Acne vulgaris is the most common skin disease in the world as it affects individ

uals of all age group be it newborn babies,children,teenagers or adults.

What is Acne Vulgaris : Acne vulgaris or pimple or zit is a disorder of the pilo
-sebaceous unit where the hair follicle meets the sebaceous glands in the skin.
The pilo-sebaceous unit consists of hair shaft,hair follicle,sebaceous gland whi
ch makes sebum and the erector pili muscle whose contraction causes erection of
hair.Acne vulgaris is characterized papules-pustules and nodules formation.
The sebaceous glands function to facilitate both desquamation and also lubricati
on of the skin. Embryologically the sebaceous glands develop from the hair germs
and the epidermis. Structurally the sebaceous glands are multi-lobed structures w
hich contain lipid secreting cells.The sebum produced by the sebaceous glands is
a mixture of triglycerides(50%),squaline(15%),wax(25%) and the rest is choleste
rol and free fatty acids.The face,chest and back regions of the body are found to
contain the highest concentration of pilo-sebaceous units.The sebaceous glands
are present all over the body except in the palms,soles,dorsum of foot and lower
lip.The sebaceous glands are large in newborn infants but regress shortly after b
irth.They remain relatively small in infancy and childhood but become enlarge an
d more active in the pre-pubertal period.
Acne Vulgaris and Acne Rosacea : Although both the skin conditions share the com
mon prefix acne but they are totally different. Patients wonder as what is the dif
ference between acne vulgaris and acne rosacea.As already mentioned acne vulgari
s involves inflammation of the sebaceous glands or from functional dysregulation
of the pilosebaceous unit and can occur in any age group whereas acne rosacea i
s a skin affliction which commonly develops in individuals older than 30 years a
nd affects about 10% of fair skinned individuals.Acne rosacea also has a major r
ole of inheritance and as such runs in generations.Its prevalence is also higher
in females and also more common in people of North European descent.Acne vulgar
is histology is similar to acne rosacea along with clinical features and psychoemotional component but both have different underlying pathophysiology and so th
e treatment of acne vulgaris and acne rosacea is different.
Prognosis of Acne Vulgaris : Most teenage boys can anticipate clearing of their
acne lesions between 20 and 25 years of age. The majority of patients with adult
acne, including adult-onset acne, are women which can last up to and beyond 40 y
ears of age. Eighty five percent of people between the ages of 12--24 years will
have some acne. Worldwide spending on prescription and over the counter acne tr
eatments is estimated to be tens of billions of dollars each year which makes it
one of the fastest growing markets in the dermatological industry to date. Alth
ough the majority of cases are seen through the teenage period and in young adul
thood but acne may occur at any time during the life span. While it is not typica
lly associated with any significant co-morbidity,acne may have marked social and
psychological consequences which demands a multidimensional approach for manage
ment of acne and its prevention.
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