Acne

• spots due to excess sebum secretion

Typical Patient

• usually presents in teenage years but may continue into 30s

Symptoms / Signs

• pustules

• papules

• distribution

  • face

  • chest

  • back

Variants

• acne vulgaris

• acne keloidalis

  • scarring acne on back of neck in men

• infantile acne

• acne conglobata

  • severe, boys, tropics

• acne fulminans

• pyoderma faciale

• Gram negative folliculitis

Pathology

• increase in sebum secretion

• thickening of keratin lining of sebacous duct

• infection with Propionobacterium acnes

• increase in free fatty acids

• inflammation around sebaceous gland

• may be related to hormones, fluid retention (PMS), diet, seasons, external factors, corticosteroids

Investigations

Treatments

• reassurance

  • that clears with time

  • not infectious

• topical

  • benzoyl peroxide

  • topical retinoic aid

• systemic

  • tetracycline - minocycline, oxytetracycline

  • oral oestrogens (Diannette)

  • Retinoids e.g. isotretinoin (Roaccutane)

Prognosis

• should clear with time

Complications

• scarring

• acne fulminans

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