Acne are the black or red eruptions that develop predominantly over the face. Though benign, their presence causes much anxiety to the sufferer. 

Acne occur at any age but mainly in teenagers. It is considered as one of the, "teen”, problems. 

Acne occur due to changes in the unit of the skin structure containing a hair follicle and sebaceous glands. They occur mostly in areas that have greater density of sebaceous glands, i.e. over the face, chest and upper back. 

Sebaceous glands get blocked due to production of more sebum blocking the pores. This can be due to the masculinizing hormone androgen, levels of which tend to increase during puberty. Acne tend to be hereditary and run in families. They tend to be aggravated by hormonal changes which occur during menstruation and pregnancy. Drugs like anabolic steroids, glucocorticoids, also induce acne as a side effect. 

Though debatable, some studies claim that mental stress can also aggravate acne. 

Bacteria like Propionibacterium acnes, Staphylococcal epidermidis have been implicated in causing acne. 

The acne manifest as red coloured small pustular lesions with a black head or with a white or red top. At times there is inflammation of the surrounding skin. On puncture of an acne, some pus and inflammatory debris is excluded. 

There may be mild itching and or pain over the acne. Sometimes people experience some discomfort over the face while moving out in the sun. On scratching it, there is risk of bacterial infection setting and also causing permanent scars on the face. Otherwise it is a benign condition which will not harm an individual in any way. 

There is no significant symptom except the cosmetic disfigurement and resultant mental stress. Acne can lower the self esteem of a teenager and even lead him or her to depression in extreme cases. The problem has assumed significant proportions today due to the stress on a smooth, flawless complexion in the advertisements by the companies selling cosmetics. Pharmaceuticals selling anti-acne creams have also added to the  hype and myths  about  acne.

As such, acne subside as one grows older, without any treatment, though when, cannot be predicted accurately.   

The theory that a high fat diet contributes to acne is not validated by research.

The first step in treatment of acne is a keeping the face clean. Washing face regularly with a mild soap or copious amounts of water helps to clean and  keep the skin pores open.

Many kinds of ointments, creams and lotions are available for treatment of acne. They contain  benzoyl peroxide (antibacterial), retinoic acid, niacin a component of vitamin B.complex, etc. substances which reduce acne. Local application of antibitotics like tetracyclines, erythromycin and clindamycin is used for severe cases or those with secondary bacterial infections. Systemic antibiotics can also be used for severe cases. 

Dermabrasion is a surgical technique used for removing acne particularly when they are extensive on the face and recurrent or persistent. It is a long procedure in which the entire skin is scraped off and new skin comes up over a period of months. 

Destruction of the acne by laser therapy is a comparatively new technique but there is risk of damage to the surrounding skin along with the acne.

Whatever treatment one takes, acne can relapse later, though the intensity may be less.

One can seek treatment for acne if they are severe and troublesome; otherwise it can be ignored.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital