Acne is a very common disease. It affects up to 90% of the population. Primitive cultures that do not consume processed food and eat low glycemic diets may have a lower incidence of acne.
The disease may begin at around puberty when the increased production of androgens stimulates sebaceous gland activity. The disease can then persist for many years. Men may have more extensive involvement but women may have activity that lasts into their 40s. The disease can affect the face chest, back and upper arms.
Acne can affect self-esteem. Taunting and ridicule compound the problem. Young patients with severe acne may have suicidal thoughts.
This is a disease of the pilosebaceous unit (hair follicle). For some unknown reason the keratinocytes stick together near the top of the hair follicle. A plug forms and sebaceous material builds up under the plug. Propionibacterium acnes proliferate in this material and produce inflammatory stimulating substances that then produced inflammatory papules, pustules and cysts. Treatment consists of using retinoid topical medications to disrupt the plug and topical or oral antibiotics to control the bacteria.