When the whiteheads of acne are not effectively controlled, the lesion part will further develop into inflammatory papules or pustules. In terms of severity acne is divided into four levels, generally acne belongs to the first degree, then inflammation is called the second degree, nodules are the third degree, and cystic scars are the fourth degree, while acne is generally mild, inflammation is moderate, and nodular cysts are severe. Mild to moderate acne is clinically more common in terms of incidence probability. The cause of acne is the blockage of sebaceous ducts in whiteheads, and a parasitic bacterium, Propionibacterium acnes, can multiply in anaerobic conditions and cause localized skin infections, resulting in inflammation such as redness, swelling, heat, pain and itching. Inflammatory acne mostly occurs when you stay up late and get tired, eat spicy stimuli or take hormones due to illness, etc. The original acne will become red, swollen and large, and some superficial lesions will develop into pustules, while those in a deeper location will become inflammatory papules. The pustules will rupture outward, and the pus will come out and heal. If the inflammatory papules do not recover well, they will further develop into nodular cysts and eventually leave scars, which will eventually affect the facial appearance and many of them will bring social and psychological stress to themselves. The current treatment status is as follows: Mild inflammatory acne can be treated with topical applications only. The most commonly used is the application of antimicrobial ointments, such as fusidic acid ointment, clindamycin ointment, erythromycin isotretinoin gel, and peroxynivalenol gel, etc. The latter two local skin irritation is more obvious. Clinically, we often see patients with facial allergic irritation due to improper use or skin sensitivity, with large redness, swelling, itchiness, and even oozing blisters, which require timely treatment by dermatologists to control. If you have a lot of localized lesions, you can also use topical fruit acid products to make a mask, especially for whiteheads with inflammatory lesions, clinically used is the hydralic acid resurfacing and fruit acid resurfacing, but there is a risk of allergic irritation in some patients. However, there is a risk of allergic irritation in some patients. Treatment should be done under the guidance of a professional clinic and experienced physician. In contrast, herbal masks are safer, and although there is the possibility of allergic irritation, the incidence is much smaller. In clinical practice, herbal powders are used to clear heat, detoxify and disperse swelling. Compared to skin resurfacing, the latter has less obvious immediate effect and requires half an hour once a day, which is usually effective after one to two weeks. Finally there are some patients who cannot use medicine for various reasons, they can also do local red and blue light treatment, but the efficiency is not ideal, but the efficacy of high-energy blue light is possible, that is, photon 420nm hand cabinet head treatment, generally once a week for treatment, powerful twice a week, treatment will be effective three times, if it is not effective means that the therapy is not suitable, then it should be discontinued. The principle is to use the local metabolism of Propionibacterium acnes to produce porphyrins, while the 420nm wave irradiation locally produces monomorphic oxygen ions, which efficiently kills Propionibacterium acnes and eliminates inflammation; at the same time, it can inhibit the secretion of sebum by sebaceous glands and reduce greasiness; it can also promote the recovery of acne inflammation and accelerate the fading of pigment and scar repair. When the area of inflammatory acne is large, drugs can be added for internal use. At present, the most effective treatment is the use of antimicrobial agents. Minocycline is preferred, while other antimicrobial agents are less effective. Other antimicrobials are less effective. However, it takes one to two weeks for them to take effect, and they need to be taken orally for a longer period of time. I often met some students who came back from abroad, they were abroad for acne inflammation, the doctor usually gave a minocycline oral medicine, the response is still good. However, the disadvantage is that some patients will experience dizziness, stomach discomfort and nausea, and prolonged oral intake will cause diarrhea and vaginal dysbiosis in female patients, while individual patients will also experience hyperpigmentation and photosensitivity after sun exposure, and patients who are preparing for childbirth and pregnancy should not take it within three months because of teratogenic effects. Some doctors may recommend oral isotretinoin drugs such as Tylenol, which should be taken together with effective antibacterial drugs, and clinically minocycline and isotretinoin drugs together are prone to dizziness, so avoid combining the two drugs unless the doctor weighs the pros and cons. For inflammatory acne, I recommend using isotretinoin with caution. Finally, oral Chinese medicine is sometimes a good choice. Experienced herbalists will choose the appropriate Chinese medicine for systemic conditioning according to the patient’s individual situation, effectively reducing the further development and recurrence of the disease and promoting the body’s self-recovery. The disadvantages are the inconvenience of decocting the herbal medicine by oneself (but now there is a decoction service, a one-time decoction can be wrapped up and hot water can be used when taking it.