Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Patients with acne can experience significant psychological morbidity and, rarely, mortality due to suicide [1,2]. The psychological effects of embarrassment and anxiety can impact the social lives and employment of affected individuals. Scars can be disfiguring and lifelong. In one prospective study of 90 patients with acne, a significant improvement in self-esteem was found with treatment of the acne . Thus, it is imperative that clinicians are familiar with acne vulgaris and its treatment.
The pathogenesis, clinical manifestations, diagnosis, and differential diagnosis of acne vulgaris will be reviewed here. The treatment of acne vulgaris is discussed elsewhere. (See "Treatment of acne vulgaris" and "Hormonal therapy for women with acne vulgaris" and "Oral isotretinoin therapy for acne vulgaris" and "Light-based, adjunctive, and other therapies for acne vulgaris".)
Estimates of the prevalence of acne vulgaris in adolescents range from 35 to over 90 percent [4,5]. Acne tends to resolve in the third decade, but it may persist into or develop de novo in adulthood. The exact prevalence in adults is uncertain, and studies using a clinical examination typically find a lower prevalence than surveys asking for patients to self-report acne.
Post-adolescent acne predominantly affects women, in contrast to adolescent acne, which has a male predominance . In one survey of over 1000 adults, self-reported acne in men and women was documented as follows :
●20 to 29 years: 43 and 51 percent, respectively