Acne is a common chronic skin disease involving blockage and inflammation of pilosebaceous units (hair follicles and theirs accompanying sebaceous gland).

It can cause long lasting and detrimental psychosocial and physical effects. It is associated with depression and anxiety, regardless of disease severity. Furthermore, acne may cause permanent scarring that is difficult to correct.

It can be presented as:

• Non-inflammatory lesions: white head and black head
• Inflammatory lesions: papule, pustule, nodulse, cystic
• Mixture of inflammatory and non-inflammatory lesions

Causes / Pathogenesis:

• Follicular epidermal hyperproliferation
• Excess sebum production
• Presence and activity of commensal bacteria P Acnes
• Inflammation

Diagnosis:

• Comedonal acne
• Mild acne
• Moderate acne
• Nodulocystic acne (severe)

Management:

Treatment should be directed toward the known pathogenic factors, including:
–    Topical creams of tretinoin, adapalene, isotretinoin
–    Antibiotics
–    Estrogen/progestin combination contraceptive pills
–    Acne products: BPO benzoyl peroxide, erythromycin, clindamycin
–    Low glycemic diet & avoidance of junk foods
–    Manual extraction of comedones
–    Intralesional steroid injections
–    Superficial chemical peel (glycolic or salicylic acid)
–    Laser therapy: Dual Yellow laser, Q-Switch Nd:Yag