Article title: Diagnosis and treatment of acne

Acne vulgaris (commonly called acne) is a skin disease caused by changes in the pilosebaceous units of the skin. The bacteria that caused acne is Propionibacterium acnes, which actually provoke an immune response .

Factors that caused acne included excessive sebum production and maybe triggered or worsened by factors such as mechanical obstruction for example: shirt collar ; occupational exposures and even medications. Cosmetics and topical corticosteroids can resulted in acne too. Acne occurred in areas with the greatest concentration of sebaceous glands like the face, neck, chest, upper arms and back.

Acne can be classified by the types, and even by the level of severity. Mild acne is characterized by presence of few to several papules and pustules, with no nodules while moderate acne is characterized by the presence of nodules. Severe acne consists of both papules, pustules and nodules.

There are several ways to treat acne for example:

Tropical agents whereby it is based on the severity and types of acne. For instances, those suffering from mild acne condition, topical retinoids, benzoyl peroxide and azelaic acid can be used. Antibiotics and medication containing bacteriostatic and inflammatory properties are effective for treating mild to moderate acne condition. Retinoids and retinoid analogs : Tretinion is a comedolytic agent that normalize desquamation of the epithelial lining, and thus prevent obstruction of the pilosebaceous outlet. Like Adapalene , it has direct anti-inflammatory properties. Tazarotene caused more irritation, burns and erythema compared to other retinoids and thus are considered only when tropical tretinoin of adapalence therapy is not effective.

Tropical antibiotics is another forms of treatment. They are used together with benzoyl peroxide with any degrees of inflammatory acne. The most common tropical antibiotic used are clindamycin and erythromycin. Benzoyl peroxide has stronger effect on papules than tretinion while weaker effect on comedones.

Systemic agents

Oral antibiotics is used when acne is resistant to tropical therapies and are the initial therapy for those with moderate to severe inflammation. It must be taken for six to eight weeks and given for six months to prevent development of it.First line antibiotics used included tetracycline and erythromycin but however, erythromycin is as the second line agent as the P. acne is increasing resistance to it. Doxycycline is also frequently used to treat moderate to severe acne problem. Minocycline is used when one’s is unable to tolerate or shows no responsed to other treatment.

Oral contraceptive pills ( OCPs ) has been prescribed and used to treat acne as it decrease the circulating androgens thus decrease sebum production. OCPs when used with oral antibiotics, seems to decrease the effectiveness of it. A review of pharmakinetic data showed a reduction of contraceptive steroid hormones only with the uses of rifampin.

Goals of acne therapy include controlling, preventing scarring and minimizing morbidity. Patient education is important as it helps to minimize lack of compliance, which is the most common cause of treatment failure. Dermatologist maybe referred if one’s do not have any respond to other treatment as gram negative folliculitis maybe suspected.

In summary, acne can caused negative physical, emotion and psychological impact on a person. Thus, it is important to educate patient about acne and the treatment available and to provide emotional support for him/ her. Acne is not a one day thing, u do not see the result instantly; it takes time to clear and heal, and patience is needed. Never hesitate to see a dermatologist when one’s think he / she needs it.