[Progress in medicine in individual presentations, XI. Modern forms of therapy in acne]

Several pathogenetic factors contribute to the development of acne vulgaris. These include genetic predisposition, hormonal influences, increasing sebaceous secretion, bacterial colonization of the follicle and keratinization defects in the follicular epithelium. Modern acne therapy can take specific forms on the basis of recent research on pathogenesis. Sebostatic therapy can be performed by the topical application of benzoyl peroxide or the systemic administration of hormones (oestrogens, antiandrogens). Local treatment with retinoic has proved optimal in achieving a comedolytic effect. Moreover, the long-term use of antibiotics--tetracyclines, erythromycin systemically or benzoyl peroxide topically--is beneficial in respect to a reduction in Propionibacterium acnes. Experiments with immunological therapy are still in the early stages. Optimum results are obtained by the rational combination of several therapeutic modalities adapted to the type of acne to be treated.