Many factors contribute to the development of acne vulgaris. They include an increase in sebum production from puberty onwards, and the colonisation of sebaceous glands by bacteria, particularly the anaerobic diphtheroid Propionibacterium (formerly Corynebacterium) acnes. The severity of the acne parallels sebum excretion rates. Acne lesions include comedones (blackheads and whiteheads), in which keratinisation is abnormal and excessive, inflammatory papules, pustules, nodules and cysts, and post-inflammatory scarring. Most cases of acne can now be treated very successfully if an appropriate regimen is continued long enough. This article reviews the most important treatments.
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