The meaning of acne is prime of life. It is almost universal in teenagers. It comes at a time when body image is of great importance and any deviation from being less than perfect can provoke anxiety. Acne patients are often described as being self conscious and having a low self esteem. Consequently, they may also become dissatisfied with other aspects of their body image such as their weight or shape.

Acne is a never-ending inflammatory disorder of the pilosebaceous unit. These specialized follicles are located primarily on the face, chest and back, and are activated to produce sebum at puberty. The physiological role of sebum is not fully known; however, it is thought to protect the skin from bacteria and fungi, and its lipid film helps control water loss. Sebum is a prerequisite for this and the sebaceous glands themselves are under the control of the androgens testosterone and dehydropiansterone.

It is likely to be caused by end-organ hypersensitivity to these androgens rather than to the total degree of circulating androgens, because the level itself does not correlate with severity. The seborrhea is perceived as greasy skin, which may persist even after the acne resolves.

Acne is the most common skin disorder seen during adolescence, left untreated, may cause physical and psychological scarring. Acne is affected often to males than females. It usually occurs in children, beginning at puberty and persisting through adolescence. Fortunately, modern treatment is effective, and teenagers with it are no longer dismissed or told they will grow out of it. Treated appropriately and quickly, acne can be controlled or even cured with good cosmetic results.

Health care professionals have an important role in recognizing the psychological impact of acne on a young person. Optimizing management through good communication ad support before, during and following therapies is essential.

Acne is a disease of the sebaceous follicle which occurs predominantly on the face, chest and upper torso. The normal pilosebaceous unit consists of sebaceous glands, a rudimentary hair and a wide follicular duct lined with stratified squamous epithelial cells.

With acne, there is hyper proliferation of the cells lining the follicular duct. The cells adhere to the duct walls and, combine with a sebum and bacteria, which results in a partial obstruction of the follicular duct. This process is visible on the skin surface which has either a black or white head; and is commonly referred to as a blackhead or a whitehead. The black color of the plugs is due to pigment, as comedones are also known as blackheads are the precursors of both non-inflamed and inflamed acne lesions.

The major features involved in the production of acne are increased sebum production, ductal hypercornification, colonization of the duct with propionibacterium acnes and inflammation. Acne is rarely misdiagnosed and usually does not require investigations such as a skin biopsy. However, in difficult patients swabbing the skin for it, in order to look for antibiotic resistance, can be useful.

This is treated with antibiotics and with a topical steroid drug. Oral contraceptives are sometimes found to be helpful. The antibiotics most often used include erythromycin and tetracycline.

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