Significance

• Acne is a widespread problem that affects people of all ages, but is most common during the teen years. Adult women are more prone to developing acne than men, especially in the days preceding their menstrual periods. In total, acne affects at least 85% of the population at some point, and nearly everyone will develop at least one pimple during their lifetime.
  
  Mild cases of acne may not cause any significant long-term effects, but severe cases of acne can interfere with social relationships, negatively affect confidence and self-esteem, and lead to permanent scarring and difficulty forming intimate relationships. Because acne vulgaris affects so many people, and because the skin condition is considered by many to be unsightly and unhealthy, drug manufacturers have devoted considerable attention to producing and manufacturing creams and drugs aimed at preventing and treating acne outbreaks.
  
  

Identification

• Symptoms of acne vulgaris include comedones, pustules, papules and nodules on or under the skin. Closed comedones are generally called whiteheads, while open comedones are typically called blackheads. Bumps generally occur on the face, neck, chest, back, upper arms, and shoulders. Larger pimples, sometimes referred to as cystic lesions, may be painful and lead to scarring. Depending on the severity of the acne vulgaris, the skin may appear red and inflamed, and larger cysts may itch or become painful over time. Repeated cases of acne, especially when not treated properly, may result in scarring and pitting on the skin. These scars are generally permanent.
  
  

Causes

• Acne vulgaris is caused by the clogging of the skin's pores by oil and dead skin cells. When bacteria are able to penetrate the skin, swelling, pus, and redness may develop. This infection and resulting inflammation is what gives acne vulgaris its appearance. Increasing levels of hormones during puberty cause the skin to become more oily, which can result in the development of severe forms of acne vulgaris. Acne vulgaris is not caused by diet, but some people may notice that eating certain foods causes their existing acne to become worse.
  
  Some cases of acne may be genetic, as those with severe acne vulgaris often report having a parent or other close family member with a similar skin condition. Certain medications, including steroids, iodides, lithium, and antiepileptics may encourage the development of acne in some people. Acne vulgaris may also be caused by a number of medical conditions, including polycystic ovary syndrome, congenital adrenal hyperplasia, and other disorders that cause an increase in androgen levels.
  
  

Prevention/Solution

• Prevention of acne vulgaris is difficult, and generally involves keeping the skin as clean as possible, identifying any foods or skin products that may trigger or worsen outbreaks, and avoiding activities that may irritate the skin, such as picking at acne lesions or scrubbing the skin when bathing. Treatment of mild cases is usually done with an over-the-counter salicylic acid or benzoyl peroxide solution. More severe cases may require the use of prescription creams, oral or topical antibiotics, or birth control pills. The specific medication prescribed will depend on individual tolerance and the severity of acne present.
  
  

Considerations

• Ongoing treatment of acne vulgaris is important to prevent permanent scarring and to repair damage to the skin. In some cases, scar tissue can be removed by a dermatologist, and other remedies, including collagen injections, may improve the overall appearance of the skin. When over-the-counter treatments are not effective, prescription medications may be necessary. However, some acne treatments can cause severe side effects in some people, and therefore it is essential to proceed with any treatment regime carefully and only while under the supervision of a doctor. One commonly prescribed medication, Accutane, may cause birth defects and has been linked to depression.