AWISH Clinic


Acne is the most common cutaneous disease affecting teenagers and young adults. It is not physically disabling, and its psychological impact can be striking, according to low confidencedepression, and stress. The psychological effects of embarrassment and fear can impact the social lives and employment of affected individuals. Scars can be disfiguring and lifelong. In one prospective study of 90 patients with acne, they found a significant improvement in self-esteem with acne treatment. Thus, clinicians must be familiar with acne Vulgaris and its treatment.


Postadolecent acne predominantly affects women, in contrast to adolescent acne, which has a male predominance. In one survey of over 1000 adults, self-reported acne in men and women was documented as following.

  • 20 to 29 years: 42 and 52 percent, respectively 
  • 30 to 39 years: 21 and 36 percent, respectively 
  • 40 to 49 years: 13 and 27 percent, respectively 
  • Ages 50 and older: 8 and 16 percent, respectively


Pilosebaceous follicles: — Acne vulgaris is a common inflammatory disease of the pilosebaceous unit. Four main pathogenetic factors are involved.

  •  Follicular hyperkeratinization 
  • Increased sebum production 
  • Propionibacterium acnes (also known as Cutibacterium acnes) within the follicle 
  • Inflammation

Follicular hyper keratinization

It is a critical element in acne’s pathogenesis and the retinoid activity’s primary target. Hyperkeratinization occurs when the follicle cells become cohesive and do not naturally shed onto the skin’s surface.

Increase sebum production

Sebum production slows until you hit puberty. When you hit adolescence, sebum production may increase up to 500 %. Male teenagers tend to produce more sebum than their female equals.

Propionibacterium acnes or Cutibacterium acnes

These type of acnes are a skin problem that occurs in many people due to the existence of the bacteria. Having clear, smooth skin is the dream for everyone, especially for women.


Acne is an irritating skin condition caused by captured oil and wreckage on your skin. When your facial pores become closed with oil, bacteria on your face lead to acne breakouts. Acne can soon become inflamed, causing painful, large red bulges on your skin.


A terminology change from Propionibacterium acnes to Cutibacterium acnes has been proposed based upon genetic analysis.

Treatments for Acne


Medical therapies for acne target one or more of four key factors that promote the development of acne lesions: follicular hyperproliferation and abnormal desquamation, increased sebum production, Cutibacterium (formerly Propionibacterium) acnes proliferation, and inflammation.

These factors are targeted as follows: 

Follicular hyperproliferation and abnormal desquamation.

  • Topical retinoids  
  • Oral retinoids  
  • Azelaic acid 
  • Salicylic acid 
  • Hormonal therapies

Increased sebum production

  • Oral isotretinoin
  • Hormonal therapies

C. acnes proliferation 

  • Benzoyl peroxide
  • Topical and oral antibiotics
  • Azelaic acid


  • Oral isotretinoin
  • Oral tetracyclines
  • Topical retinoids
  • Azelaic acid


Procedures for Acne

— Chemical Peel

  • Salicylic Acid 
  • Azelaic Acid
  • Yellow Peel 

— Laser Treatment 

— Comedone Extraction

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