Many people believe (including some dermatologists/experts) that acne can only be relieved but not cured. At the other end of the spectrum, there are often advertisements with the phrase “3 days, no refund”. As far as the current treatment methods are concerned, it is entirely possible to achieve results in a few days, but for a complete treatment, it is impossible to achieve the purpose of treatment without half a year’s time. Therefore, do not believe in those advertisements and do not listen to folk remedies. The pathogenesis of acne: There are four recognized pathogenic links: hyperfunction of the sebaceous glands, hyperkeratosis of the follicular funnel, proliferation of Propionibacterium acnes and inflammatory response. A common misconception about the pathogenesis is that hyper sebaceous gland function = endocrine disorder = elevated androgen levels. It is difficult to explain this in one or two sentences. In short, the majority of acne patients have no difference in androgen levels from normal people (i.e., they are normal), and there is no “endocrine disorder” in the medical sense (more on this later). Propionibacterium acnes and the proliferation of an inflammatory response are not the same as an infection either. Do not mistake acne for a bacterial infection (but many people do), so it is a mistake to treat acne with the same antibiotics used to treat folliculitis. In fact, due to the advertisements and various “tips” and exaggerations by various online experts, many people listen to the so-called facial cleansing and deep cleansing, resulting in excessive cleansing. The skin eventually develops into a variety of skin subhealth problems such as skin sensitivity, enlarged pores, and dry skin outside and wet skin inside. It is important to note that excessive cleansing can harm the skin barrier function. It is important to emphasize that although acne (pimples) most commonly occurs in teenagers and has earned its elegant name: acne, remember that more and more adults, especially women in their 30s, are developing acne. “So don’t be surprised when a professional dermatologist diagnoses you with acne. Treatment: First of all, it is important to distinguish the level of acne (severity), in addition to clarifying the patient’s treatment history and medication history (to understand whether there is drug resistance and treatment resistance). Mild acne If the inflammatory rash is predominant, topical clindamycin and benzoyl peroxide are preferred, and if the rash is predominantly acne, topical retinoids are preferred. However, it is important to understand the patient’s skin type. Many topical medications have certain irritation reactions, and patients should be taught how to avoid irritation reactions to medications (i.e., taught how to use the medication correctly). Some online experts recommend using Banzai (benzoyl peroxide) in the morning and Daphne (a type of retinoic acid) in the evening, which in theory is a very good combination, but the combination of these two drugs can be very irritating and may cause dryness, peeling, irritation, etc. in a significant number of people, so it is to be expected that if patients use this treatment on their own and do not understand these irritation reactions, many people will have problems. It is expected that many people will have problems. This is the main reason why I am not a big fan of giving patients “tips” on the Internet. Moderate to severe acne is best treated with a combination of oral medication, or photodynamic therapy, laser and photon therapy, etc. Topical medication alone is unlikely to work! If oral medications are used, the course of treatment is the key, generally requiring a course of more than six months in order to treat acne more thoroughly. Commonly used medications include antibiotics (such as memantine), sex hormones (such as Daing-35), and vitamin A acid (such as Tylenol). It is strongly recommended that the use of these medications must be under the guidance of a physician, and that you do not trust the advice of online experts (even if they are experts) to purchase medications on your own.