It is an inflammatory disease of the skin which is caused by the changes in the pilosebaceous units. They are also commonly referred to as zits or pimples.   It generally occurs in puberty as a result of an abnormal response to normal levels of hormones. It generally diminishes over a period of time or may tend to decrease when a person enters in his early twenties. This skin disease affects a significant percentage of human beings at some point of their lives.

Cause

Up till now the cause of acne is not known. The condition is partially also termed as hereditary. A number of factors can result in acne which is mentioned below:

·           Stress which results in increased secretion of hormones from the adrenal glands.

·           Hormonal activity. For e.g. menstrual cycles

·           Using anabolic steroids

·           Hyperactive sebaceous glands

·           Bacteria

·           Dead skin cells accumulating

·           Using any medications which contain androgens, barbiturates, halogens and lithium.

Up till now hormone driven over production of sebum was considered to be the major factor behind acne but now narrowing of follicle channel is also being considered as the second major contributing factor.

Symptoms

Acne vulgaris is the most common form of acne. There is an extreme secretion of oil from the glands which combines with natural dead skin cells to block the hair follicles.  Skin bacteria Propionibacterium acnes multiply uncontrollably when oil secretions build up under the blocked pores. As a result the skin inflames producing visible lesions. It mainly affects the back, chest, face, upper arms and shoulders.

The distinctive lesions are inflammatory cysts, comedones, nodules, papules and pustules. They are in an inflamed form of pus filled or red colored bumps. Apart from causing scars, it affects a person physiologically resulting in depression and reduced self esteem.

Treatment

Although a number of products are sold in the market which claim to cure acne but they don`t have any scientific backing.  A combination of treatments when undertaken reduces the amount and severity of acne in a number of cases. Since these treatments are accompanied with side effects therefore a greater degree of monitoring is required.

There are a number of treatments which have been found out to be effective:

Skin Exfoliation

It can be either done mechanically or using an abrasive cloth or a liquid scrub or chemically. Some visible flaking is possible depending upon the type of exfoliation used. Anti-acne topicals and moisturizers containing chemical exfoliating agents can be brought over the counter.

Topical Bactericidal

These are widely available OTC bactericidal products which contain Benzoyl peroxide for minimizing acnes. There are other antibacterial which include chlorhexidine gluconate or triclosan but they have been found to be less effective.

Oral antibiotics

The commonly used antibiotics are erythromycin or one of the tetracycline antibiotics.

Hormonal treatments

In case of females, acne can be improved with the help of hormonal treatments.  It has been found out that the anti-testosterone Cyproterone in combination with an estrogen Diane 35 has been found effective in reducing androgenic hormone levels.

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