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Acne is a chronic inflammatory disease of the pilosebaceous units (oil secreting gland of the skin also known as sebaceous gland, which is present around the hair follicle). It is characterized by the formation of comedones, red/erythematous papules and pustules, less frequently by nodules or pseudo cysts and, in some cases, is accompanied by scarring. The condition usually starts in adolescence and frequently resolves by the mid-twenties. But can start as early as 9 years of age and may continue to appear even after 40 years of age. One type of pimples appear during infancy known as infantile acne and usually subside at the end of second year, but may last up to 5 years of age. Some people have particularly severe acne. This may be because of genetic factors (family members have bad acne). Hormonal factors (higher levels of male/androgenic hormones) due to polycystic ovaries .Excessive corticosteroids eg Cushing disease.Environmental factors such as high humidity.Cosmetics especially certain moisturisers, foundation and pomades. Watch out for products that contain lanolin, petrolatum, vegetable oils, butyl stearate, lauryl alcohol and oleic acid. Excessive dairy products, meat protein and certain medications may provoke acne.

Acne is often confined to the face but it may involve neck, chest and back. It is characterised by Open and closed uninflamed comedones (blackheads and whiteheads),inflamed papules and pustules, nodules and pseudocysts These heals with post-inflammatory erythematous or pigmented macules and scars. Severity is classified as mild, moderate or severe. The psychological and social impacts of acne are a huge concern, especially because acne affects adolescents at a crucial period when they are developing their personalities. During this time, peer acceptance is very important to the teenager and unfortunately it has been found that there are strong links between physical appearance and attractiveness and peer status.

Treatment of acne depends on its severity. Some time investigations are necessary before treatment and the investigations depends upon type of acne and its associated conditions. Mild type of acne can be treated with topical medications alone but moderate and sever type of acne needs systemic medications. Acne can be effectively treated, although response may sometimes be slow. Where possible, avoid excessively humid conditions such as a sauna, working in an unventilated kitchen or tropical vacations. Follow a low-glycaemic, low-protein and low-dairy diet.Eat plenty of fresh fruit and vegetables. If you smoke, stop. Nicotine increases sebum retention and increased scale within the follicles, forming comedones (blackheads and whiteheads). Minimize the application of oils and cosmetics to the affected skin. Abrasive skin treatments can aggravate both comedones and inflammatory lesions. Try not to scratch or pick the spots. To avoid sunburn, protect your skin outdoors using a sunscreen and protective clothing. Consult your doctor and take early treatment to prevent pigmentation and scars.

Dr.Laxman Mavarkar

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Jane and I wanted to thank you so much for the care you and your colleagues took of Jane whist in Mauritius. Everything went well and Prakash did a great job of getting us to your clinic and back over the 6 dialysis days. We had a wonderful holiday and our children and grandchildren plus the other family all enjoyed it enormously. Best wishes to you all

Andrew and Jane Stewart