Acne is a very common skin condition that forms a large section of any dermatology workload. There are different types of acne but the commonest one is a variant called “acne vulgaris” which means “common acne”. The term acne in public generally refers to acne vulgaris. The condition is very common and may affect around 90% of the teenagers at some point although in many cases the condition itself can be very mild and transient.
Acne is a condition that arises from a specialised unit in the skin called the pilosebaceous unit which is essentially the grease gland and the associated hair follicle and duct opening. The grease gland is referred to as the sebaceous gland in medical terms. Acne is the result of 4 main mechanisms that ultimately lead to the clinical presentation of acne. These mechanisms are: increased activity of the grease glands (hence the associated oily skin), increased presence of one type of a bacteria present in the glands called cutibacterium acnes, inflammation which is largely the result of excessive sebum and the presence of large numbers of bacteria, and finally blockage of the duct openings as a result of excessive keratin build up in the ducts which lead to the pore openings visible on the surface of the skin. In some cases one or two of these mechanisms may prevail but in most cases all 4 mechanisms are present. This is important to understand as the treatment of acne should address as many of these factors involved to ensure clearance of acne.
There are a number of treatments available for acne and these include topical therapy with various different types of creams and facial washes, systemic treatment which includes tablets. These can include antibiotics or the more effective treatment called isotretinoin or Accutane in some countries. Laser treatment is also very effective in certain types of acne and can also be combine with topical or systemic therapy. The choice and duration of treatment will depend on the type and severity of acne and is best decided by the dermatologist following discussion with the patient. In some cases dietary and make-up advice can be given to certain patients as these are factors that can also play a role in acne.
Professor Firas Al-Niaimi has widely published on acne and its treatments and these articles can be found in the publications section of the website.