Acne is a disease of the “pilosebaceous unit,” which means the hair follicles and the associated oil gland. The condition occurs when the opening of the hair follicle becomes blocked by skin cells. The sebum (oil produced by the sebaceous gland) is trapped under the skin; infection and inflammation occurs, resulting in pimples, pustules, and deeper nodules. These inflamed lesions can then lead to scarring in many individuals if left untreated.
Acne is one of the most common disorders treated by Dermatologists. Although most people think of acne as a teenager problem, the condition is very common in adults and can persist for years in some individuals.
Treatment of acne is directed primarily at removing the plugged oil glands, also known as blackheads and whiteheads, that are leading to the development of the inflamed, red pimples and pustules. Cleansers that contain salicylic acid or glycolic acid can help remove the obstruction to the hair follicle, thus eliminating some of the whiteheads and blackheads. Prescription medications, such as tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac), are even more effective at reducing the number of comedones and, therefore, improving acne. Anti-inflammatory agents, primarily topical and oral antibiotics, are used judiciously to directly reduce the red, inflamed lesions to prevent scarring. Newer treatments, including chemical peels, specifically targeted to improve acne are used when necessary, as well as newer oral and topical agents, such as Aczone or Nicazal, that help control acne. Finally, hormonal treatment, such as birth control pills, or spironolactone, and the systemic oral retinoid isotretinoin (formerly Accutane) are used in refractory or stubborn cases of acne.