Acne is most common in the teenage years, individual differences relating to severity and the extent of scarring. Peak severity is in the late teenage years but acne may persist into the third decade and beyond, particularly in females.


  • Increased sebum excretion is necessary for the development of acne, it is not sufficient to cause it alone. The main determinants of sebum excretion are hormonal, accounting for the onset in the teenage years.
  • Hormones- Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. Progestogens also increase sebum excretion, whilst oestrogens reduce it.
  • Propionibacterium acnes bacteria colonises the pilosebaceous ducts and acts on lipids to produce pro-inflammatory factors, and the pilosebaceous unit becomes occluded.
  • Diet-increase carbohydrate diet ,increase oily food .
  • Stress can make acne worse.
  • Familial
  • Genetics
  • Polycystic ovary syndrome


  • Lesions are usually seen to the face, shoulders, upper chest and back, but may extend to the buttocks
  • Seborrhoea (greasy skin) is often obvious
  • Open comedones (blackheads) due to plugging by keratin and sebum of the pilosebaceous orifice
  • Closed comedones (whiteheads) due to accretions of sebum and keratin deeper in the pilosebaceous ducts
  • Pimples (pustules), which are papules with pus at their tips
  • Large, solid, painful lumps beneath the surface of the skin (nodules)
  • Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)
  • Acne excoriée refers to the effects of scratching or picking, principally on the face of teenage girls with acne.


  • Do not touch or pick at problem areas.
  • Protect skin from the sun.
  • Avoid cosmetics.
  • Reduce stress.
  • Wash your face frequently.
  • Drink plenty of water( 3-4 liters).
  • Eat vegetable ,green leaves.
  • Eat fruits.
  • Avoid oily food.
  • Avoid junk food ,cake ,confectionery.





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