Acne, medically called Acne vulgaris, is a common skin disease 
that affects 85-100% of people at some time during their lives. 
Acne vulgaris affects the areas of skin with the densest 
population of sebaceous follicles; these areas include the 
face, the upper part of the chest, and the back.

Follicular epidermal hyper proliferation and hyper 
keratinization appears to be one of the primary events in the 
development of an acne lesion. The follicular epidermis is 
hyper proliferative. Increasing levels of the adrenally derived 
hormones are correlated with the development of the primary 
acne lesion. This hyper proliferation may also be stimulated 
by an alteration in sebum and lipid levels in acne lesions. 
For example, some fatty acid levels are decreased in acne 
lesions, and the levels ormalize after successful treatment 
with isotretinoin. 

Excess sebum is also a key factor in the development of acne. 
The amount of sebum produced and the degree and the severity 
of the acne are strongly correlated. Sebum excretion is under 
hormonal control. Androgens stimulate sebum production, whereas 
estrogens have an inhibitory effect. 

P acnes is a microaerophilic organism present in many acne 
lesions. Although, it has not been shown to be present in the 
earliest lesions of acne, its presence in later lesions is 
almost certain. P acnes stimulates inflammation by producing 
proinflammatory mediators that diffuse through the follicle 
wall. Hypersensitivity to P acnes may also explain why some 
individuals develop inflammatory acne vulgaris. 

It is obviously a disease: acne can cause physical pain and 
psychosocial suffering, can lead to scarring, and a severe 
inflammatory variant of acne, acne fulminans, can be associated 
with fever, arthritis, and other systemic symptoms. Acne 
vulgaris is more common in males than in females during 
adolescence, and is more common in women than in men during 
adulthood. 

Benzoyl peroxide cream is available over the counter and is 
effective for a number of people. It will kill the bacteria by 
it's application twice a day.  You can find out more about skin 
care and find an effective benzoyl peroxide product here:
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Another topical treatment is called tretinoin/isotretinoin. 
This acts like chemical sandpaper and dries up the oil. The 
side effects may leave you very red and are unacceptable to 
many . With perseverance many will find relief. Users often 
find it helpful to stop for a day or two if the side effects 
get too bad and then recommence once the skin has recovered 
slightly. Like Benzoyl peroxide, tretinoin needs time to work.

Other topical treatments available include topical antibiotics 
and zinc. Cleocin is a popular topical that many find useful 
for mild acne.

Antibiotics are often prescribed by physicians and can be 
effective in clearing up mild to moderate acne. Minocycline is 
one of the most common and is usually prescribed in six-month 
courses. It is well tolerated but you should once again avoid 
the sun as you can develop spots on your skin. Oxytetracycline 
is another commonly prescribed antibiotic, which is similar in 
action to minocycline. 

If the tetracyclines don't work you will probably be given 
erythromycin. Whatever antibiotic you go on you should remain on 
it for a minimum of six months and expect to see an improvement 
in about a month. This is because the capillaries that feed your 
skin are very small and so the drug needs plenty of time to get 
into your system. Antibiotics work best when combined with a 
topical peeling agent such as tretinoin. It is good to take 
some yogurt or acidopholous culture to replenish the loss of 
good bacteria from antibiotics. Also, there are issues around 
developing a tolerance as well as the usage of antibiotics for 
skin perhaps conflicting for more urgent medical problems such 
as strep throat or pneumonia.

There are alternative treatments available, some sufferers have 
used sun lamps and non-uv light boxes with good effect and 
homeopathic treatments are well spoken. Of course sun lamps are 
now controversial due to questions of skin cancer. 

If you do have acne remember that there is help available today 
and many over the counter products have a money back guarantee.