ACNE - A REVIEW OF OPTIMUM TREATMENT

Acne vulgaris is a disease of the pilosebaceous unit of the skin. It m ay have profound psychological sequelae. The lesions are due to abnorm ally adherent keratinocytes causing plugging of the follicular duct fo llowed by accumulation of sebum and keratinous debris. This results in the formation of the primary lesion of acne, the comedo. Inflammation of comedones produces papules, pustules and nodules, which often prom pt patients to seek treatment. Various effective treatments include to pical anti-inflammatory, antibiotic and peeling agents, oral antibioti cs, topical and oral retinoids, and hormonal agonists and antagonists. Useful combination regimens are discussed, and treatment approaches s uggested. Mild cases of comedonal acne may respond to a topical retino id or benzoyl peroxide, while inflammatory lesions benefit from topica l antibiotics. More severe inflammatory acne is treated with systemic antibiotics. Recalcitrant cases often require oral isotretinoin or hor monal manipulation.