Different types of Acne Vulgaris and Its Homoeopathic Management

Dr Nandini J D 

This article reviews about etiology, types, pathogenesis, causes, diagnosis, general and Homoeopathic management of Acne.

INTRODUCTION
Acne vulgaris is one of the most common skin disease worldwide, affecting all ethnicity and races. The highest prevelance of acne occurs in adolescent.

SYNONYM AND INCLUSION

• ACNE VULGARIS
• COMEDONAL ACNE
• PREPUBERTAL ACNE
• NODULOCYSTIC ACNE (ACNE CONGLOBATA)
• ACNE FULMINANS

VARIANTS OF ACNE

• ACNE FULMINANS
• ACNE CONGLOBATA
• COSMETIC ACNE
• OCCUPATIONAL ACNE
• DRUG-INDUCED ACNE
• ACNE ASSOCIATED WITH PSYCHOLOGICAL PROBLEMS

1. ACNE EXCORIEE
2. BODY DYSMORPHIC DISORDER
3. EATING DISORDER

• GRANULOMATOUS ACNE
• ACNE MECHANICA

ETIOPATHOGENESIS
Acne vulgaris is a multi-factorial disorder, which has genetic association, individuals with excessive sebum production between 7-8 years of age (adrenarche),.

Follicular hyperkeratinisation and comedone formation and microbial colonization with Propionibacterium acnes which is aerobic diptheriod.

CAUSES

• Oils
• Facials and cosmetic use
• Friction and pressure
• Pregnancy
• Psychological stress
• Sunlight
• Diet- consuming high glycemic index foods and skimmed milk.

CLINICAL FEATURES AND DIAGNOSIS

1. AGE GROUP

• Occurs in adolescence and in either of sex, due to increase in hormone testosterone.
• They usually decrease by the age of 25.

1. SITE

• Affects the skin having maximum of sebaceous follicles, face, back, and upper part of chest, shoulders and upper arms.
• COMEDONES– a) Open Comedones- Blackheads represent domeshaped filled with keratin.

b)Closed Comedones-Whiteheads are 1mm in diameter, skin coloured and no visible opening.

       3. INFLAMMATORY LESIONS

• PAPULES- Conical <3mm size and has pore at summit.
• PUSTULE– Due to intense inflammation
• NODULES– measure 4mm in size, larger and  are tender. They become fluctuant—cystic—abscess forms—sinus tracts develop.
• Later SCAR and HYPERPIGMENTATION

1. THE COMPREHENSIVE ACNE SEVERITY SYSTEM

TREATMENT USED IN CONVENTIONAL MODE OF MANAGEMENT

• Topical benzoyl peroxide
• Topical retinoids
• Topical antibiotics
• Hormonal therapy with Oral Contraceptives
• Azelaic acid and salicylic acid
• Dapsone
• Laser treatment

MANAGEMENT

1. GENERAL

• Wash face frequently with warm water using mild soap.
• Avoid scrubbing the skin when cleansing.
• Avoidance of chocolate or sugar consumption.
• Avoid use of cosmetics, and removal of cosmetics before sleep
• Drink plenty of water
• Don’t prick or squeeze acne lesions.

1. HOMOEOPATHIC REMEDIES BASED ON THEIR CAUSE, ONSET, LOCATION AND  APPEARANCE INCLUDE

BASED ON ONSET

• Acne, From abuse of KI: Aur
• Acne, From abuse of mercury: Kali-i.,Mez.,Nit-ac.
• Acne, From cheese: Nux-v.
• Acne,From syphilis: Aur., Kali-i.,Merc.,Nit-ac.

BASED ON THEIR ONSET, LOCATION

• Acne, In anemic girls at puberty, with vertex headache, flatulent dyspepsia, better by eating: Calc-p.
• Acne, In drunkards: Ant-c.,Bar-c.,Led.,Nux-v.,Rhus-tox
• In fleshy young people with coarse habits, bluish red, pustules on face, chest, shoulders: Kali-br
• Acne, In scrofulous: Bar-c.,Brom.,Calc., Calc-p.,Con.,Iod.,Merc.,Mez.,Sil.,Sulp.
• Acne, In tubercular children: Tub
• Acne, With Cachexia: Ars.,Carb-v.,Nat-m.,Sil.
• Acne, With gastric derangements: Ant-c.,Carb-v.,Cimic.,Lyc.,Nux-v.,Puls.,Rob.

BASED ON THEIR APPEARANCE

• Acne, with glandular swellings: Brom.,Calc-s.,Merc
• Acne, with indurated papules: Ars-i, Carb-an., Eug, Iod., Kali-br.,Kali-i., Nat-br., Nit-ac., Sulp.
• Acne, with menstrual irregularities: Aur-m-n.,Bell.,Bell-p.,Berb.,Berb-a.,Calc.,Cimic.,Con.,Eug.,Kali-i., Kali-br., Psor.,Puls.,Sang., Sars., Verat.
• Acne, with pregnancy: Bell., Sabin., Sars.,Sep.
• Acne, with symmetrical distribution: Arn
• Acne, with scars: Carb-an., Kali-br

REFERENCE

1. Burns T, Breathnach S, Cox N, Griffiths C. Rooks textbook of dermatology. 7th ed. Volume 3. Blackwell Publishing Ltd.
2. Fauci As, Kasper DL, Braunwald E, Hauser SI, Jamesson JL, Loscalzo J, Harrisons Principles of Internal Medicine. 19TH ed. Volume 2. New York  MCGraw Hill.
3. Douglas ME. Skin Disease Their Description, Etiology, Diagnosis and Treatment. B Jain Publishers Ltd.
4. Davidson. S Davidson  Principles and Practice of Medicine, 21^ST ed, London,UK,Churchill Livingstone,Elsevier.
5. KV Das Krishna Textbook of Medicine. 5^th ed.Jaypee Brothers Medical Publishers Ltd.
6. Boericke William, New Manual of Homoeopathic Materia Medica with Repertory. Bjain Publishers Ltd.
7. Allen HC, Allen’s Keynotes Rearranged & Classified. B. Jain Publishers. 2002.
8. Kent JT, Repertory of Homoeopatthic Materia Medica. B.Jain Publishers.1992

Dr. Nandini J D
PG Scholar, Department of Practice of Medicine
Government Homoeopathic Medical College & Hospital, Bangalore.
Under the Guidance of Dr. P D Praveen Kumar
Professor & HOD Department of Practice of Medicine.