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Acne, a nightmare for any young generation nowadays. From smooth and beautiful facial skin turns into dirty spots that tarnish the beauty that suppose to be owned by any individual.

So what actually is acne?? Acne is derived from greek word “acme” or “a prime of life”. It is actually a lesion in the sebaceous gland (a.k.a. sebum gland or oily gland) of hair follicle. The common sites of acne are face, earlobe, back, chest, and anogenital area. However the facial acne is particularly a nuisance for an individual as it is the most visible one.

Even though sebaceous gland is responsible for acne, it also holds certain functions. It functions to secrete sebum which composed from triglyceride, fatty acid, wax esters, and sterols. This sebum is responsible to lubricate the skin, prevent crack of the skin and to cool down skin during hot weather.

How does sebaceous gland causing acne?? The changes happen during acne started with increase in sebum secretions. Then the keratin lining of sebaceous duct will get thickened and forms comedones or black spots (or white spots). The change of colour of comedone is due to melanin. As the sebum secretions increase in amount, a bacteria known as Propionibacterium acnes proliferates inside the sebum. After that, inflammation will occur around the sebaceous gland and produce acne. Basically, the main culprit that is causing acne is increase in sebum secretion.

So what causing the increase in sebum secretions?? There are few causes of increase sebum secretions includes hormonal factor, fluid retention, dietary habit, season changes, exogenous factor, and medications.

Hormonal factor plays an important role in sebum secretions as increase in androgen (male hormone) will cause increase in sebaceous glands size which in turn increase the amount of its secretions. This explains why the male adolescent is more common to get acne compared to adolescent girls.

Fluid retention particularly during premenstrual period leads to increase hydration and swelling of sebaceous duct. This explains why there is exacerbation of acne during the premenstrual period. Apart from that sweating also makes acne worse due to same mechanism.

Dietary habits of eating chocolate, nuts, fizzy drinks or coffee worsen acne problems. However the exact mechanism on how these foods causing acne has yet to be determined.

Acne often improves with natural sunlight and it is worse during winter. The Ultraviolet light said to improves acne however the efficacy of the UV light treatment is unpredictable. Exogenous exposure to oils (particularly common in cooks in hot kitchen) has known to worsen acne. Exogenous exposure to coal tar, dicophane (DDT), and polychlorinated biphenols also has known to worsen acne.

Some medications also can worsen acne. These medications include corticosteroids (both systemic and topical), androgen and combined oral contraceptive pills (COCP). Consult with the doctor who prescribed the medication if acne problems arise from usage of these medications.

So what should we do if we have acne?? Relax, acne is usually resolved spontaneously and it is not infectious. There are few methods to hasten the resolution of acne which includes conservative method, topical cream, and medications.

The conservative method is done by applying hot wet soft cloth on the face (simple alternative to facial sauna), followed by gentle rubbing in a plain soap, or diluted Savlon solution (an antiseptic solution). This will cause dissolution of comedone however they (particularly savlon solution) may cause considerable skin scaling and dryness. NEVER PINCH THE ACNE!! Pinching the acne will expose the acne to secondary infection and it is responsible for ugly scar on the skin.

Topical cream for acne is widely available nowadays. It is up to the consumer to choose which one is the most suitable. The best topical cream for acne should contain Benzoyl peroxide in concentrations of 1–10%, salicylic acid and vitamin A solution. So try to find out the best solution for your acne problem. Note: Benzoyl Peroxide may irritates the skin depends on your type of skin (for example oxy: picture below)

If both conservative method and topical cream are unsuccessful, consult your doctor for antibiotic. Commonly prescribed antibiotic for acne is tetracycline. However the treatment needs time, sometimes need months to take effect. Other alternative for tetracycline are erythromycin and co-trimoxazole.

Newly available treatments are UV light therapy, antiandrogen, and synthetic retinoids. However the efficacy of these treatments has yet to be determined.