Epidemiology of acne vulgaris

Abstract

SummaryDespite acne being an almost universal condition in younger people, relatively little is known about its epidemiology. We sought to review what is known about the distribution and causes of acne by conducting a systematic review of relevant epidemiological studies. We searched Medline and Embase to the end of November 2011. The role of Propionibacterium acnes in pathogenesis is unclear: antibiotics have a direct antimicrobial as well as an anti-inflammatory effect. Moderate-to-severe acne affects around 20% of young people and severity correlates with pubertal maturity. Acne may be presenting at a younger age because of earlier puberty. It is unclear if ethnicity is truly associated with acne. Black individuals are more prone to postinflammatory hyperpigmentation and specific subtypes such as 'pomade acne'. Acne persists into the 20s and 30s in around 64% and 43% of individuals, respectively. The heritability of acne is almost 80% in first-degree relatives. Acne occurs earlier and is more severe in those with a positive family history. Suicidal ideation is more common in those with severe compared with mild acne. In the U.S.A., the cost of acne is over 3 billion dollars per year in terms of treatment and loss of productivity. A systematic review in 2005 found no clear evidence of dietary components increasing acne risk. One small randomized controlled trial showed that low glycaemic index (GI) diets can lower acne severity. A possible association between dairy food intake and acne requires closer scrutiny. Natural sunlight or poor hygiene are not associated. The association between smoking and acne is probably due to confounding. Validated core outcomes in future studies will help in combining future evidence.The clinical and histological features of acne, a chronic inflammatory disease of the pilosebaceous unit, are well described. Scarring is often present following inflammation 3 as illustrated in Figure 1. The pathophysiological events occurring in acne are also relatively well studied. Lesions start when keratinocytes lining the hair follicle desquamate creating a microcomedone. At puberty increased sebum production creates an environment that can sustain the colonization of Propionibacterium acnes. As P. acnes proliferates, inflammatory and chemotactic mediators are produced, which in turn drive inflammatory processes. 4Despite advances in understanding the pathophysiology of acne, much less appears to have been written about its epidemiology, which is strange considering that acne is almost universal in teenage years. Epidemiology not only describes the burden of disease in terms of incidence, prevalence and variations according to age, sex, social class, ethnic group and geography, but also has the potential to identify specific risk factors for disease occurrence or progression, which may be amenable to manipulation. Discovery of risk factors or factors that exacerbate existing disease could lead to appropriate primary or secondary preventative measures and treatments, which in turn could lead t...

Acne Vulgaris in Jeddah Medical Students: Prevalence, Severity, Self-Report, and Treatment Practices

“…Acne prevalence was reported to be 85% in the population age of 12 to 24 years [2] [12] [13]. On the acne self-assessment questionnaire, acne was reported by 83.4% of students compared to 98% by the physician's examination.…”

“…Women are most commonly affected with a mean age for presentation of 24 years [1]. In the US, the prevalence rate of acne is 85% in those aged 12 to 24 years [2]. Only a small percentage of acne patients are treated by a dermatologist or prescribed medications [3].…”

Antibacterial photosensitization through activation of coproporphyrinogen oxidase

“…Furthermore, ∼10% of hospitalized patients suffer from an SSTI (1). These infections are typically caused by Gram-positive bacteria including Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acnes, and Bacillus anthracis, the causative agents of "staph infections," hospital-acquired infections, acne, and cutaneous anthrax, respectively (1)(2)(3)(4). S. aureus and P. acnes are the most prevalent causative agents of SSTIs (1)(2)(3)(4).…”

“…These infections are typically caused by Gram-positive bacteria including Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acnes, and Bacillus anthracis, the causative agents of "staph infections," hospital-acquired infections, acne, and cutaneous anthrax, respectively (1)(2)(3)(4). S. aureus and P. acnes are the most prevalent causative agents of SSTIs (1)(2)(3)(4). In fact over 90% of the world's population will suffer from acne over the course of their lifetime, leading to annual direct costs of over $3 billion (1,2,5,6).…”

“…S. aureus and P. acnes are the most prevalent causative agents of SSTIs (1)(2)(3)(4). In fact over 90% of the world's population will suffer from acne over the course of their lifetime, leading to annual direct costs of over $3 billion (1,2,5,6). The threat of these pathogens is compounded by the tremendous rise in antibiotic resistance, reducing the efficacy of the existing antibacterial armamentarium (1,3,4).…”