Acne medicamentosa

What is Acne medicamentosa ?

Acne medicamentosa (generally recognised as drug-induced acne) is acne triggered or irritated by drug or medication.

Acne is a skin condition of the pilosebaceous units triggered by hormones, therefore any medication that induces and stimulates acne medicamentosa allows man-made hormones to manifest in the human body e.g. Corticosteroids

The pilosebaceous unit is made up of the hair follicle with the hair shaft, sebum produced by the sebaceous gland, and the arrector/erector pili muscle which allows the hair to rise up when it contracts.

Some over-the-counter drugs, prescribed medication and alternative medication can cause acne medicamentosa. This can be a frustrating and unpleasant side-effect, if the medication has to run its course over a period of time, or especially for people that have never had acne before. Nevertheless, drug-induced acne will disappear once the drug or medication usage seizes and stops. On the other hand, if the prescribed drug is extremely important to the good health and well-being consult a medical/family doctor and discuss alternative options that could reduce the prevalence of acne.

Chemistry and body tolerance varies, hence, what triggers acne medicamentosa in one sufferer may not do the same and trigger a breakout in the other. This is because the human body reacts in different ways to different medical treatments. There is also the possibility that it could be an allergic reaction. Hence, always consult a medical expert if in doubt.

What causes Acne Medicamentosa?

Anticonvulsants

Certain anticonvulsant drugs also known as anti-seizure or anti-epileptic drugs such as Dilantin have been prescribed for seizures and epilepsy. The side-effects of long-term use of Dilantin/Phenytoin may include acne, facial coarseness and hirsutism.

Anabolic-Androgen Steroids

These type of drugs like Danazol and Stanozolol have been know to be used in athletics and in body building. It is typically used to enhance body mass and build muscle. It is also used to boost strength, stamina and performance. The drug is known for its side-effects and wide-spread use and abuse. Male users may suffer from acne on the shoulders, chest and back while female users may suffer from acne on the face.

Barbiturates

This is a sedative-hypnotic type of drug, described as sleep-inducing and anxiety-decreasing. Hence, a type of central nervous system depressant that may cause relaxation and sleepiness. Generally prescribed for anxiety and emotional stress as a sedative to patients. Nevertheless, it can be very addictive and therefore only prescribed as a last resort. The drug can be very effective in treating anxiety and stress but it may also cause acne. They are also effective as anxiolytics, hypnotics and anticonvulsants.

Contraceptives

Hormones have a direct link to acne. Therefore, contraceptives may be prescribed by doctors to control acne breakouts. This is because the contraceptives can have an effect on the balance of the body's hormones.

However, the usage of contraceptives may occasionally cause acne because, as alluded to earlier, it deals with hormones. Nevertheless, under normal circumstances, ladies with acne challenges, beforehand, will discover that contraceptives can tackle acne, but this is not necessarily the situation for some ladies.

Oral contraceptives contain both progestin and estrogen hormones. While estrogen is reasonably stable between brand names of contraceptives, there are a number of unique variations of progestin and therefore, each one of these may have a completely different impact and influence on the human body.

Estrogen – American English

Oestrogen – British English

Oral contraceptives that have the type of progestin that boosts the androgen (male hormone) levels in women and have a low estrogen content are more likely to make acne worse.

Most females, with acne, may discover that acne gets better with the use of oral contraceptives. However, the tendency toward androgenicity in some females may aggravate and cause acne breakouts.

Corticosteroids

These are man-made hormones commonly used to tackle skin disorders and ailments such as eczema and hives. However, because the bodily hormones generally tend to be the major cause of skin disorders like acne, corticosteroids are similarly seen as a cause of drug induced acne.

How does corticosteroids work?

Corticosteroids replicate the reaction of bodily hormones that the body generates naturally in the adrenal glands, which is found on top of the kidneys. Whenever the prescribed dose of corticosteroids surpasses the body's normal levels, it inhibits inflammation, which could minimise the symptoms and signs of inflammatory conditions like asthma and arthritis.

It can suppress the immune system and help control conditions in which the body's immune system mistakenly attacks its tissues. It can be administered topically, by mouth, by injection, by an inhaler and by intranasal spray.

Corticosteroid medication like Hydrocortisone, Prednisone and Cortisone could be used to treat chronic lung disease and asthma. Just like cortisol (known as 'the stress hormone', a natural steroid produced by the body during times of intense stress), corticosteroids can encourage sebum production and cause acne medicamentosa and blemishes.

Systemic Steroids

Systemic steroids are man-made versions of the body's natural steroid, known as cortisol. Cortisol is normally created by the adrenal glands; systemic steroids are used to replace or supplement cortisol. Some of these steroids are Dexamethasone, Betamethasone, Hydrocortisone, Methylprednisolone, Prednisone, Triamcinolone, Prednisolone. Whilst systemic steroids may be beneficial for certain types of skin conditions, it may, also cause acne medicamentosa in other patients.

Dehydroepiandrosterone (DHEA)

This is an anti-ageing hormone used as a steroid hormone, popularly used as a nutritional and health supplement. Some of the health advantages include an improved memory, a stronger immune system, the ability to lose weight and a leaner muscle mass.

DHEA is transformed into testosterone by the body and as a result the body starts to produce more hair which tends to cause the pores to become clogged and eventually lead to acne medicamentosa and breakouts.

Immunosuppressants

Imuran/Azathioprine is an immunosuppresant that can be used to restrain the body's defence and auto-immune system in patients waiting for an organ transplant. It may help prevent organ rejection. It may also suppress the body's natural ability to resist and tackle the bacteria that causes acne.

Lithium

Lithium is a mood stabilising drug that physicians usually prescribe for people stricken by bipolar disorder or manic depression. When taken it helps to calm nervousness and control the communication between brain synapses. Nevertheless, some patients that take lithium have found that it causes acne outbreaks that may occur on the chest and back. It is an excellent drug for restoring good mental health but in return it may aggravate an acne medicamentosa breakout.

Sobriety Medication

For people that are alcohol dependent and recovering alcoholics sobriety medication may be prescribed by physicians to help break a drinking habit. Antabuse (commonly called Disulfuram) is a prescription medicine that is intended to help alcoholics stop drinking. The regular use of Antabuse has been known to cause acne medicamentosa in some of its users.

Thyroid Medication

The thyroid gland is a gland positioned beneath the voice box (larynx) that releases the thyroid hormone. The thyroid supports and controls growth and the metabolic process. Some thyroid medication like Thiouracil and Thiourea have been known to cause acne. Such thyroid preparations have been used to invigorate the thyroid gland in patients with low thyroid function. Large amounts of iodine, which also helps to regulate the thyroid function, can also cause breakouts.

Cosmetics

Acne triggered by cosmetics is known as acne cosmetica. This type of acne is caused by the use of cosmetic products. It is not as a result of the normal natural process that creates acne. Acne cosmetica is characterised by a rash of small pink bumps on the cheeks, chin and forehead, this skin disorder slowly intensifies and may or may not be temporary, depending on how the product aggravates the acne.


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