Acne occurs from dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, and oily skin. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world. Some rural societies report lower rates of acne than industrialized ones.

In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum. Another common factor is the excessive growth of the bacterium Cutibacterium acnes, which is present on the skin.

Treatments applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid, are commonly used. Antibiotics and retinoids are available in formulations that are applied to the skin and taken by mouth for the treatment of acne. However, resistance to antibiotics may develop as a result of antibiotic therapy. Several types of birth control pills may help prevent acne in women. Early and aggressive treatment of acne using isotretinoin may be helpful to decrease the long-term complication on individuals.

Adapalene gel can be used widely because it suppresses the secretion of sebum and has the effect of suppressing the recurrence of acne. Adapalene gel can irritate the skin if too much is applied initially. Benzoyl peroxide and azelaic acid, on the other hand, can be used on inflammatory acne sites because they help with inflammation. In general, long-term treatment of 1 month or more is required to see an effect.

#Benzoyl peroxide [OXY-10]
#Adapalene gel [Differin]
#Tretinoin cream

#Topical clindamycin
#Comedone extraction
  • Acne in the torso area. The upper part of the torso and back are common areas of acne.
  • Typical cheek acne.
  • Acne can occur on the back. If acne suddenly occurs widely on the back, drug eruption may be considered.
  • Typical forehead acne. Acne in adolescence tends to start with the forehead.
  • In the center of the picture, a white, non-inflammatory comedone is observed.
References Diagnosis and treatment of acne 23062156
Acne, the most common skin condition in the United States, is a persistent inflammatory skin problem. Treatment aims at addressing four main factors contributing to acne: excessive sebum production, skin cell buildup, Propionibacterium acnes colonization, and resulting inflammation. Topical retinoids effectively manage both inflammatory and non-inflammatory lesions by preventing and reducing comedones while addressing inflammation. Benzoyl peroxide, available over-the-counter, is a bactericidal agent without promoting bacterial resistance. While topical and oral antibiotics work alone, combining them with topical retinoids enhances their effectiveness. Adding benzoyl peroxide to antibiotic therapy lowers the risk of bacterial resistance. Oral isotretinoin, approved for severe and stubborn acne, is administered through the iPLEDGE program.
 Guidelines of care for the management of acne vulgaris 26897386
Common topical treatments for acne include benzoyl peroxide (BP), salicylic acid, antibiotics, combinations of antibiotics with BP, retinoids, combinations of retinoids with BP or antibiotics, azelaic acid, sulfone agents. Oral antibiotics have long been a key part of acne treatment, especially for moderate to severe cases. They work best when used alongside a topical retinoid and BP. Tetracycline, doxycycline, minocycline, trimethoprim/sulfamethoxazole (TMP/SMX), trimethoprim, erythromycin, azithromycin, amoxicillin, cephalexin have all shown evidence of effectiveness.
 Acne Vulgaris: Diagnosis and Treatment 31613567
Topical retinoids are always recommended for treating acne. When using systemic or topical antibiotics, it's important to combine them with benzoyl peroxide and retinoids, but only for up to 12 weeks. Isotretinoin is reserved for severe cases of acne that haven't responded to other treatments. While there's some evidence for physical treatments like laser therapy and chemical peels, as well as complementary approaches such as purified bee venom and certain diets, their effectiveness is still uncertain.
 Effects of Diet on Acne and Its Response to Treatment 32748305 
Several studies have evaluated the significance of the glycemic index of various foods and glycemic load in patients with acne, demonstrating individuals with acne who consume diets with a low glycemic load have reduced acne lesions compared with individuals on high glycemic load diets. Dairy has also been a focus of study regarding dietary influences on acne; whey proteins responsible for the insulinotropic effects of milk may contribute more to acne development than the actual fat or dairy content. Other studies have examined the effects of omega-3 fatty acid and γ-linoleic acid consumption in individuals with acne, showing individuals with acne benefit from diets consisting of fish and healthy oils, thereby increasing omega-3 and omega-6 fatty acid intake. Recent research into the effects of probiotic administration in individuals with acne present promising results; further study of the effects of probiotics on acne is needed to support the findings of these early studies.