Effectively treating acne

Acne may occur due to an increase in sebum production, keratinocyte hyperproliferation, colonisation with Propionibacterium acnes and subsequent skin inflammation.¹ It is an androgen-dependent condition affecting the pilosebaceous unit.¹ It is often considered an adolescent disease,² but acne can persist into the 30s in approximately 40 per cent of cases.³ Acne often requires long-term treatment due to periodic flare-ups. There can be significant psychosocial sequelae. Clinical features include: seborrhoea, comedones, inflammatory lesions comprising papules and pustules, as well as nodules. Post-inflammatory hyperpigmentation in addition to scarring might be present.⁴

A 30-year-old lady presented with facial acne that had begun in her teens. Her symptoms had deteriorated over the last few months. She thought stress related to bereavement might have been a contributory factor. She found her facial acne embarrassing and she felt low in mood.