mild-to-moderate acne flare-ups. It has actually been
in use for over fifty years. Its mode of action is not fully understood. It is however
believed to interact with a substance in the top layer of the skin thereby causing a
keratolytic effect similar to that produced by salicylic acid.
Sulphur can be obtained as both prescription, and over-the-counter preparations. Because of its pungent smell, it is seldom used alone. The side effects of sulphur are usually mild.
Other Topical (external) applications
Some antibiotics or antobacterials are also available for topical skin treatment of acne;
and they include Azelaic acid (Azelex), Clindamycin (Benzaclin, Duac), Erythromycin,
and Sulfacetamide (Klaron).
There are also natural remedies which have been tested and proven to take good care of
acne. Their side effects are usually very mild and they are not toxic to the body, unlike
some of the drugs which are synthesized artificially and their chemical constituents are
toxic to the body system.
To get the natural cure for your acne, click here to order for your “Acne free in 3 days
Management of Scars
Some patients who were treated for acne got cured but some permanent scarring
remained on their faces. This scarring can be a source of concern (for aesthetic reason).
These scars can be removed by surgery to elevate deep and depressed scars. Laser
resurfacing could be employed to smooth out the smaller scars.
Fractional resurfacing, which is the newer form of laser resurfacing could really be helpful because they are less invasive, and they also heal faster than the older methods. They may need to be repeated up to three or more times in order to achieve a better result.



Stephen M. DeBock536 Ridgeview CourtToms River, NJ 08753(732) 286-2169 (H)(732) 462-1156 (W) MEDIA POLLUTION: A Survival Course Designed by Stephen M. DeBock Simple test for power of advertis ing: how easily are youinfluenced? Is one or more of the following in your medicineAll aspirin is 5 grains of acetylsalicylic acid. Bayercosts more because it advertises more. Would you want to b

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