The microcomedo will continue to expand with densely packed keratin, sebum, and bacteria. Eventually this distension will cause follicular wall rupture. The extrusion of the keratin, sebum, and bacteria into the dermis results in a brisk inflammatory response. The predominant cell type within 24 hours of comedo rupture is the lymphocyte. CD4 + lymphocytes are […]

The second key feature in the pathogenesis of acne is excess sebum production from the sebaceous gland. Patients with acne produce more sebum than those without acne although the quality of sebum is the same between the two groups (18). One of the components of sebum, triglycerides, may play a role in acne pathogenesis. Triglycerides […]

Follicular epidermal hyperproliferation results in the formation of the primary lesion of acne, the microcomedo. The epithelium of the upper hair follicle, the infundibulum, becomes hyperkeratotic with increased cohesion of the keratinocytes. The excess cells and their tackiness result in a plug in the follicular ostium. This plug then causes downstream concretions of keratin, sebum, […]

Emmy M. Fernandez, Andrea L. Zaenglein, and Diane M. Thiboutot Department of Dermatology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey Pennsylvania, U. S.A. INTRODUCTION Acne is an exceedingly common condition affecting millions of adolescents and young adults. Not surprisingly, the psychological and economic impact of acne is reflected in these vast numbers. The […]

Photography has been a useful tool for evaluating and documenting treatment benefits (Fig. 3 for example). Several acne-grading methods have even been proposed based on photographs. Recent advancement in digital imaging has made image capture and evaluation much more convenient. The techniques that have been applied to clinical imaging go beyond just regular photography that […]

Since acne is a multi-factorial disorder, dermatologists recommend the use of combination therapy. In analogy, an OTC combination therapy was recently developed to treat multiple pathogenic factors of acne. This system combines a 2.5% benzoyl peroxide lotion with an SA cleaner that also contains glycolic acid. A daytime broad-spectrum sunscreen containing a proprietary blend of […]

Alpha-hydroxy acids (AHAs) such as glycolic acid and lactic acid have been used for many years by dermatologists at concentrations of 20% to 30% for facial peel procedures. More recently, AHAs have been added to OTC washes and moisturizers at concentrations of 4% to 6%. AHAs have been found to soften the stratum corneum, remove […]

Oral supplements have recently become more popular as a way of promoting total well­being. Some supplements are marketed as part of a multi-step aging or acne treatment. Nutraceuticals marketed for acne typically contain either herb extracts or specific vitamins (especially vitamin A and vitamin B-complex).

A lipophilic derivative of SA (capryloyl SA or LHA) has been proposed as a new anti-acne agent by a European firm. In a recent study, they showed that the LHA cream was well tolerated and significantly more effective than a control moisturizing cream throughout the 87-day period as per the global evaluation scale (65). However, […]