Acne

Acne refers to a common skin disorder that affects hair follicles and sebaceous glands, resulting in expansion and blockage of the follicle and overall inflammation of affected areas.

Both males and females are equally affected by acne. Adolescents and young adults are affected the most: 85% of 16-18 year-olds have acne. In rare cases, other age groups can also be affected.

Acne is caused due to a combination of different factors. The actual mechanism has not been discovered yet. However, it is believed that acne can be caused due to acne bacteria, family history, endogenous and exogenous androgenic hormones, innate immune activation with inflammatory mediators, and distension as well as occlusion of the hair follicles.

The flares of acne can be provoked by the application of occlusive cosmetics, different drugs (e.g. hormones, steroids, and anticonvulsants), high environmental humidity, and a diet high in dairy products.

The most common site of acne is face, but neck, back, and chest can also be affected. The common features include inflamed papules and pustules, open and closed uninflamed comedones (blackheads and whiteheads), and post-inflammatory erythematous or pigmented macules and scars. Severe acne is characterised by modules and pseudocysts.

Any type of acne results in adverse social and psychological effects. For example, some patients can develop self-esteem and body image issues. Some may feel embarrassed to make any eye contact with their peers. Girls with acne tend to wear heavy make-up in order to cover rashes and pimples, even though extensive make-up usage provokes even more acne. Truncal acne can greatly reduce one’s participation in sports like swimming and rugby. There may be social withdrawal and relationship building problems too. Some individuals may find it extremely difficult to form friendships and relationships with their peers due to a lack of confidence and concern to cause a negative impression among others.

Acne is classified as mild, moderate, and severe. Mild acne refers to less than 30 lesions. Moderate acne refers to 30-125 lesions. Severe acne refers to more than 125 lesions.

In most cases, tests are not necessary to diagnose acne since its features are pretty evident to specialists. In some cases, features may be atypical which requires physicians to perform skin swabs for culture and microscopy. Female patients may be requested to do hormonal tests.

Acne treatment varies from one patient to another. Moreover, it also depends on its severity: mild, moderate, and severe types have their own treatment options.

Mild acne can be treated with topical antiacne agents, such as benzoyl peroxide, tretinoin, or adapalene gel. Low-dose combined contraceptives can also be prescribed. Antiseptic or keratolytic cleansers with salicylic acid are highly recommended. Lastly, laser treatment sessions can greatly reduce acne.

Moderate acne can be treated with tetracycline: usually 50-200 mg of daily dosage is prescribed for 6 months. Women who do not respond well to low-dose combined oral contraceptives may be recommended antiandrogen therapy combined with long-term cyproterone acetate and ethinylestradiol.

Severe acne can be treated with oral antibiotics in high doses for six months or longer.

Overall, acne treatment is quite complex. There are different ways and methods that are unique to each case.

Centre for Medical and Surgical Dermatology offers unique and personalized acne treatment options for each patient. For more information on acne condition, visit the following link:

Acne

For non-medicamentous options for treating moderate and severe acne, visit the following link:

Non-medicamentous options for treatment moderate to severe acne and acne scars

For acne scarring removal, visit the following links:

Energy-based techniques

Non-energy based techniques