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Acne vulgaris, more commonly referred to simply as acne, is a chronic inflammatory disorder of the pilocebaceous unit that affects at least 85 percent of adolescents and young adults. Acne has been implicated in psychiatric and psychological processes more than most other dermatological conditions. There are many aspects of this disease that contribute to its nondermatological effects including predominant adolescent prevalence, anatomical distribution of lesions, misperceptions regarding etiology, and social pressures.

Acne is a disorder of the pilosebaceous unit of the skin and can present as noninflammatory and/or inflammatory lesions. Several events occur that result in these lesions. Increased systemic androgen levels cause an increase in sebaceous gland size and activity, resulting in abnormally high production of sebum. (At puberty, production of androgenic hormones increases in both sexes, thus, the association of acne with puberty.) The organism Propionibacterium acnes thrives in the lipid-rich sebum.

Acne can cause significant embarrassment and anxiety in affected patients. It is important for family physicians to educate patients about available treatment options and their expected outcomes. Topical retinoids, benzoyl peroxide, sulfacetamide, and azelaic acid are effective in patients with mild or moderate comedones. Topical erythromycin or clindamycin can be added in patients with mild to moderate inflammatory acne or mixed acne.

If you have acne cysts, talk to your doctor about stronger medicine. Isotretinoin (such as Accutane) works very well, but it can cause birth defects. And using Accutane may be associated with depression. Let your doctor know if you have had depression before taking this medicine. And if you are female, you must protect against pregnancy by using two forms of birth control. Even one dose of this medicine can cause birth defects if a woman takes it while she is pregnant. You cannot take isotretinoin if you are breast-feeding.

The face and upper neck are the most commonly affected, but the chest, back and shoulders may have acne as well. The upper arms can also have acne, but lesions found there are often keratosis pilaris, not acne. Typical acne lesions are comedones, inflammatory papules, pustules and nodules. Some of the large nodules were previously called "cysts" and the term nodulocystic has been used to describe severe cases of inflammatory acne.

Acne vulgaris can also be completely eradicated by keeping the pores of the skin clean and open. Hormonal treatments are also very effective and precise in treating acne vulgaris. Several hormonal treatments include the combination of oestrogen/progestogen methods of hormonal contraception. Hormonal treatment involves less Side effects, however, may include a temporary whitening of the skin around the injection point; and occasionally a small depression forms. This method also carries a much smaller risk of scarring than surgical removal.

Mild acne treatment is often characterized as "home treatment" since the main products are purchased Over The Counter (OTC). It's important to note that these OTC products take time to work and their benefits are often not seen until after two weeks, and sometimes take 6 to 8 weeks before their full effectiveness is achieved.


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