| Abstract | | Acne vulgaris is one of the most frequently seen chronic skin disease and is the commonest dermatological disorder of adolescents. Acne is a disease affecting the pilosebaceous follicles, in which there are four major aetiological Factors: increased sebum production, hypercornification, abnormal bacterial function and inflammation. Patients with mild acne will do well with topical therapy, and those with more severe acne need oral therapy. It is essential to stress to the patient that topical therapies will need to be used For the next several years. Most frequently used preparations are: mild keratolitics. benzoyl peroxide. retinoic acid and other retinoids, topical antibiotics such as erytrhomycin and clindamycin as well as azelaic acid. Oral treatment is indicated in subjects with moderate and severe acne. The three main groups of oral therapy in acne are: antibiotics, hormones and retinoids. Antibiotics are usually the first line of oral therapy and are given during several months. Tetracycline of primary generation is the first choice. but latelly further alternative in the tetracycline group are minocycline or doxycycline. Erythromycin has been shown to be effective too. as well as clindamycin. Hormonal therapy is indicated in those females who are not responding well to conventional therapy. One of the commonest hormonal regimen is estrogen plus cyproteron acetat given for 6 - 12 months. In acne conglobata, but lately also in less severe acne with scaring and significant psychological stress, treatment of choice is isotretinoin 0.5 - 1.0 mg/kg/day during 16-30 weeks period with cumulative dose of 120 mg/kg.
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