Acne refers to a disease that primarily affects boys and girls during puberty, which in severe cases persists in adults. It is a multifactorial process in which a combination of the following factors plays a major role: there is follicular keratinization and an increased sebum production by the influence of male sex hormones (so-called androgens). A secondary bacterial infection with the bacterium Propionibacterium acnes all adds up to an inflammatory reaction of the skin.
In acne vulgaris there are three major varieties:
Acne comedonica: located in the central facial area there are open (black) and closed (white) comedones.
Acne papulopustulosa: also located in the central facial area, in this form of acne pustules and papules can be found on the skin of the back or around the neckline.
Acne conglobata: refers to a severe form of acne with deep inflammatory nodes both on the face, chest and back. Especially often young men are affected.
A special form of acne in this case represents the acne inversa, which presents with frequent deep nodes and abscesses in the area of the armpits and groin, but also in the genital area and below the chest. It is extremely difficult to treat and in some cases requires an assessment of the hormonal status and a surgical intervention.
The treatment of acne vulgaris generally includes cosmetic treatment with scrubs; drug treatment depends on the severity of the inflammation. Frequently a combination of antibacterial creams and low-dose antibiotics is useful to reduce bacterial colonization as cause of the inflammatory response. In the further course, the use of vitamin A acid preparations are discussed in men; the use of hormones in women can be useful. I will gladly inform you of risks and benefits of each of the therapy options at your next appointment.
