Acne generally begins around the time of puberty. The sebaceous gland which have been small, enlarge and seem to work over time to secrete oil. The pores may become enlarged and show white heads and blackheads. Skin bacteria release free fatty acids and other inflammatory mediators which produce acne bumps and even cysts. Acne may be only a minor annoyance but in some it can progress to become a serious, scarring disease with lifetime ramifications.
Treatment can be started with over the counter cleansers containing benzoyl peroxides and or salicylate acids. Often these can be very effective. For more difficult cases prescription topicals containing retinoids such as Retin A or Adapalene may be prescribed. Antibiotics in either topical form or systemic pills may be used judiciously.
For females certain oral contraceptives may be effective. A drug, Spironolactone, a blood pressure medication with mild antiandrogenic activity may be helpful and is being used more frequently as the use of antibiotics has diminished.
Finally the drug isotretinoin has been used in this country since 1980. Taken under supervision with appropriate lab testing it can be life changing for someone suffering from acne.
Many office procedures can also be of benefit. Chemical peels, silk peel, microdermabrasion and Photodynamic therapy can all be beneficial, especially when used in combination with good home are and judicious use of prescriptions meds.