Acne is a skin condition usually related to hormonal changes at puberty. The oil-producing sebaceous glands in the hair follicle over-produce sebum, which, together with dead skin, block the pores in the skin. These cause skin blemishes like whiteheads (enclosed blockage within a hair follicle) and blackheads (when the plug of sebum and skin cells is pushed to the skin surface). Spots can also become inflamed and infected, causing pustules and cysts.
Inflammatory skin condition
Inflammatory skin conditions are caused by an overactive immune system. Symptoms range from mild with itching, redness, and discomfort to severe with blisters, scaly patches of skin, and weeping sores. They include:
- Eczema, also known as atopic eczema or atopic dermatitis, is an inherited condition that is closely linked to asthma and hay fever. Eczema is usually found in elbows, behind the knees, and on fingers. It causes a rash that becomes red and itchy and can be made worse by factors like chemicals on the skin or dry, humid weather.
- Dermatitis is red, itchy, swollen patches of skin usually caused by direct skin contact with an irritant like solvents and harsh chemicals, or in response to an allergic trigger like perfume, latex or nickel
- Psoriasis is a non-allergic autoimmune condition, where the immune system attacks self, and it causes dry patches of thickened scaly skin over the body.
Rosacea and scabies
Rosacea is characterised by a red rash found mainly on the face. It is an inherited disorder but is also made worse by factors like sun exposure, cold temperatures, strong winds, some medications like steroids, certain foods, cosmetics, and stress.
Scabies is caused by an allergic reaction to the parasitic mite Sarcoptes scabiei that burrows into the skin, causing irritation and itching. A rash can develop over the whole body resulting in severe itching and discomfort.
Rosacea symptoms can be exacerbated (made worse) by scabies, which is thought to trigger inflammation.
Fungal skin infections
Fungal infections of the skin caused by tinea can affect many parts of the body. These include between the toes (athlete's foot), ringworm of the body (tinea corporis), tinea of the groin and tinea of the scalp (tinea capitis). Candida is a yeast-like fungus that infects mucous membranes, usually in the mouth, throat, and genitals. It is commonly referred to as thrush, which is seen as white patches in the mouth that can become painful. Symptoms of fungal infections of the skin include inflammation, itching, and rash, which can become severe.
Unwanted growth of facial hair in women is called hirsutism. It is often associated with high levels of androgen hormones in conditions such as polycystic ovary syndrome (PCOS).
Topical treatments for skin conditions
- Topical antibiotics like dapsone are used to treat acne to help clear blemishes and prevent the spread of bacterial infection from an infected spot.
- Retinoids like tretinoin are used to treat severe acne by reducing inflammation. Retinoids are keratolytic and work by softening hardened cells that clog pores. They also promote new cell growth to help heal skin blemishes.
- Azelaic acid has antibacterial and keratolytic properties and is used to treat mild acne.
- Topical corticosteroids like desonide and clobetasol are used to treat inflammatory skin conditions like eczema, dermatitis, psoriasis and rosacea. They work by blocking inflammation and reducing irritation so that the skin can heal.
- The anti-parasitic ivermectin is used to treat scabies and rosacea, where high numbers of scabies parasites have invaded the skin, causing inflammation.
- Antifungals like terbinafine are used for fungal skin infections like tinea and candida.
- Eflornithine reduces the production of unwanted facial hair in hirsutism by blocking an enzyme in hair follicles of the skin that stimulates hair growth.