Acne, what is it?

Acne (acne vulgaris) is a common chronic inflammatory skin disease involving damage to the hair follicle-fatty gland complex.

• • Acne affects more than 9% of the world’s population.
  • Acne usually starts before adolescence (between 7 and 12 years old) and disappears by the third decade, but it can persist or start in adulthood.
  • Acne is most commonly found in men during adolescence and, conversely, more common in women after adolescence.

What causes acne?
Acne usually develops when a combination of several factors is present.

• • Family predisposition (people with close family members with acne have a higher risk of acne)
  • Endogenous and exogenous androgenic hormones.
  • Cutibacterium (or Propionibacterium) acne bacterium
  • Active immune response with inflammatory mediators
  • Hair follicle dilation and occlusion

Factors that provoke and aggravate acne

• • Hormonal changes (e.g. hyperandrogenism, polycystic ovary syndrome)
  • Stress
  • Ultraviolet (UV) rays
  • A daily diet rich in dairy and high glycaemic index products
  • Medicines (e.g. steroids, hormones, etc.)
  • Use of occlusive cosmetics (e.g. oil-based)
  • High body mass index
  • Environmental pollution

Localisation of rashes
Rashes are most common in the areas with the most sebaceous glands:

• • face
  • neck
  • chest
  • upper back and arms

Clinical forms

• • Comedonal acne – closed and open comedones
  • Papulopustular acne
  • Nodulocystic and conglobate acne

Diagnostics

• • We usually diagnose common acne on the basis of the clinical picture.
  • There are no tests to confirm the diagnosis.
  • Additional testing is carried out when hyperandrogenism or another specific condition that may lead to acne is suspected.

Treatment

• • The aim of acne treatment is to control the disease, to ensure that the patient follows the prescribed treatment, to gradually adapt and change the treatment in time if there is no treatment effect or if an adverse drug reaction (ADR) occurs.
  • Acne treatment is started only after determining the severity of the disease, the type of rashes that predominate, and the patient’s quality of life changes.

There are many treatments for acne vulgaris:

1. 1. non-medication (elimination and avoidance of provoking factors, adaptation of daily facial care products)
   2. medical (topical and systemic)
   3. alternative methods (e.g. photodynamic therapy, laser therapy)

• • The most successful results are achieved with stepped and integrated treatment
  • You should use the treatment for at least two to three months before assessing whether it is effective

Recommendations

• • Wash your face no more than twice a day.
  • Use warm water for washing, not hot water.
  • Avoid oily skin products (often labelled as “non-comedogenic”, a “green line” for acne-prone skin).
  • Do not mechanically press, scratch or touch the pimples (you can cause infection).
  • Use sunscreen (more than SPF30).
  • Follow the recommendations of your doctor.

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