Acne

 Overview

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It causes whiteheads, blackheads or pimples. Acne is most common among teenagers, though it affects people of all ages.

Effective acne treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.

Symptoms :

Acne signs vary depending on the severity of your condition:

Whiteheads (closed plugged pores)

Blackheads (open plugged pores)

Small red, tender bumps (papules)

Pimples (pustules), which are papules with pus at their tips

Large, solid, painful lumps under the skin (nodules)

Painful, pus-filled lumps under the skin (cystic lesions)

Seek emergency medical help if after using a skin product you experience:

*Faintness

*Difficulty breathing

*Swelling of the eyes, face, lips or tongue

*Tightness of the throat

Treatment

If you've tried over-the-counter (nonprescription) acne products for several weeks and they haven't helped, ask your doctor about prescription-strength medications. A dermatologist can help you:

Control your acne

Avoid scarring or other damage to your skin

Make scars less noticeable

Acne medications work by reducing oil production and swelling or by treating bacterial infection. With most prescription acne drugs, you may not see results for four to eight weeks. It can take many months or years for your acne to clear up completely.

Topical medications :

Retinoids and retinoid-like drugs

 Drugs that contain retinoic acids or tretinoin are often useful for moderate acne

Antibiotics

 These work by killing excess skin bacteria and reducing redness and inflammation. For the first few months of treatment, you may use both a retinoid and an antibiotic, with the antibiotic applied in the morning and the retinoid in the evening. The antibiotics are often combined with benzoyl peroxide to reduce the likelihood of developing antibiotic resistance. 

Azelaic acid and salicylic acid

Azelaic acid is a naturally occurring acid produced by a yeast. It has antibacterial properties. A 20% azelaic acid cream or gel seems to be as effective as many conventional acne treatments when used twice a day. Prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding.

Dapsone.

 Dapsone (Aczone) 5% gel twice daily is recommended for inflammatory acne, especially in women with acne. Side effects include redness and dryness.

Oral medications

Antibiotics. For moderate to severe acne, you may need oral antibiotics to reduce bacteria. Usually the first choice for treating acne is a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin). A macrolide might be an option for people who can't take tetracyclines, including pregnant women and children under 8 years old.

Combined oral contraceptives.

 Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. 

Anti-androgen agents. 

The drug spironolactone (Aldactone) may be considered for women and adolescent girls if oral antibiotics aren't helping. 

Isotretinoin.

Isotretinoin (Amnesteem, Claravis, others) is a derivative of vitamin A. It may be prescribed for people whose moderate or severe acne hasn't responded to other treatments.