Acne vulgaris, commonly known as “pimples,” is a common chronic inflammatory skin disease that occurs in the sebaceous glands of hair follicles in adolescents. It is thought to be related to four major factors: excessive sebum production, hyperkeratosis of the follicular sebaceous duct openings, propionibacterium acnes colonization, and inflammatory response, with severe cases being genetically related. The main clinical manifestations are acne, red papules, pustules, nodules, and even the formation of large cysts, superficial depressed scars or hyperplastic scarring on the jaws on the face, forehead and back of the shoulders. Referring to the Cunliffe grading method, it is classified as mild, moderate or severe. Mild acne is dominated by whiteheads and blackheads; moderate acne is dominated by inflammatory papules and pustules; and severe acne is dominated by severe inflammatory papules, nodules and inflammatory cysts. Mild patients with lesions are easier to treat; persistent moderate and severe acne is usually treated with topical and/or systemic application of antibiotics and retinoids, which are limited in the treatment of young acne due to antibiotic resistance and the toxic side effects of retinoids, especially in patients at the reproductive stage, which remains one of the challenges faced in clinical treatment. The post-acne hyperpigmentation, rough aging skin and various types of scarring produced by moderate and severe acne not only cause damage to the patient’s skin, but also have an impact on the physical and mental health of young people in terms of socializing, employment and choosing a spouse. Treatment of acne Due to the existence of different subtypes of acne and individual differences between patients, the treatment of acne should vary from person to person, rather than being set in stone. A personalized treatment plan should be tailored to each patient’s specific skin lesions and different degrees. 1. Mild acne: If the acne is mainly black and white head acne or accompanied by more acne, pick out the acne; if the acne is mainly oily skin or post-acne pigmentation, use Chinese herbal inversion; if there is a little inflammatory lesion, use Chinese herbal inversion + blue light treatment. 2. Moderate acne: Combined blue light treatment along with internal and external medication. 3.Medium and severe acne: Combine blue light therapy or red light therapy or ALA photodynamic therapy while taking internal and external medications. 4. Severe acne: Especially those with obvious nodules and cysts can directly adopt ALA photodynamic therapy. Avoid triggering and aggravating factors 1. Strictly control alcohol and spicy stimulating foods; 2. Reduce the intake of fried, sweet and greasy food and keep a light diet; 3. Strengthen skin protection and reduce computer radiation; do not use greasy and heavy cosmetics; avoid sun exposure in summer to reduce discoloration; pay attention to skin moisturization in winter; 4. Keep bowel movements smooth, avoid dry stools and hangovers; 5. Live a regular life, avoid staying up late and keep sleep 6, maintain a positive and optimistic attitude, treat the disease correctly and establish confidence to overcome “acne”. Correcting concepts and avoiding misconceptions 1. Many people mistakenly believe that acne is an insignificant disease that occurs only during adolescence and will gradually subside on its own as it grows older, so there is no need for treatment. It is not known that such a delay leads to an increase in the degree of damage inflammation, discoloration and scar formation, and misses the best time for early treatment, making the treatment passive and remedial. Therefore, we should attach great importance to the initial treatment of acne to retain our youth and not leave regrets. 2. Many patients are eager to cure their disease and take whatever drugs they want to use or take the same drugs to try when they see that others have good treatment results. As a result, acne is not treated but also causes skin irritation or skin allergies. Patients with acne need to be in a healthy mood and should not be in too much of a hurry. The inflammation of the lesions is likely to worsen and form larger nodules, cysts and scars. Only in regular hospitals are there professionals with expertise to identify for patients which lesions can be picked out and which lesions should be selected for other treatment programs. 4. Do not abuse and use antibiotics indiscriminately because patients with mild acne or acne manifestations do not need to use antibiotics; there are also some antibiotics that are not effective or resistant to killing Propionibacterium acnes and controlling acne inflammation. Do not refuse and fear the use of retinoids. As long as the dose of retinoids is controlled and used in patients with reproductive plans is avoided, retinoids are still safe and effective. 5. In the past, acne was treated only with topical medication or topical plus internal medication, and the efficacy was not very satisfactory due to the single treatment method. The emergence of new technologies has diversified treatment methods, especially red and blue light therapy and ALA-photodynamic therapy can more rapidly control inflammation, kill Propionibacterium acnes, and promote scar repair. The timely control of inflammation can also reduce post-inflammatory acne pigmentation; new technologies also play a role in preventing acne recurrence and reducing the degree of recurrence. Therefore, the birth of the new technology can be considered a blessing for patients with moderate to severe acne.