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1. The General

What is acne and what causes it?
Acne is the most common skin problem amongst adolescents and most teenagers.

The hair pores in the skin contain sebaceous in oil glands. These glands make sebum, which is an oil that lubricates hair and skin. Most of the time the glands make the right amount of sebum, and the pores are fine. But sometimes a pore gets clogged up with too much sebum, dead skin cells, and even bacterial germs, and acne can develop. In such cases a whitehead is usually formed. The material may turn black, and a blackhead or comedone occurs.

Often these discharge onto the skin spontaneously or when a little pressure is applied, however some can remain closed. In such cases as further sebum is produced the comedone becomes larger and a pustule may form. If the pustule continues to grow, a painful cyst may develop. This may penetrate into the deeper layers of the skin and leave unattractive scars after being emptied out.

Acne develops on those areas of the skin where sebaceous glands are most numerous: the face, scalp, neck, chest, back, upper arms and shoulders. Bacteria are often present in acne lesions. However, acne is not infectious. It is due to an interaction of normal skin bacteria associated with the overproduction of sebum.

If a pore gets clogged up, closes, and bulges out from the skin, people are left with a whitehead. If a pore gets clogged up but stays open, the top surface can darken and people are left with a blackhead. Sometimes the walls of the pore are broken, allowing sebum, bacteria, and dead skin cells to make their way under the skin - and people are left with a small, red infection called a pimple. Clogged up pores that open up deep in the skin can cause cysts, which are infections that are bigger than pimples.

Why do so many people get acne?
People get acne because of all the hormones that come with puberty. As body begins to mature and develop, these hormones stimulate the sebaceous glands to make more sebum, or oil, and the glands become overactive. When there is too much sebum, it clogs the pores and leads to acne.

Clinical manifestations:

1. comedo type: at beginning it manifests similar to gravel white rice or metuliform-shape white papules. Later from the top black spots emerge.
   
   
2. papular-pustular: red papules, within it there forms central pustular undergoing a swollen boil change, occurring repeatedly.
   
   
3. artificial dermatitis type: papular-pustular acne, due to squeeze, scratch or pressure, undergoes skin erosion, leading to purple scar left.
   
   
4. cyst type: in addition to the general papule, pustules, there are a variety of cystic detriment which leads to the formation of scar or the swelling on the skin

The Origin of Acne
The only real cause of acne is overactive oil glands in the skin - and that's it. Acne isn't caused by eating greasy foods like french fries or pizza, chomping on chocolate, or drinking dark sodas. Acne is not caused by poor hygiene. So, please just let acne run it's course. And stress doesn't usually cause acne but can worsen it at times because more sebum is usually produced when people are stressed out.

What can we do about acne?
To help prevent the oil build-up that can contribute to acne, wash face twice a day with soap and warm water. Don't scrub face hard with a washcloth - acne can't be scrubbed away, and scrubbing may actually make it worse by irritating the skin.

• If wearing makeup, make sure it's oil-free, noncomedogenic, or nonacnegenic. This means it won't clog pores and contribute to acne.
• When washing face, be sure to take the time to remove all of makeup.
• If using hair sprays or gels, try to keep them away from face, as they can also clog up pores.
• If having long hair that touches face, be sure to wash it frequently enough to keep oil away.
  
  

There are many lotions and creams available at the drugstore to help prevent acne and clear it up at the same time.

How to treat acne?
For treatment of mild to moderate acne, products with benzoyl peroxide are usually effective enough for treating acne.

Patients with severe acne (especially cystic acne) who do not respond to other therapies can be treated with Roaccutane. Roaccutane dramatically reduces the formation of grease by the sebaceous glands, decreases the number of bacteria and reduces the skin inflammation. A four to six month course is usually required, after which most patients have virtually no acne and many will not need oral treatment again.

Most patients experience some side effects while taking Roaccutane. The more common side effects include dry skin, cracked lips, dry eyes and occasionally elevated levels in blood fats.

Yet, if you are pregnant, or you intend to become pregnant, you are breastfeeding, then you are advised not to take Roaccutane. Also you are prohibited to take the medicine if you have mental illness, strange feeling or abnormal ideas.

• Antibiotics
  Oral antibiotics work by reducing bacteria and minimising the amount of inflammation. Antibiotics do not address the other causative factors in acne and may take several weeks or months to clear up acne. There are several products available and they are usually given twice daily for at least 6 months. Side effects are uncommon, and usually consist of indigestion and diarrhea.
  
  
• Contraceptive Pill
  A type of hormonal contraceptive pill can also be prescribed for acne. Oral contraceptives, being female hormones, help to counteract the effect of male hormones on acne. Because they are female hormones their use is limited to female patients.
  
  
• Salicylic acid is used as a peeling or drying agent.

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