Acne is an inflammatory dermatosis of the pilosebaceous follicle which is extremely polymorphic, hence differing from individual to individual. Even in the same subject between one eruption and another. But is also refers to the possibility of new forms of chemical, physical and cosmetic acne, which gives the disease an importance that, up until now, seemed to be determined only by the “sense of social inferiority and aesthetics” of these patients.
With the medication now available, it is possible to achieve satisfactory results in 90% of all patients, but only if the treatments are used selectively.
It is therefore necessary to recall the four basic principles that regulate the treatment of Acne:
- reducing the activity of the sebaceous glands.
- correcting the hyper-keratosis of the infundibulum.
- decreasing the follicular bacterial colonisation.
- decreasing the extracellular inflammatory reactivity.
The various medication used systemically belong to different categories by chemical, pharmacological and mechanism of action characteristics, and each of them act more or less effectively on at least one of the pathogenetic factors of acne. The major “acne therapy groups” include an antibiotic therapy, a hormonal therapy, a retinoid therapy and other systemic therapies.
- BLACKHEADS: this represents the initial visible common lesion in acne. It consists of a collection of lipid and protein keratin material. Blackheads may be visible as white points or black points depending on the presence or absence of an opening on the skin surface.
- PAPULES: a small solid and persistent spot. This derives from a blackhead after the onset of inflammation and may regress, if it does not transform any further, without scarring.
- PUSTULES: the inflammatory process can lead to suppurative episodes with the formation of pustules, which are nothing more than collections of purulent exudate.
- NODULES: the progress and deepening of the inflammatory process leads to a fibrous reaction of a solid consistency that affects the superficial and middle dermis.
- CYSTS: the collection of sebaceous material in the cavity, formed as a result of inflammatory processes resulting from pustules or nodules, leading to the formation of cysts.