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Acne
Other namesAcne vulgaris
Photograph of an 18-year-old male with moderate severity acne vulgaris demonstrating classic features of whiteheads and oily skin distributed over the forehead
Acne vulgaris in an 18-year-old male during puberty
SpecialtyDermatology
SymptomsBlackheads, whiteheads, pimples, oily skin, scarring[1][2]
ComplicationsAnxiety, reduced self-esteem, depression, thoughts of suicide[3][4]
Usual onsetPuberty[5]
Risk factorsGenetics[2]
Differential diagnosisFolliculitis, rosacea, hidradenitis suppurativa, miliaria[6]
TreatmentLifestyle changes, medications, medical procedures[7][8]
MedicationAzelaic acid, benzoyl peroxide, salicylic acid, antibiotics, birth control pills, isotretinoin[8]
Frequency633 million affected (2015)[9]

Acne, also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles.[10] Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring.[1][2][11] It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back.[12] The resulting appearance can lead to anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.[3][4]

Genetics is the primary cause of acne in 80% of cases.[2] The role of diet and cigarette smoking in the condition is unclear, and neither cleanliness nor exposure to sunlight appears to play a part.[2][13][14] In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum.[5] Another common factor is the excessive growth of the bacterium Cutibacterium acnes, which is present on the skin.[15]

Treatments for acne are available, including lifestyle changes, medications, and medical procedures. Eating fewer simple carbohydrates such as sugar may minimize the condition.[7] Treatments applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid, are commonly used.[8] Antibiotics and retinoids are available in formulations that are applied to the skin and taken by mouth for the treatment of acne.[8] However, resistance to antibiotics may develop as a result of antibiotic therapy.[16] Several types of birth control pills help against acne in women.[8] Medical professionals typically reserve isotretinoin pills for severe acne, due to greater potential side effects.[8][17] Early and aggressive treatment of acne is advocated by some in the medical community to decrease the overall long-term impact on individuals.[4]

In 2015, acne affected approximately 633 million people globally, making it the eighth-most common disease worldwide.[9][18] Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world.[19][20][21] Some rural societies report lower rates of acne than industrialized ones.[21][22] Children and adults may also be affected before and after puberty.[23] Although acne becomes less common in adulthood, it persists in nearly half of affected people into their twenties and thirties, and a smaller group continues to have difficulties in their forties.[2]

  1. ^ a b Vary JC (November 2015). "Selected Disorders of Skin Appendages--Acne, Alopecia, Hyperhidrosis". The Medical Clinics of North America (Review). 99 (6): 1195–211. doi:10.1016/j.mcna.2015.07.003. PMID 26476248.
  2. ^ a b c d e f Bhate K, Williams HC (March 2013). "Epidemiology of acne vulgaris". The British Journal of Dermatology (Review). 168 (3): 474–85. doi:10.1111/bjd.12149. PMID 23210645. S2CID 24002879.
  3. ^ a b Barnes LE, Levender MM, Fleischer AB, Feldman SR (April 2012). "Quality of life measures for acne patients". Dermatologic Clinics (Review). 30 (2): 293–300, ix. doi:10.1016/j.det.2011.11.001. PMID 22284143.
  4. ^ a b c Goodman G (July 2006). "Acne and acne scarring - the case for active and early intervention". Australian Family Physician (Review). 35 (7): 503–4. PMID 16820822. Archived from the original on 21 April 2013.
  5. ^ a b James WD (April 2005). "Clinical practice. Acne". The New England Journal of Medicine (Review). 352 (14): 1463–72. doi:10.1056/NEJMcp033487. PMID 15814882.
  6. ^ Kahan S (2008). In a Page: Medicine. Lippincott Williams & Wilkins. p. 412. ISBN 9780781770354. Archived from the original on 6 September 2017.
  7. ^ a b Mahmood SN, Bowe WP (April 2014). "[Diet and acne update: carbohydrates emerge as the main culprit]". Journal of Drugs in Dermatology (Review). 13 (4): 428–35. PMID 24719062.
  8. ^ a b c d e f Titus S, Hodge J (October 2012). "Diagnosis and treatment of acne". American Family Physician (Review). 86 (8): 734–40. PMID 23062156. Archived from the original on 18 February 2015.
  9. ^ a b GBD 2015 Disease Injury Incidence Prevalence Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  10. ^ Aslam I, Fleischer A, Feldman S (March 2015). "Emerging drugs for the treatment of acne". Expert Opinion on Emerging Drugs (Review). 20 (1): 91–101. doi:10.1517/14728214.2015.990373. PMID 25474485. S2CID 12685388.(subscription required)
  11. ^ Tuchayi SM, Makrantonaki E, Ganceviciene R, Dessinioti C, Feldman SR, Zouboulis CC (September 2015). "Acne vulgaris". Nature Reviews. Disease Primers. 1: 15033. doi:10.1038/nrdp.2015.33. PMID 27227877. S2CID 44167421.
  12. ^ "Frequently Asked Questions: Acne" (PDF). U.S. Department of Health and Human Services, Office of Public Health and Science, Office on Women's Health. July 2009. Archived from the original (PDF) on 10 December 2016. Retrieved 30 July 2009.
  13. ^ Knutsen-Larson S, Dawson AL, Dunnick CA, Dellavalle RP (January 2012). "Acne vulgaris: pathogenesis, treatment, and needs assessment". Dermatologic Clinics (Review). 30 (1): 99–106, viii–ix. doi:10.1016/j.det.2011.09.001. PMID 22117871.
  14. ^ Schnopp C, Mempel M (August 2011). "Acne vulgaris in children and adolescents". Minerva Pediatrica (Review). 63 (4): 293–304. PMID 21909065.
  15. ^ Cite error: The named reference Zaenglein2018 was invoked but never defined (see the help page).
  16. ^ Beylot C, Auffret N, Poli F, Claudel JP, Leccia MT, Del Giudice P, Dreno B (March 2014). "Propionibacterium acnes: an update on its role in the pathogenesis of acne". Journal of the European Academy of Dermatology and Venereology (Review). 28 (3): 271–8. doi:10.1111/jdv.12224. PMID 23905540. S2CID 26027411.
  17. ^ Vallerand IA, Lewinson RT, Farris MS, Sibley CD, Ramien ML, Bulloch AG, Patten SB (January 2018). "Efficacy and adverse events of oral isotretinoin for acne: a systematic review". The British Journal of Dermatology. 178 (1): 76–85. doi:10.1111/bjd.15668. PMID 28542914. S2CID 635373.
  18. ^ Hay RJ, Johns NE, Williams HC, Bolliger IW, Dellavalle RP, Margolis DJ, et al. (June 2014). "The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions". The Journal of Investigative Dermatology. 134 (6): 1527–1534. doi:10.1038/jid.2013.446. PMID 24166134.
  19. ^ Taylor M, Gonzalez M, Porter R (May–June 2011). "Pathways to inflammation: acne pathophysiology". European Journal of Dermatology (Review). 21 (3): 323–33. doi:10.1684/ejd.2011.1357. PMID 21609898.
  20. ^ Dawson AL, Dellavalle RP (May 2013). "Acne vulgaris". BMJ (Review). 346 (5): 30–33. doi:10.1136/bmj.f2634. JSTOR 23494950. PMID 23657180. S2CID 5331094.
  21. ^ a b Goldberg DJ, Berlin AL (October 2011). Acne and Rosacea: Epidemiology, Diagnosis and Treatment. London: Manson Pub. p. 8. ISBN 978-1-84076-150-4. Archived from the original on 2 July 2016.
  22. ^ Spencer EH, Ferdowsian HR, Barnard ND (April 2009). "Diet and acne: a review of the evidence". International Journal of Dermatology (Review). 48 (4): 339–47. doi:10.1111/j.1365-4632.2009.04002.x. PMID 19335417. S2CID 16534829.
  23. ^ Admani S, Barrio VR (November 2013). "Evaluation and treatment of acne from infancy to preadolescence". Dermatologic Therapy (Review). 26 (6): 462–6. doi:10.1111/dth.12108. PMID 24552409. S2CID 30549586.
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