Acne

Acne is an inflammatory condition of the hair and oil gland unit of skin. It most often affects the face of younger patients but can also show up on the neck, chest, upper back and even upper arms. It may also persist into middle adulthood. The cause of acne is complicated but generally thought to be due to hormone influences and the overgrowth of a bacteria named Propionibacterium acnes. Contrary to popular belief, acne is not caused by eating chocolate or fatty foods. Because acne is influenced by hormones, it may worsen during menses or use of exogenous steroids. In rare cases, it may be due to genetic hormone abnormalities, such as in a hyperandrogenic states.

Acne can present in a variety of forms including blackheads (comedones), red inflamed bumps (papules and pustules) or deeper tender bumps (cysts, nodules). Treatment varies depending on the presentation. Topical medications are used for comedones or mild acne conditions. These include topical antibiotics, retinoic acids (and other acids), and benzoyl peroxide. Oral antibiotics are often added for moderate conditions, and Accutane (isotretinoin) may be consider for severe cases. The goal in severe cases is to prevent further scarring. Chemical peels may also help with treatment. In conditions where acne is cause by hormone imbalance, oral contraceptives or other antiandrogenic substances may be used. (AAD phamphlet)