Page 85 - LECTURE NOTES

N.B Intradermal rupture of sebaceous gland induces an inflammatory reaction due to

the leakage of follicle contents (Sebum, keratin, bacteria) in to the dermis.
This inflammatory response may result from the action of certain skin bacteria, such as

propoonibacterium acnes, that live in the hair follicles and break down the triglycerides
of the sebum into free fatly acids and glycerin. The resulting inflammation produces

papules, pustules, nodules, cysts or abscesses.

Management

¾ The disease is age limited, worse around puberty and subsides in early
twenties. It is controlled with treatment.

¾ Combination of therapies should be used are available to control acne

effectively
¾ Topical treatments may be all that is needed to treat mild to moderate acne.

¾ In severe cases antibiotics such as tetracycline are used to treat the problem

Surgical Treatment
¾ Consists of comedo extraction needed for cystic lesion, injections of steroids

into the inflamed lesson, and incision and drainage of large, fluctuant, nodular
cystic lesions.

Nursing management
¾ Inform patient that acne arises because of combination of factors

¾ Instruct patient to wash the face with mild soap and water twice a day to

remove surface oils and prevent obstruction of the oil glands
¾ Caution the patient to avoid scrubbing the face constantly

¾ Hair should be kept off the face and shampooed daily if necessary
¾ Inform patient that all forms of friction and trauma should be avoided

¾ Teach patient that squeezing merely worsens the problem, this may be cause
of post inflammatory hyperpigmantation

¾ Teach patient to be consistent with treatment because the problem is chronic

¾ Advise patient that cosmetics, shaving creams, and lotions can agitate acne
¾ Reassurance and emotional support, reduction of stress

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