ACNE

Acne is the most common disease in the world, arising from oily skin, blackheads and spots. For approximately 15% of people, the spots will persist, be widespread and create scarring. 5% of women and 1% of men in their 40’s will still be suffering long after it started.

The sebum produced by the sebaceous gland overworks due to Androgens ( male hormones). Dead skin cells that sit on the surface of the skin start to shed more slowly and clog pores where the sebum (oil) usually escapes. The combination of these two factors will result in the skin forming a tiny blockage, the starting point for all acne. This is the environment for acne bacteria which begin to multiply. This in turn leads to a chain reaction resulting in inflammation. If the blockage does not become infected then it remains as a solid lump – the blackhead.

Acne can leave inflammation, pigmentation and scarring (‘rolling, box and ice pick scars’).

Acne will eventually stop when the body stops responding to the immunological stimulus that is inducing acne. There are very few treatments that will cure acne, even Roaccutane, which is the strongest drug for acne, will have a 50% relapse rate.

Rosacea

Rosacea is facial flushing usually on the cheeks, and can also be present on the forehead, chin and nose. Some patients have only flushing or Erythematotelangiectatic rosacea, but others will progress to develop acneform inflammatory lesions – the papulopustular rosacea.

Most clinical trials in Rosacea have concentrated on the inflammatory lesions of Rosacea, mainly ignoring the flushing and facial redness. The only exceptions are Synchrorose and Bromonidine.