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Acne Vulgaris

What is Acne Vulgaris?

Acne is a condition which develops in and around the hair follicles and their oil producing glands called the sebaceous glands. Although these glands exist all over the surface of the body, it is only on the face, chest and back that acne develops.


The oil produced by sebaceous glands is called sebum and it begins to appear soon after puberty. When the oil glands become blocked, this leads to the formation of comedones — blackheads and whiteheads.

Bacteria in the deeper part of the hair follicle and beneath the sebum blockage release chemicals which act upon the sebum and break it down to release other chemicals. These chemicals make the skin around the hair follicle red and inflamed, resulting in a pimple. If inflammation worsens, pus may develop within the pimple. Large, painful swellings called nodules and cysts may develop, which can result in scarring after the condition has eventually settled. These scars can either be depressed and sunken, or bulging and hard.

When to seek medical advice

See your doctor if:

  • The condition has begun to affect quality of life
  • There is widespread distribution of the acne
  • Self-care methods have not been effective
  • There are large nodules and cysts
  • There is significant scarring
Treatment and drugs

Treatment applied to the skin

Patients with mild acne usually respond well to topical treatments. These include sulphur and resorcinol preparations (e.g. acne clear cream and lotion), benzoyl peroxide-containing preparations, antibiotics (erythromycin and clindamycin gel and lotions) and vitamin A-derived creams or gels (adapalene and tretinoin).

Oral treatment

If the acne worsens and there are many inflamed spots, then topical treatment alone may not be adequate. Dermatologists typically prescribe antibiotic tablets, such as doxycycline, erythromycin, minocycline or cotrimoxazole.

For severe acne

In very serious cases that do not respond to the above treatment, or in cases of severe nodulocystic acne, a tablet called isotretinoin may be given. This medication may give rise to side effects such as dry skin, cracked lips or body aches. However the most serious risk is possible damage to the unborn baby if taken during pregnancy, hence it is important for women of child-bearing age to practice strict contraception while on isotretinoin therapy.
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