Acne vulgaris is the most common skin disease. It is estimated that 80% of people will experience acne at some point in their lives. 20% have severe acne that can lead to permanent scars.

Acne is a common chronic skin disease that involves the blockage and inflammation of the pilosebaceous units (hair follicles and their accompanying sebaceous glands). Acne can appear as non-inflammatory lesions, inflammatory lesions, or a combination of both, which mostly appear on the face, back, and chest.

Acne is caused by the following four factors:

1. Proliferation of follicular epidermis with subsequent blockage of the follicle
2. Excessive production of sebum (skin surface fat)
3. Presence and activity of bacteria 4. Inflammation

In addition, genetics is also a key factor in the pathophysiology of acne.

Symptoms:

Acne vulgaris is characterized by non-inflammatory, open or closed comedones and inflammatory papules, pustules and nodules. Acne vulgaris usually affects areas of the skin with the largest number of fat follicles, such as the face, upper chest, and back. Local symptoms of acne vulgaris may include pain, tenderness, or erythema.

Systemic symptoms are often absent in acne vulgaris. In rare but severe cases, acne vulgaris can lead to acne conglobata, with highly inflammatory nodulocystic acne and associated abscesses. Acne fulminans is even more severe than acne conglobata, with systemic symptoms such as fever, joint pain, and general weakness. In addition, acne Vulgaris may have a psychological effect on any patient, regardless of the severity or degree of illness.

Treatment:

1. Acne products (eg, erythromycin and benzoyl peroxide, clindamycin and tretinoin, clindamycin and benzoyl peroxide, azelaic acid, benzoyl peroxide, dapsone topical)
2. Topical retinoids (eg, topical tretinoin, adapalene, tazarotene, isotretinoin)
3. Antibiotics (eg, tetracycline, minocycline, doxycycline, sarcycline, trimethoprim/sulfamethoxazole, clindamycin, clindamycin topical, erythromycin topical, daptomycin, minocycline topical foam)
4. Selective aldosterone antagonists (eg, spironolactone)
5. Combined estrogen/progestin oral contraceptives (eg, ethinyl estradiol, drospirenone, and levomefolate; ethinyl estradiol and norethindrone; ethinyl estradiol and norethindrone; estradiol and norgestimate; ethinylestradiol and drospirenone)

Isotretinoin or Roaccutane is one of the most effective treatments for acne. In other words, the most effective and strongest treatment for acne is Roaccutane.

The possibility of complications with Roaccutane is very rare and it has no effect on women’s fertility. Only married women should avoid pregnancy during the treatment period with this drug and for one month after stopping the drug.

Diet in acne:

Avoiding unhealthy foods has been suggested as a non-pharmacological measure to manage acne vulgaris.

Skim milk has been found to be associated with acne.