Acne is a disease of pilosebaceous units in the skin. It is thought to be caused by the interplay of four factors. Excessive sebum production secondary to sebaceous gland hyperplasia is the first abnormality to occur. Subsequent hyperkeratinization of the hair follicle prevents normal shedding of the follicular keratinocytes, which then obstruct the follicle and form an inapparent microcomedo. Lipids and cellular debris soon accumulate within the blocked follicle. This microenvironment encourages colonization of Propionibacterium acnes, which provokes an immune response through the production of numerous inflammatory mediators. Inflammation is further enhanced by follicular rupture and subsequent leakage of lipids, bacteria, and fatty acids into the dermis.

Diagnosis

The diagnosis of acne is based on the history and physical examination. Lesions most commonly develop in areas with the greatest concentration of sebaceous glands, which include the face, neck, chest, upper arms, and back. Acne vulgaris may be defined as any disorder of the skin whose initial pathology is the microscopic microcomedo. The microcomedo may evolve into visible open comedones (”blackheads”) or closed comedones (”whiteheads”). Subsequently, inflammatory papules, pustules, and nodules may develop. Nodulocystic acne consists of pustular lesions larger than 0.5 cm. The presence of excoriations, postinflammatory hyperpigmentation, and scars should be noted. Acne may be triggered or worsened by external factors such as mechanical obstruction, occupational exposures, or medications. Cosmetics and emollients may occlude follicles and cause an acne form eruption. Topical corticosteroids may produce perioral dermatitis, a localized erythematous papular or pustular eruption. Endocrine causes of acne include Cushing’s disease or syndrome, polycystic ovary syndrome, and congenital adrenal hyperplasia.

Clinical clues to possible hyperandrogenism in women include dysmenorrhea, virilization and severe acne.

Classification

In 1990, the American Academy of Dermatology developed a classification scheme for primary acne vulgaris. This grading scale delineates three levels of acne: mild, moderate, and severe. Mild acne is characterized by the presence of few to several papules and pustules, but no nodules. Patients with moderate acne have several too many papules and pustules, along with a few to several nodules. With severe acne, patients have numerous or extensive papules and pustules, as well as many nodules.

Acne also is classified by type of lesion comedonal, papulopustular, and nodulocystic. Pustules and cysts are considered inflammatory acne.

Therapy

Selection of topical therapy should be based on the severity and type of acne. Topical retinoids, benzoyl peroxide, and azelaic acid are effective treatments for mild acne. Topical antibiotics and medications with bacteriostatic and anti-inflammatory properties are effective for treating mild to moderate inflammatory acne. Proper selection of topical formulations may decrease side effects and increase patient compliance. Fortunately, most acne medications are available in several forms.

Topical Antibiotics

These agents are another mainstay of acne treatment. Topical antibiotics commonly are used in conjunction with retinoids or benzoyl peroxide in patients with any degree of inflammatory acne. These drugs normally are applied once or twice daily.

It’s important that you know the root causes of acne when looking for fact acne solutions. There are some simple measures which you can take in your everyday life which will go a long way in helping you achieve fair skin without even reaching for pills or ointments.

Part of a healthy lifestyle involves regular exercise and rest. The exercise is the active ingredient of the two. Keeping up with steady aerobic exercises greatly increases the flow of both blood and oxygen in your body. This is essential to having healthy skin. Just as importantly, you need to get plenty of rest at night after exercising as this refreshes your body and keeps your circulation strong.

Clean skin is an obvious part of reducing breakouts as well as your existing acne. Use non-comedogenic or non pore clogging lotions and soaps twice a day, especially right before bed. Avoid antibacterial soap as it overly dries out your skin which can more easily cause scarring. Don’t rub or touch your face too much, not only will it agitate your existing acne but it spreads the bacteria to cause fast acne spreading.

Nutrition is arguably a big part of acne. While it’s long since been disproved that a number of “myth” foods can give you breakouts, it’s still true that many agents in certain foods can directly cause overnight and fast acne. While chocolate is one of these “myth” foods on the very basis that it’s chocolate, the caffeine it contains is still a major factor. Caffeine throws your hormones into overdrive and produces an abundance of oils in your skin. You should avoid caffeine containing foods as a result, especially unnecessary candies and sweets which have no basic nutritional value to begin with.

Just remember whatever you put into your body will eventually show. While this sounds intimidating, you can use it to your advantage, as well. Fruits and vegetables are always a good bet, they have the reverse effect of caffeines and the vitamins they contain nourish your skin. A number of “detox” acne treatments have recently come onto the market which are quickly gaining a favorable reputation among users and even dermatologists because of the science behind it. This simply involves completely removing the problem ingredients which you put into your body and the fast acne clearing effects are remarkable.