Recommended Treatment Options in Acne Management

The document from 2006 discusses acne as an inflammatory disease of the pilosebaceous follicle, with pathogenesis involving four key stages: increased sebum production due to androgens, formation of microcomedones, colonization of the pilosebaceous duct with Propionibacterium acnes, and inflammation. Topical retinoids are recommended as first-line treatment for all but the most severe cases of acne, but often a combination of treatments is necessary. Acne typically develops during puberty when androgens like dihydrotestosterone increase sebum production, which, along with changes in its composition, promotes colonization by P. acnes. This bacterium is strongly implicated in the development of acne, and although acne is not infectious, colonization with P. acnes at puberty is associated with the onset of the disease. The document reviews the stages of acne development and the appropriate choice of treatment.