Acne vulgaris is the generic name for common acne, which mostly affects a patient’s face, but may also develop on the back, chest, and shoulder. Some people also claim that they get acne on their upper arms, but in most cases, these lesions are keratosis pilaris and not acne. Acne vulgaris lesions occur in the form of comedones, papules, pustules, and nodules. When the nodules are larger and more virulent than usual, they are called cysts, hence the term nodulocystic acne.

Types of acute acne vulgaris

Acne Conglobata: This is a chronic and acute form of acne vulgaris, and the commonest symptoms are large eruptions, inflammation, scarring, and prominent blackheads on the face, neck, upper arms and buttocks. The large nodules may conceal deep ulcers beneath them, causing extensive scarring. For some unknown reason, men develop acne conglobata more than women, usually in the age group of 18-35 years. The drug family isotretinoin (derived from Vitamin A) is usually the best treatment for acne conglobata, though the condition may recur once treatment is over, so regular monitoring is essential.

Acne Fulminans: This form of acne targets people with already existing inflammations, and is characterized by sudden and virulent eruptions of ulcerating acne, fever, and inflamed and aching joints. It has been found that a patient with acne fulminans has usually undergone treatment for acne conglobata, and that the Acne Treatment has not been a success. Acne fulminans usually requires a dose of cortico-steroids or non-steroidal anti-inflammatory medication. If the attacks recur, however, long-term treatment with isotretinoin may be required.

Nodulocystic Acne: Excruciatingly painful cysts, which may occur on the face, neck, scalp, back, chest and shoulders characterize this severe form of acne. Nodular acne cysts may arise from papular or nodular acne lesions, and are usually infected. Therefore, they should on account be interfered with, unless by a dermatologist. This is essential, because if two infected cysts develop close together, they could merge to cause cell destruction and inflammation, resulting in acne conglobata. While isotretinoin is the first line of defense for cysts, extreme cases may require surgical intervention.

Treatment of acne vulgaris

Acne vulgaris treatments range from over-the-counter (OTC) topical ointments to antibiotics and LASER therapy, but it is absolutely essential to consult a dermatologist before embarking on a course of treatment. Most OTC products contain benzoyl peroxide and are effective in cases of mild to moderate acne. However, benzoyl peroxide is known to cause dryness, irritation and redness of the skin.

Antibiotics such as erythromycin and tetracycline may prove successful over the short term, but their efficacy is limited because acne outbreaks may return within days of the treatment ending, and acne-causing bacteria have proved adept at developing a resistance to antibiotics.

In many women, dermatologists use hormone therapy for acne vulgaris, aimed at reducing levels of the male hormone androgen. A stronger alternative is to use oral isotretinoin, marketed as Accutane, Sotret and Claravis, which strike at the root of acne vulgaris by reducing oil production from the sebaceous glands.

But for people with less acute cases of acne vulgaris, skin-cleansing systems and products such as Exposed, TriClear or Proactive are likely to prove highly effective.

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