Acne, commonly known as acne, pimples, acne, and acne, is known in ancient Chinese medicine as facial sores and wine spurs. It is a common disease in dermatology. According to scholars, 95% of males and 85% of females suffer from acne of varying degrees during adolescence, so it is apt to call it “acne”. Acne is a chronic skin disease that occurs in the sebaceous glands of the hair follicles, mostly on the head and face, neck, chest and back, and other areas rich in sebaceous glands. The age of acne is now expanding and is not exclusive to young people. I. What causes acne? The pathogenesis of acne is not well understood. Endocrine factors, the role of sebum, and microorganisms in the hair follicle are the main factors in the development of acne. Acne is closely related to sexual endocrinology, and rarely develops before puberty. People who have lost or reduced sexual function, such as eunuchs who were castrated at the ancient court, do not develop acne; people with reduced sexual function, such as those who apply testosterone, can promote the growth of beard and acne; when corticotropin or corticosteroids are used to treat disease, they often cause acne rashes; women often have acne attacks before menstruation, and acne symptoms are reduced during pregnancy. Both men and women have androgens and estrogens. The organs that secrete sex hormones are the testes and adrenal glands in men, and the ovaries, placenta and adrenal glands in women. Progesterone and dehydroepiandrosterone (DHA) in the adrenal cortex are also involved. The latter may play an important role in early acne. Testosterone is converted into the more active 5-alpha dihydrotestosterone by the action of 5-alpha reductase in the skin, which stimulates sebaceous gland cell turnover and lipid synthesis, causing an increase in sebum secretion, producing thick and abundant sebum, which cannot be excreted completely and gradually accumulates in the mouth of the hair follicle. The epithelial cells shed on the follicle wall increase and mix with the thick sebum, becoming a cheese-like substance, which plugs in the mouth of the follicle to form acne, and later the tip exposed outside the mouth of the follicle gradually dries out, and after the oxidation of air, melanin deposition, dust pollution and discoloration to form blackhead acne, the presence of Acinetobacter, white staphylococcus and oval bacillus, especially Acinetobacter These free fatty acids can cause non-specific inflammatory reactions to occur in and around the hair follicle. When the minimal ulceration of the acne wall and the free fatty acids enter the nearby dermis, coupled with the squeezing of nearby cells by the blackheads, their antibacterial power decreases and they become susceptible to bacterial infection causing inflammation, so the patient Pimples, pustules, nodules, nodules and abscesses occur. In recent years, it has been suggested that the disease is immune-related. In the humoral immunity of its patients, serum IgG levels are increased and increase with the aggravation of the disease, and Acinetobacter produces antibodies in the patient’s body, and circulating antibodies reach the local area to participate in the pathogenic process of early inflammation. Regarding the relationship between micronutrients and acne, it has recently been demonstrated that low zinc in acne patients may affect the utilization of vitamin A, prompting the keratinization of the sebaceous glands of hair follicles, and low copper may weaken the body’s resistance to bacterial infection, etc. In short, acne patients with low micronutrients zinc, copper, iron, and elevated manganese may cause the body’s fat metabolism and sex hormone secretion to be affected to some extent, which, together with low skin resistance, may have a certain relationship with the development of acne. This, together with low skin resistance, may be related to the development of acne. In addition, genetics is also an important factor in the development of acne. In addition to the above factors, eating more animal fats and sugary foods, gastrointestinal disorders such as indigestion or constipation, mental stress, and hot and humid climates can have a negative impact on acne patients. Second, what are the manifestations of acne and how is it diagnosed? In seborrheic damage, the affected tissue is abscessed and surrounded by many lymphocytes and multinucleated leukocytes, and sometimes staphylococci can be found. If the damage has been prolonged, plasma cells, foreign body giant cells and proliferating fibroblasts can also be seen. In larger lesions, the sebaceous glands are partially or completely destroyed, sometimes becoming very large cysts. The lesions occur mainly on the face, but also on the upper chest and back and shoulders, and occasionally on other areas, and the periorbital skin is never involved. At the beginning, patients almost always have blackheads and oily seborrhea, but also often have papules, nodules, pustules, abscesses, sinus tracts or scarring, and the various types of damage vary in size and depth, often with one or two of them predominating. After puberty, most patients can naturally heal or have their symptoms reduced. Clinically, according to the main manifestations of the lesions can be divided into the following types: 1, pitting acne Blackhead acne is the main damage of acne, is stuffed in the follicle sebaceous gland mouth of the cheese semi-solid, exposed in the follicle mouth of the outer end of the black, such as pressure squeezed, the head is black and the body is yellow-white translucent The sebaceous plugs are discharged. 2.Papular acne The lesions are mainly inflammatory papules, small hard papules from millet to pea size, light red to dark red, with a blackheaded pimple or a sebaceous pimple with an unblackened tip in the center of the papule. 3.Pustular acne The performance of pustules is dominated by pustules, which are grain to green bean in size and are follicular pustules and pustules formed at the tip of the papule, with thicker pus after breaking and leaving shallow scarring after healing. 4.Nodular acne When the inflammation site is deeper, pustular acne can develop into thick-walled nodules of varying sizes, light red or purplish red, some in deeper locations, with significant elevation and in hemispheres or cones, they can exist for a long time or gradually absorbed, and some pus ulcerated to form significant scarring. 5.Atrophic acne Papular or pustular damage destroys the glands and causes pit-like atrophic scarring. The ulcerated pustules or naturally absorbed papules and pustules can cause fibrous changes and atrophy. 6. Cystic acne forms sebaceous cysts of varying sizes, often secondary to purulent infection, and often bleeds jelly-like pus after rupture, while inflammation is often not heavy, and later forms sinus tracts and scarring. 7. Aggregate acne is the most severe type of damage, with polymorphic lesions, many pimples, papules, pustules, abscesses, cysts and sinus tracts, scarring, and keloids occurring in clusters. 8, malignant acne The damage is a greenish-red or purplish-red papule, pustule or nodule of millet to bean size, light and soft, and contains pus and blood, they do not heal for a long time, and later heal leaving tiny scars, also do not feel pain, infiltration is also rare, this type is mostly seen in patients with weak health.