Acne is a very common skin disorder of the pilosebaceous units (consisting of a hair follicle and its oil gland) that affects 85-100% of all people at some point in their lives. Although acne is most common during the adolescent years, many adults can be affected as well. There are varying degrees of acne ranging from mild to severe. Mild forms of acne consist of closed comedones (whiteheads) and open comedones (blackheads). Severe forms of acne consist of inflammatory papules (pimples) and cysts which then can increase the risk for scarring.

Typically the face and upper neck are most common affected, however the chest, back, and shoulders can be affected as well. Types of acne include:

• Acne vulgaris
• Non-inflammatory acne
• Inflammatory acne
• Cystic acne

Acne is typically caused by blockage of the pores of sebaceous (oil) glands. These pores can be clogged due to excessive sebum (oil) production and shedding of skin cells. Once plugged the sebum can be infected or inflamed by skin bacteria resulting in acne. Inflammation near the skin's surface produces a pustule (a pimple with pus) while deeper inflammation results in a papule (a pimple without pus) and if much deeper a cyst or nodule. Predisposing factors for acne include:

• Family history and genetic predisposition
• Hormonal activity
• Stress
• Hyperactive sebaceous glands
• Certain medications
• Mechanical friction or pressure from helmets or backpacks
• Environmental factors such as humidity

Goals of acne treatment are to relieve symptoms and to minimize scarring. Treatment is based on a variety of factors including, the severity of acne, medical history, medication tolerance, and patient preference. Common treatment regimens include:

• Topical bactericidals products containing benzoyl peroxide
• Hormonal treatments such as birth control pills and spironolactone
• Topical retinoids such as tretinoin, adapalene, tazarotene
• Phototherapy treatments such as IPL treatments

Successful management of acne often involves a combination of multiple different treatment modalities.

Acne scars are typically caused by damage to the collagen layer of skin as a result of the ongoing inflammation and at time from self-inflicted injury from picking. Acne scars can be improved by a number of different skin resurfacing procedures that can help stimulate collagen production and reduce the depth of the acne scars.

• IPL treatments
• Chemical Peels
• Topical lightening creams such as hydroquinone and retinols.

Acne Scars Patient data: Age:26 Skin Type II History of present condition: hyperpigmentation Previous medications: tetracycline; clindamycin solution Current treatments: Six Vitalize Peels every 3-4 weeks Concurrent medications: clindamycin solution Progressive improvement and good resolution of acne and acne scarring after six Vitalize Peels