Acne is the most common chronic inflammation of the skin affecting 75% to 95% of teenagers but can remain a severe skin problem also for adults.
Whereas the typical signs of ageing such as loss of elasticity, age spots, uneven skin tone and wrinkles are more easily accepted and coped with, acne skin can have an adverse effect on self esteem and social relationships.
Prevalence of acne In a recent community-based study, 68% of male and 66.8% of female teenage participants were reported to have acne. Although less frequently encountered than in adolescence, a significant number of adults older than 20 years suffer from acne outbreaks.1 Usually acne is regarded as a physiologic phenomenon, which is likely to regress spontaneously after adolescence but in some individuals, acne persists. In fact, 8% to 20% of women and men between 25 and 35 years old and 5% of people 45 years old and more reported to have acne.2 Acne persistence during adulthood is more common in women.3
Pathogenesis of acne Acne is a common skin disease of the pilosabaceous follicles, characterised by non-inflammatory comedones and by inflammatory papules, pustules, and nodules in its more severe forms. Androgen stimulation is causative in the acne puzzle because the sex hormone triggers the sebaceous glands to produce more sebum. In parallel, hyperkeratinisation blocks the pilosebaceous canal by an excess of keratinocytes leading to a small swelling, referred to as microcomedo. If the mouth of the canal remains closed a so-called whitehead is seen. If the duct dilates and finally opens, oxidation processes create a so-called blackhead. These non-inflammatory comedos together with the sebum provide optimal conditions for the anaerobic Propionibacterium acnes (also part of the normal skin flora) to proliferate. The bacteria convert excess oil to free fatty acids, thus initiating inflammatory reactions causing irritation, redness, and discomfort but also papules and pustules. Acne is sometimes followed by mild to moderate reactions, such as postinflammatory hyperpigmentation (PIH).
Log in or register FREE to read the rest
This story is Premium Content and is only available to registered users. Please log in at the top of the page to view the full text.
If you don't already have an account, please register with us completely free of charge.