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Beliefs and perceptions of patients with acne
Abstract
There is a paucity of information on the knowledge and understanding of patients with acne about their condition.
The objective of this study is to evaluate the knowledge, beliefs, and perceptions of acne patients regarding their understanding of acne pathogenesis, sources of information, treatment options, and expectations.
Patients referred to a community-based dermatologist for management of acne vulgaris completed a self-administered questionnaire. Responses were correlated with demographic and clinical information.
Seventy-four percent of patients waited more than 1 year before seeking medical attention for acne. Nonprescription products used most frequently were cleansers, acne pads, and lotions. Acne was most often believed to be caused by hormonal and genetic factors, although diet, poor skin hygiene, and infection were also implicated. Information on acne was obtained primarily from family physicians, mass media, friends, and family, but was largely believed to be inadequate. Acne was believed to be curable by 49% of patients with an anticipated treatment duration of less than 6 months. Male patients and those with severe acne preferred systemic therapy compared with female patients and those with lesser grades of acne.
There is a need for accessible, accurate, community-based education on the natural history of acne, pathogenesis, risk of sequelae, the effectiveness and expected duration of treatment, and the importance of prompt medical attention.
... Hal ini sejalan dengan penelitian di Pakistan dan Kanada yang menyebutkan sebagian besar pasien (54% dan 74%, secara berurutan) menderita akne vulgaris lebih dari 1 tahun sebelum berkonsultasi ke dokter. 8,14 Hal ini dapat disebabkan adanya variasi dalam perilaku mencari pengobatan yang terkait dengan kurangnya pengetahuan dan persepsi tentang AV di antara populasi pada umunya dan di antara pasien AV sendiri. 7 Sebagian besar responden 38.3% telah mencoba lebih dari 1 jenis produk bahkan 5% responden telah mencoba 5 jenis produk kecantikan untuk mengatasi AV sebelum memutuskan untuk berobat ke dokter, dimana produk kosmetik yang paling sering digunakan adalah sabun pembersih wajah (38.1%). ...
... Aspek Kehidupan Responden perberat akne vulgaris adalah stres. 6,7,14 Penelitian di China menyebutkan terdapat korelasi yang bermakna antara stres dan derajat keparahan AV. Stres dapat menyebabkan peningkatan kadar hormon glukokortikoid dan androgen yang mengakibatkan terjadinya eksaserbasi AV. 16 Terkait dengan faktor kebersihan wajah, beberapa penelitian sebelumnya menunjukkan hasil yang bervariasi. ...
... Penelitian Yahya (26.3%) dan Tahir (64%) menunjukkan bahwa faktor kebersihan wajah yang kurang sebagai faktor yang paling besar memperberat terjadinya AV sedangkan faktor kebersihan wajah bukan yang pencetus terbanyak pada penelitian Al Hoqail (15%) dan Tan (29%). 6,8,12,14 Peran makanan/diet baik dalam menyebabkan maupun memperberat AV masih kontroversial. Intervensi diet dengan menggunakan karbohidrat dengan indeks glikemik rendah diduga mempunyai efek terapeutik terhadap pengobatan AV karena efek diet ini terhadap sistem endokrin. ...
Pendahuluan: Beberapa penelitian di negara maju maupun berkembang telah menunjukkan bahwa penderita akne vulgaris (AV) mendapatkan informasi yang inadekuat tentang penyebab dan penanganan AV. Tujuan: Mengetahui karakteristik pengetahuan dan persepsi penderita AV terkait faktor penyebab, sumber informasi, penatalaksanaan dan dampak psikososial AV di kota Mataram Metode: Penelitian ini merupakan survei karakteristik pengetahuan dan persepsi dengan rancangan penelitian deskriptif dengan pendekatan cross sectional. Hasil: Dari 162 responden, 51,2% sudah menderita AV selama lebih dari 1 tahun dan 54,9% termasuk derajat ringan. Sebanyak 30% responden menyatakan bahwa AV disebabkan oleh penyebab tunggal dan jenis penyebab terbanyak adalah karena kurangnya kebersihan wajah (34,8%). Stres (25,3%) merupakan faktor yang paling banyak dianggap berperan dalam memperberat AV. Tiga sumber informasi terbesar terkait AV berasal dari internet (20,9%), televisi/radio (19,9%) dan dokter (17,2%). Harapan responden (55,6%) pengobatan berlangsung dalam waktu kurang dari 2 minggu untuk mengatasi AV. Sebagian besar responden (38,3%) telah mencoba lebih dari 1 jenis produk untuk mengatasi AV sebelum memutuskan untuk berobat ke dokter dan sabun pembersih jerawat merupakan produk yang paling banyak digunakan oleh responden (38,1%). Sebagian besar responden (36,4%) menyatakan bahwa menderita AV memiliki pengaruh yang sangat besar terhadap penampilan. Kesimpulan: masih adanya informasi yang belum adekuat dari sumber yang telah ada terkait penyebab, faktor yang mencetuskan dan penanganan AV.
... Over one-half of pupils (56.4%) indicated genetics as aggravating factors, while lack of sleep and smoking were considered to be risk factors for almost a half of pupils (47.8% and 47.0%, respectively). Our findings are consistent with other studies which reported that poor diet [11,15,[18][19][20][21][22][23][24], hormones/female menstrual cycle [1, 8, 11, 14, 15, 18 −21, 23, 25, 26], inadequate skin hygiene [8,11,15,[18][19][20][21]23], and genetic factors [8,13,18,20,21] are the most important factors contributing to acne. Commonly identified acne aggravating factors also include stress [8,12,14,15,22,23,25,[27][28][29][30], excessive sweating [8,15], makeup use [8,15], lack of sleep [15,22], and smoking [8,31]. ...
... Over one-half of pupils (56.4%) indicated genetics as aggravating factors, while lack of sleep and smoking were considered to be risk factors for almost a half of pupils (47.8% and 47.0%, respectively). Our findings are consistent with other studies which reported that poor diet [11,15,[18][19][20][21][22][23][24], hormones/female menstrual cycle [1, 8, 11, 14, 15, 18 −21, 23, 25, 26], inadequate skin hygiene [8,11,15,[18][19][20][21]23], and genetic factors [8,13,18,20,21] are the most important factors contributing to acne. Commonly identified acne aggravating factors also include stress [8,12,14,15,22,23,25,[27][28][29][30], excessive sweating [8,15], makeup use [8,15], lack of sleep [15,22], and smoking [8,31]. ...
... Over one-half of pupils (56.4%) indicated genetics as aggravating factors, while lack of sleep and smoking were considered to be risk factors for almost a half of pupils (47.8% and 47.0%, respectively). Our findings are consistent with other studies which reported that poor diet [11,15,[18][19][20][21][22][23][24], hormones/female menstrual cycle [1, 8, 11, 14, 15, 18 −21, 23, 25, 26], inadequate skin hygiene [8,11,15,[18][19][20][21]23], and genetic factors [8,13,18,20,21] are the most important factors contributing to acne. Commonly identified acne aggravating factors also include stress [8,12,14,15,22,23,25,[27][28][29][30], excessive sweating [8,15], makeup use [8,15], lack of sleep [15,22], and smoking [8,31]. ...
Background
Acne is a common chronic inflammatory skin disease with a high prevalence in adolescent and early adult years. The aim of this study was to assess the self-perceived beliefs of Montenegrin secondary school pupils regarding the acne aggravating and ameliorating factors.
Methods
This cross-sectional survey of the pupils was conducted during October and November 2020 in four randomly selected public secondary schools in Podgorica, Montenegro. All 500 pupils were asked to fill in a questionnaire that included questions on age, sex, presence of acne, perceived acne aggravating and ameliorating factors, and sources of their information about acne.
Results
A total of 500 pupils, 234 (46.8%) boys, and 266 (53.2%) girls, aged 14−17 years, participated in the study. Acne was self-reported in 249 (49.8%) pupils, whereas 251 (50.2%) did not report acne. Factors most often believed to aggravate acne were inadequate face washing (85.0%), hormones (84.0%), sweets (82.0%), greasy food (72.6%), makeup (71.2%), and stress (67.8%). Overall the most prevalent acne ameliorating factors were cosmetic treatment (80.4%), increased water consumption (77.6%), a diet change to a healthier food choice (77.4%), and being on school holidays (62.2%). Girls reported more frequently that genetics, stress, sweets consumption, inadequate face wash, and makeup are acne exacerbating factors, whilst cosmetic treatment, increased water consumption, smoking, and being on school holidays are acne ameliorating factors. Boys more frequently considered the benefit of losing weight. There was no statistically significant difference between pupils with and without acne in perceived factors, except for cosmetic treatment. Those with acne more frequently believed in the benefits of cosmetic treatment.
Conclusions
Many adolescents’ self-perceived beliefs about factors that aggravate and ameliorate acne are myths and misconceptions without evidence-based justification. More efforts are needed to educate pupils about the acne aggravating and ameliorating factors, its health-related consequences, and the treatment possibilities.
... Other risk factors might be considered as contributing factors to acne prevalence and severity including physiological factors such as the menstrual cycle, pregnancy, anxiety, and depression, and external factors such as hot and humid weather, mechanical skin irritation from local pressure and squeezing, daily ingested diet (chocolate, milk, nuts, high glycemic diet,….etc) and excessive sweating (Stoll et al., 2001;Fung et al., 2001). ...
... The age of acne patients who were included in this study ranged from 15-34 years with a mean of 19.4 years, +/-3.38. Acne is not only a disease of adolescence, it also presents in adults of both sexes this could be to hormonal changes as high estrogen levels in pregnancy or stress conditions that affects the sebum secretion (Fung et al., 2001). Late-onset acne, (acne that developed after age 21 years) has been shown to be the result of abnormalities in plasma androgens (Darley et al., 1982;Clark et al., 1997). ...
Bacterial species and risk factors were examined in acne vulgaris patients in Northern West Bank. Samples were obtained from face and upper trunk lesions of 138 patients (age: 15-34 years) at Dermatology clinics. Samples were incubated in blood agar plates under aerobic and anaerobic conditions. Patients were asked to answer a questionnaire and all provided written informed consent. Bacteria were isolated from 88% of the patients including Propionibacterium acnes, Staphylococcus epidermidis and Staphylococcus aureus. Risk factors mentioned by patients included emotional stress, high temperature, sweating and local pressure. Chocolate, nuts and fatty food were mentioned as exacerbating, and vegetables and fruits as ameliorating foods for their acne, respectively. Results show high correlation between acne and bacteria with no relation between risk factors and specific bacterial strains
... year, and often seek other remedies, rather than going to dermatologist. [8][9][10] Some misconceptions are about factors that exacerbate acne lesions, like poor hygiene, hormones and premenstrual flare, dietary factors like sweets, diary, fats, cosmetic, emotional stress, infection, sweating, exercise, and others. [9][10][11] Other that some factors improves acne evolution, like cosmetic treatment (comedo extraction), sun, UVA, drinking water or shift to healthier dietary habits, factors that are recently supported by studies results. ...
... [9][10][11] Other that some factors improves acne evolution, like cosmetic treatment (comedo extraction), sun, UVA, drinking water or shift to healthier dietary habits, factors that are recently supported by studies results. 8,12 The power of false myths and poor medical education has a great impact on the evolution of acne, and a new concept may be in focus: ...
Introduction: Acne is a chronic inflammatory skin condition seen commonly in adolescence and young adulthood. Despite being a frequent and nonthreatening life condition, acne has a significant psychological impact and comorbidity. Aims: This review will describe prevalence, common clinical features, different clinical presentations, differential diagnoses, and treatment recommendation. Special focus has been put on psychological aspects. Methods: We conducted a literature search on PubMed from January 2001 to June 2020 with the search terms of Acne vulgaris, psychological, adolescents, anxiety, suicide, mood disorders. Reference lists of identified articles were examined for further relevant studies. The search was limited to English language articles. No specified quality criteria were used for study inclusion. Results: The clinical manifestations of acne are very important in the differential diagnosis and its psychological implications. Conclusion: Through this article, we conclude that despite being a frequent and nonthreatening life condition, acne has a significant psychological impact which requires effective treatment to improve the patient’s skin and self-esteem.
... Misunderstanding and misinformation is associated with the beliefs that poor hygiene, hormones, diet, cosmetics, infection or stress are the factors that exacerbate acne in teenagers (10,12). ...
... Patients use "acne treatments" (cleansers, acne pads, masks, cover-up products, acne lotions, etc.) before seeking medical attention. It was reported that 74% of such patients waited more than 1 year before medical consultation (12). Unfortunately, delay in obtaining adequate treatment for acne has been shown to increase the risk of scarring (13). ...
Acne and Rosacea are chronic inflammatory skin diseases with an increasing frequency and an important negative impact on the quality of life, which are associated with a large number of false myths regarding causes and treatment. The butterfly effect is associated with chaos theory, and it is a concept originated in meteorology, which represents the dependence on initial conditions.
... Social barriers to the use of traditional cosmetic products exist in a study evaluating patients' perceptions of acne, which showed that female patients were more likely than male patients to use camouflage for acne scarring. This study also showed that 46% of those surveyed believed makeup to be an aggravating factor for acne [25]. Given these possible barriers to the use of makeup products for cosmetic usage, sunscreen products with an added tint may have the potential to increase compliance for use among a broader demographic of patients seeking photoprotection without the use of traditional cosmetics. ...
Introduction:
The impact of ultraviolet (UV) light on the skin is well-established to have both immediate and delayed effects with increasing awareness of the impact of visible light (VL) on the skin with regard to photoaging and dyspigmentation. The effects of VL disproportionately impact the skin of color with regard to discoloration of the skin leading to guidelines for photoprotection that include the use of iron oxides in sunscreen products that impart a tint.
Methods:
Commercially available sunscreen products found in the suncare and sun protection displays at local stores, pharmacies, and grocery stores were cataloged, and ingredients were reviewed for the presence of iron oxides.
Results:
Of the 410 commercially available sunscreen products cataloged, 1.7% of facial sunscreen products available offered iron oxides, and 0.5% of non-lip products offered shade matching.
Conclusion:
With only 1.7% of commercially available facial sunscreen products offering iron oxides in addition to traditional broad-spectrum UV protection, there is a clear gap in the market for iron oxide-containing sunscreen products to meet the photoprotection needs for the skin of color.
... There is a greater severity of acne in males than in females during the late adolescent period [15,16]. ...
... Semi Structured interview was devised by the researcher by consulting relevant existing literature (Alharithy, 2011;Tan, Vasey, Fung, 2001;Brajac, Bilic-Zulle, Tkalcic, Loncarek & Gruber, 2004;Haider, Mamdani, Shaw, Alter, & Shear, 2006;Capitanio, 2010). Clinical information was also added after consulting different health professionals by the researcher to assess culture differences. ...
The aim was to explore the relationship between subjective severity of acne, appearance distress, and social anxiety. Correlational research design and purposive sampling were used in the current study. Acne patients aged between 15 to 40 years from various public and private hospitals were included in the sample. The sample size was determined by G Power to be 111. Body Image Disturbance Questionnaire and Social Interaction Anxiety Scale were used for assessment. A semi structured interview along with a scoring key was used to evaluate subjective severity of acne. Results revealed a significant positive correlation between subjective severity of acne, appearance distress and social anxiety. Subjective severity of acne significantly predicted appearance distress but not social anxiety. Furthermore results indicated that appearance distress predicts social anxiety in acne patients. These results draw attention for providing psychological treatment for the acne patients.
... 12 Most patients wait sometimes more than a year before turning to a doctor for help and during that period they look for information about acne treatment mainly from the media, the Internet and parents and friends, which is inadequate and also represents a lack of education. 13,14 The aim of this study was to determine the prevalence of acne among adolescents, as well as, to assess their information and knowledge about acne exacerbating and ameliorating factors. Also, differences between male and female pupils were analysed. ...
Background/Aim: Acne can occur in people of all ages, but mostly affects the population at puberty. Given the high prevalence and large impact that acne has on young people, the aim of this study was to assess adolescents' knowledge about factors that improve or worsen the clinical picture of acne, as well as to evaluate the sources used to obtain information on acne. Methods: This cross-sectional study was conducted on a sample of 460 high school pupils from the Medical School and Gymnasium in Kosovska Mitrovica. A self-administrated questionnaire was used. Univariate and multivariate logistic regressions were used to model the association between gender (males/females) or presence of acne (no/yes) and potential exacerbating and ameliorating factors, as well as sources of information. Results: 36.7 % of the respondents were male and 63.3 % were female. 48.9 % of high school pupils confirmed that they had acne. The main factors that worsen the condition of acne, were irregular face washing (88.7 %), hormones (87.0 %), fatty foods (80.9 %) and sweets (79.3 %). The majority of respondents believed that the intake of more water (83.9 %), cosmetic treatment (77.8 %), dietary changes (75.9 %), holiday (54.1 %) and sunbathing (39.3 %) affect improving acne. Taking more water (OR = 1.77; 95 % CI = 1.01-3.11) as a factor in improving acne was significantly more common in girls, while boys more often believed that sunbathing (OR = 0.62; 95 % CI = 0.41-0.94) and weight loss (OR = 0.53; 95 % CI = 0.32-0.88) affect the improvement of acne. The most important sources of information about acne were the Internet (73.0 %) followed by parents (62.6 %), friends (54.1 %), and a doctor (42.8 %). Conclusion: Acne was more common in women and those with a positive family history. The presence of misconceptions among young people regarding the factors that improve or worsen the condition of acne indicates the need for additional education.
... Significantly more males considered adolescence as most common age, because acne is more common and more severe in males during adolescence, while women are more frequently and severely affected by it in adulthood. 6 Acne is usually known to resolve with age but only 26.1% patients of our study agreed to it, as in some other studies. 5,7,8 Contagious nature of acne was believed by 21-70% participants in literature 5,9,10 and 24.5% cases of our study. ...
Background
Despite acne being a common dermatological problem, there is a paucity of literature addressing the knowledge, attitude and practice about it.
Aims/Objectives
To find out what patients know about acne, its cause and treatment, as well as myths, misconceptions and attitude towards it.
Methods
A cross-sectional, descriptive questionnaire-based study on acne patients at Maharana Bhupal Hospital, RNT Medical College, Udaipur, Rajasthan, India.
Results
Most (84.8%) patients belonged to the age group of 16-25 years. The majority (63.9%) presented 12 months after the onset of acne. More than half had average knowledge, a positive attitude and good practices, related significantly to gender and education.
Limitations
A standardized questionnaire suitable for all dialects and regional languages would have yielded more uniform results.
Conclusion
Study revealed that acne patients still need to acquire accurate, adequate and easily accessible information to seek timely and appropriate treatment, and alleviate their psychological suffering.
... Foods do not worsen acne; however a balanced diet helps the immune system work to maintain resistance to the bacteria that contribute to acne and the elimination of certain foods from the diet will not control acne 10 . No significant relation between gender and the type of acne was found, but a significant relation was found between the degree of the severity and gender. ...
Background and objective: Acne is a common skin disease of adolescence. It is caused by inflammation of the pilosebaceous units, characterized by comedones, papules, pustules, inflamed nodules and it may result in scarring. This study was performed to define the different aspects of acne in patients attending the department of dermatology and venereology in Rizgary Teaching Hospital. Methods: This study is a descriptive case- series hospital- based study, conducted on 200 patients with acne attending the department of dermatology and venereology in Rizgary Teaching Hospital in Erbil. Results: The number of female patients with acne was 145 and male patients were 55. Acne of moderate severity was the commonest type, it was found in 57% and 64% of the patients had mixed types of lesions. Seborrhea was present in 84% of patients. Hirsutism was present in 44% of female patients and pre-menstrual flare-up was found in 73% of females. A significant relation was found between gender and degree of severity of acne. Also a significant relation was found between seborrhea and the acne severity. Conclusion: This study showed that acne of moderate severity was the commonest type. Females made the majority of our acne patients. Multiple exacerbating factors were found to be contributing.
... Откровенная глупость соседствует с рекламными постами, опираясь на «проверенные» народные средства. Все это приводит к тому, что подростки обращаются за медицинской помощью намного позже, отдавая предпочтения экспериментам и самолечению [10,24]. ...
Introduction . Isotretinoin is the first-choice drug in the treatment of severe forms of acne vulgaris. The combination of systemic retinoids with durant corticosteroids helps to reduce the likelihood of developing “retinoic” dermatitis and exacerbation of acne in the initial stages of isotretinoin therapy.
Purpose of the study . Determination of the effectiveness of the combined use of isotretinoin and a durant corticosteroid in the treatment of severe forms of acne vulgaris.
Materials and methods . Twenty six patients with “severe” or “very severe” grade on the IGA scale were included in this randomised, controlled comparative study. Thirteen patients (group A) were treated with isotretinoin 0.5 mg/kg/day (cumulative dose from 120 to 150 mg/kg) for 8 months and 2 injections of betamethasone dipropionate + betamethasone sodium phosphate at dose 1 ml (2 mg + 5 mg/1 ml) at first month (1 injection per two weeks) and thirteen patients (group B) were treated with combined therapy with isotretinoin at a dose of 0.5 mg/kg/day (cumulative dose from 120 to 150 mg/kg) for 8 months and assessment was based on the IGA scale, counting the number of inflammatory and non-inflammatory elements, indicators DIA (dermatological index of acne) and DLQI and was done at baseline, 1, 4 and 8 months of treatment.
Results . At month 8, compared to group B, group A showed more significant decrease in IGA score and 76% patients achieved “clear” or “almost clear skin” degree (76% vs. 30%). The reduction in the number of inflammatory and non-inflammatory elements showed a marked clinical improvement in group A (89.2% vs 22.3 % for nodules). The decrease in DIA was 88.3% in group A and 71.3% in group B. Exacerbations of acne were recorded in 0% (group A) vs 38.0% (group B) of patients. We also found a relationship between the achievement of a 2-point reduction in the degree on the IGA scale after 8 months and the presence of exacerbations while taking isotretinoin (p = 0.012). Analyzing the DLQI between the two, we were unable to identify statistically significant differences.
Conclusions . Combines use of long acting steroid with isotretinoin provides synergic effect while minimizing the side effect of isotretinoin (decreases the number of exacerbations), demonstrates a visible effect to patients within a month, thereby increasing compliance, improving the quality of life and reducing the risk of scarring.
... Acne's impact might be influenced by one's personal and social opinions of the condition. In a survey of acne patients under the care of a dermatologist, nearly 30% believed that poor skin hygiene was the cause of acne [13]. ...
Acne vulgaris is multifactorial in origin where Propionibacterium acnes and altered keratinisation are some of the factors which contribute to the inflammation and obstruction of the pilosebaceous unit. Acne causes the formation of pleomorphic lesions like comedones, papules, pustules, nodules and cysts which may lead to scarring. Lesions of acne are predominantly seen on the face, chest, back, shoulders and upper arms. The aim of the study is to understand the psychological impact that acne vulgaris has on patients in a tertiary care hospital. The study will be carried out over a period of two years from May 21 to May 23 in Terna Speciality Hospital and Research Centre in Nerul, Navi Mumbai, in the Department of Dermatology, Venereology and Leprosy in collaboration with the Department of Psychiatry in Terna Speciality Hospital and Research Centre in Nerul, Navi Mumbai. This study is done to get a deeper look at the psyche of the people suffering from it and what can be done to manage it better.
... Представления о том, что стресс может быть причиной обострения акне, распространены как среди пациентов, так и в медицинском сообществе [33]. Тем не менее роль психогенных факторов в манифестации или обострении акне представлялась сомнительной из-за недостатка данных. ...
The concept of the exposome, formulated more than fifteen years ago, is increasingly discussed in the modern scientific literature. The term “exposome” is understood as a cumulative measure of the impact of environmental factors on an individual throughout his or her life (from the prenatal period to death) and the biological response associated with it. The sum of these factors has a significant impact on the occurrence, course, and treatment efficacy of multifactorial diseases. The skin is a border organ and is constantly exposed to environmental influences, i.e., it is a target for the exposome. The influence of the latter components has been described in skin aging, atopic dermatitis, and malignant skin neoplasms. Acne is one of the most common chronic inflammatory dermatoses. Over the past decade, the worldwide increase in the incidence of acne, its early onset and a prolonged course, affecting adult men and women, has been noted. The review presents an analysis of the data on the effects of the components of the exposome – diet, medications, stress, and pollutants - on the course of acne. Particular attention is paid to the few data on the nature of interaction between the components of the exposome and the skin microbiome, which, on the one hand, is involved in the pathogenesis of dermatoses, including acne, and, on the other hand, is changed under the influence of exposome factors, acting as an intermediary between the environment and the human body. The search for environmental factors has at least two objectives: the discovery of potential pathogenetic links, the strength of their relationship with the clinical manifestations of the disease to develop new therapies aimed at new targets; and the creation and recommendation of a protective regime for factors with a proven effect on the course of the disease, for patients suffering from acne.
... 4 The knowledge about the role of diet in acne is still lacking with incomplete knowledge and unfavourable attitude and wrong practices'. 5 It becomes essential to know the foods involved in acne pathogenesis as food plays an important part in one's life. It is imperative to know these students knowledge about acne as they are going to educate the public about the do's and don'ts to drive away their misconceptions. ...
Background: Acne is one of the most common chronic inflammatory conditions reported on daily basis in a skin clinic. It’s pathology lies at the level of pilosebaceous apparatus and is influenced by various factors like hormones, certain foods, drug intake and so on. There are several discrepancies surrounding the role of diet in acne. The aim of the study was to explore the knowledge, attitude and behaviour towards the role of diet in acne vulgaris among students.Methods: This was a cross sectional study conducted in Sree Balaji Medical College and Hospital, Chennai during January 2021 to May 2021. 107 random medical students with acne were enrolled in the study. Students with acne vulgaris not willing to participate in the study and students with acneiform eruptions were excluded. Data was collected using a standard, semi-structured questionnaire. Questionnaire was presented in English through a google form. The questionnaire comprised of socio-demographic data like age and gender. Data was entered in Microsoft word and represented in frequency and percentage.Results: Among the 107 students enrolled in the study, 37 were males and 70 were females. 56 students were in 17-20 age group and remaining 51 were in 21-24 years age group. Our study showed that 64.5% (69) agreed that there was an association between diet and acne vulgaris, while 9.3% (10) denied it and 26.2% (28) were unsure about the association between the two. Majority of them encountered acne localized to face mainly involving cheeks, only 2 people reported acne over trunk. Out of 97 students who opined of the association of diet with acne, only 13 students consulted a dermatologist and opted for medication. Out of 13, only 7 reported to have a positive outcome with combination of advised medication and stoppage of triggered foods. Out of 97 students who opined of the association of diet with acne, only 13 students consulted a dermatologist and opted for medication.Conclusions: The understanding of the disease and the ways adopted by these students look decent enough but mandate few changes in their attitude and behaviour.
... Patients' beliefs , perceptions, and practices plays a pivotal role in achieving permanent, effective and curable acne treatment (Smithard et al., 2001). Distribution of such information through community-based health education programs will increase patient understanding of their condition, as well as enhancing patient adaptation and coping mechanisms, and perhaps improving compliance with treatment (Tan et al., 2001). A number of studies were conducted world-wide to spotlight the poor knowledge and lack of proper patient education regarding acne disease and how to manage it, these studies were collected and reviewed by Claude and coworkers (Claudel et al., 2020). ...
Objectives: To assess the knowledge, perceptions and beliefs of the community regarding acne disease and treatment. Methods: A questionnaire survey of 24 items was distributed between pharmacy students, customers of community pharmacies and attendees of dermatology clinics to assess their knowledge and perceptions regarding the acne. Participants were not all acne patients. Key findings: 250 acne and non-acne participants completed the questionnaire. 50% of patients had acne condition for > 1 year before seeking medical advice and sought medical advice as a self-made decision. Patients believe that poor skin hygiene and infection are predominant causative factors of acne whereas most of them believed that diet and stress were the major exacerbating factors. Major source of their information was the internet. Acne and non-acne groups considered acne as a disease and the majority of both believed that it is curable. 46.3% and 41.3% of acne and non-acne participants respectively considered acne a contagious disease, most of the participants believed that squeezing pimples will help them go away faster. Antibiotic pills (53.6 %) and topical antibiotics (54.8%) were most often recognized by patients. As for the psychosocial impact of acne on sufferers, acne participants stated that acne condition severely affected their self-images. Conclusion: This study explores the level of misconception in the community regarding acne. These findings emphasize the need for an integrated audiovisual comprehensive national program for awareness of the public about acne. Antibiotics use on the other hand should be controlled to limit the emergence and spread of resistant strains.
... In the skincare or dermatology sector, acne or acne vulgaris is a common skin disease or condition affecting adolescents and adults, which is a complex and multifactorial skin pathogenesis (Tan et al. 2001). Staphylococcus epidermidis, S. aureus, and P. aeruginosa are often responsible for acne conditions (Wang et al. 2017). ...
Marine algae, representing a polyphyletic group, are considered as a rich food source as these organisms produce a great variety of molecules including proteins, polysaccharides, dietary fiber, amino acids, minerals, vitamins, and aromatic compounds. Among them, phenolic compounds are metabolites present in various organisms, including marine algae, and are known to be synthesized in response to different environmental conditions. In particular, they protect these organisms against herbivores or epiphytes, bacterial infection, or UV radiation. Once consumed, they may be beneficial to human health and chronic disease risk prevention since they have a wide range of bioactivities. They can exhibit antioxidant, antimicrobial, anti‐inflammatory, antitumor, antiaging, or pro‐mineralogenic activities, or act as modulators of cardiovascular disease risk. This review presents phenolic compounds encountered in marine algae, i.e. micro‐ and macroalgae, their chemical structures, together with their biological activities and their potential valorization for medical and cosmetic industries.
... Moreover, many adolescents delay seeking treatment, or seek medical assistance only with more severe acne. [10][11][12] Access to care for acne is compounded by the nationwide shortage of physicians generally, and dermatologists specifically, and the uneven geographic distribution of dermatologists in the United States. 13 As a result, some have called for new ways to reduce barriers to access for patients with acne. ...
The diagnosis of acne is typically straightforward and based on physical signs and symptoms. Some jurisdictions in Canada, the United Kingdom, and United States have enabled a pharmacist treatment model to diagnose and manage patients with mild acne using prescription medications. Studies have found the model to be safe and effective, while simultaneously increasing more timely access to care for patients which may reduce the potential adverse impacts of acne. Further, use of a standardized protocol may alleviate some of the concerns expressed over the model. This paper summarize answers to frequent questions to help policymakers consider the objective evidence for their jurisdiction.
... De entre os mitos que contribuem para uma representação social da Acne não sustentada pela ciência, estão aqueles que são apontadas como fatores influenciadores: a dieta (Pearl et al., 1998;Magin, Pond, Smith & Watson, 2006;Uslu et al., 2007;Rigopoulos, Gregoriou, Ifandi, Efstathiou, Georgala, Chalkias et al, 2007;Yahya, 2009;Davidovici & Wolf, 2010;Green & Sinclair, 2011;Tahir & Ansari, 2012;Tatasiewicz, Otdakowska & Szcerkowska-Dobosz, 2012), o stresse, o tabaco e a higiene facial (Hedden, Davidson & Smith, 2008;Yahya, 2009;Green & Sinclair, 2011), as hormonas (Brajac, Bilic-Zulle, Tjalcic, Loncarek & Gruber, 2004;Rigopoulos, Gregoriou, Ifandi, Efstathiou, Georgala, Chalkias Brazilian Journal of Health Review, Curitiba, v.4, n.1, p.1266-1294 Jan/Feb. 2021 et al, 2007), as infeções (Ali, Mehtab, Sheikh, Ali, Kader, Mansoor et al, 2010), ), a vida sexual (Goodman, 2006;Tatasiewicz, Otdakowska & Szcerkowska-Dobosz, 2012), a luz solar (Magin, Pond, Smith & Watson, 2006;Hedden, Davidson & Smith, 2008), a maquilhagem, a poluição, e a menstruação (Poli et al., 2011), o calor e a humidade (Tan, Vasey & Fung, 2001), ou ainda as bactérias (Machat, Shariff & Zimmo, 2013). ...
... Self-medication was based mostly on suggestions viewed on the internet/media/advertisements and recommendations made by seniors/friends/family members. A variety of results were observed in different study settings; some studies supported the findings in this study [19][20][21], a few reported textbooks as the main source of information [22,23], while others even noted that the majority of self-prescribers based their practice upon their own knowledge and experience from previous prescriptions [6,24,25]. Locally, in Saudi Arabia, a trend was evident when the results of this study were compared to those of previously conducted researches. ...
... The results of a study suggested that about 30% of people believed that acne was caused by poor skin health and hygiene (12). Another study was performed on the prevalence of depression and suicidal ideation among about 480 skin patients. ...
... This may be related to increased use of the Internet as a source of medical advice, particularly for conditions which are perceived to be of lesser significance. When searching the literature for other conditions where patients often seek advice and treatment from their parent or relative a study was found on acne 314 . Acne patients and their families delay seeking medical treatment. ...
Background: The theory and practice of knowledge translation underpins evidence-based practice (EBP). There is significant concern that translation of research-based evidence into clinical practice is slow and incomplete. This thesis investigates evidence for this concern in the case of a common injury, (which is managed by a variety of clinicians) the acute lateral ankle ligament sprain (LALS), and a tool frequently used to enhance EBP, the clinical practice guideline (CPG). The aim of this research is to sequentially investigate the pathway for transmission of evidence contained in CPGs through curriculum, student knowledge, and physiotherapy practice to the experience of the final consumer (the patient) using LALS as the case study. Methods: Initially, a systematic review of LALS CPGs was conducted. CPGs were critically appraised using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument online version, My AGREE PLUS. A qualitative study of educators involved in teaching LALS curricula for the Australasian College of Sports and Exercise Physicians, St John Ambulance first aid, pharmacy, nursing, and physiotherapy was performed using thematic analysis. Three online surveys completed the five studies. A survey of students to determine what they learn about LALS, a survey of clinicians to investigate their clinical practice in relation to LALS and, a survey of patients who have had a LALS to determine what treatment they received. The components of management found in the studies were compared with the most recent 2018 CPG for LALS. Results: This study found that generally, CPGs for physiotherapists (USA and Netherlands), athletic trainers (USA), physicians (Netherlands and USA) and nurses (USA, Canada, and Australia) are of poor quality. Educators, physiotherapy students, and physiotherapists prefer textbooks to CPGs to inform EBP. Across the five groups investigated, there was no common curriculum. As they practiced only triage management, the nurses, pharmacists and first aid trainers had little concept of the importance of severity of injury. In contrast, the physician and physiotherapy educators establish severity to guide management. The physicians and physiotherapists derive their judgement from their own research and reflective EBP. Australian physiotherapists and physiotherapy students are generally following the recommendations from the 2018 LALS CPG; specifically, medication advice, functional support, optimal loading, rest, ice, compression, elevation, exercises, and manual therapy and are not using electrophysical agents for LALS. Physiotherapists and physiotherapy students may be compromising safety by advising nonsteroidal anti-inflammatory drugs (NSAIDs), despite there being no curriculum that teaches them about drug interactions and the effects of these medications in delayed healing. This may be a scope of practice problem and requires further research. Four hundred and thirty-two patients with LALS completed the survey. LALS patients reported that they received recommendations from their treating physiotherapist; specifically, ice, compression, ultrasound, exercises, protection (crutches) and manual therapy. Conclusions LALS CPGs are of poor quality. Generally educators, physiotherapy students and physiotherapists do not use them to inform EBP and prefer text books. Possibly, LALS patients may not be receiving optimal EBP. Further research is needed to determine why CPGs are not used and which interventions may be useful in enhancement of knowledge transfer thereby improving patient outcomes. Key Terms: Clinical Practice Guidelines, Evidence-based Practice, manual Therapy, Physical Therapy/Rehabilitation, Physical Therapy Modalities, NSAIDs
... The American Academy of Dermatology describes acne as the most common skin condition in the United States, affecting up to 50 million Americans yearly. 1 The prevalence of acne in France was estimated to be 60% among women aged 20-29 years and 26% in those aged 40-49 years. 2 Numerous studies worldwide reported that acne has considerable effects on patients' quality of life (QOL). 3,4 Treatment of acne depends on the severity and it may take several months of treatment before the symptoms improve. ...
Purpose:
To evaluate the pharmacist's assessment of patient eligibility for safe use of isotretinoin and the quality of pharmacist's counseling.
Patients and methods:
A covert simulated patient (SP) methodology was used in which a trained female researcher, who was 25 years old, played the patient's role through this cross-sectional study by visiting community pharmacies and requesting isotretinoin capsules through a controlled prescription. A data form was used to collect the information following each pharmacy visit by asking about medical/family history and providing comprehensive counseling about the most common adverse effects, proper use instructions, and the importance of adherence to medication. The pharmacists, who did not initiate counseling, were prompted by the SP.
Results:
The pharmacists in 400 pharmacies who agreed to participate were visited by the SP. Only 7 (2%) pharmacists provided a complete assessment of patient eligibility for using isotretinoin with comprehensive counseling. Most of the pharmacists (84%) provided incomplete assessment as indicated by the overall score. Only 11 (3%) pharmacists asked the six crucial questions for the assessment of patient eligibility. On prompting, only 6 (2%) pharmacists provided complete counseling about the expected adverse effects. The most frequently provided adverse effect was dry skin, specifically dry lips (71.8%). A minority of 108 (27%) pharmacists provided education about the importance of using contraception during isotretinoin therapy. A complete level of counseling was provided by 125 (31.3%) pharmacists regarding the lab tests that the SP needs to undergo during therapy. Female pharmacists were more likely to provide counseling about the pregnancy test (mean=134, p=0.001).
Conclusion:
Suboptimal level of the patient's assessment was revealed with poor educational counseling by the community pharmacists. New strategies are needed to improve pharmaceutical care services in the UAE.
... In light of the literature results, we chose to assess 12 different food groups: fruit, vegetables, meats, fish, milk, sugary beverages, dark chocolate, milk chocolate, refined cereals, snacks and fast foods, fatty and sugary products, and delicatessen meats. 17,20,24,48 The following variables were considered in classes: age (in 4 classes); body mass index (BMI), calculated as weight in kilograms divided by height in meters squared (3 classes); educational status (3 classes); smoking status (3 classes); physical activity (3 classes); sex (male or female); and medical history (presence or absence). ...
Importance
Acne is a chronic, multifactorial inflammatory disease. The association between consumption of dairy products and fatty and sugary foods and occurrence and progression of acne remains unclear.
Objective
To assess the association between dietary behavior and current acne in adults.
Design, Setting, and Participants
A cross-sectional study was performed as part of the NutriNet-Santé study, which is an ongoing observational, web-based cohort study that was launched in France in May 2009. The present study was conducted from November 14, 2018, to July 8, 2019. A total of 24 452 participants completed an online self-questionnaire to categorize their acne status: never acne, past acne, or current acne. Associations between dietary behavior (food intake, nutrient intake, and the dietary pattern derived from a principal component analysis) and current or past acne were studied in multinomial logistic regression models adjusted for potential confounding variables (age, sex, physical activity, smoking status, educational level, daily energy intake, number of dietary records completed, and depressive symptoms).
Results
The 24 452 participants (mean [SD] age, 57 [14] years; 18 327 women [75%]) completed at least 3 dietary records. Of these, 11 324 individuals (46%) reported past or current acne. After adjustment, there was a significant association between current acne and the consumption of fatty and sugary products (adjusted odds ratio [aOR], 1.54; 95% CI, 1.09-2.16), sugary beverages (aOR, 1.18; 95% CI, 1.01-1.38), and milk (aOR, 1.12; 95% CI, 1.00-1.25). An energy-dense dietary pattern (high consumption of fatty and sugary products) was associated with current acne (aOR, 1.13; 95% CI, 1.05-1.18).
Conclusions and Relevance
In this study, consumption of milk, sugary beverages, and fatty and sugary products appeared to be associated with current acne in adults. Further large-scale studies are warranted to investigate more closely the associations between diet and adult acne.
... In this study, gender did not show a significant correlation with number of acne lesions. This finding differs from previous studies, which have suggested that male subjects tend to have a greater acne severity grade than females because of the difference in the levels of androgens and skin pH [30][31][32][33] . It appears that the difference in the study findings resulted from the small sample size in the present study and the gap of the acne severity index. ...
Background:
Acne is a chronic inflammatory disease of the pilosebaceous unit and usually affects adolescents when the peak concentrations of growth hormone, insulin-like growth factor 1, and androgen are demonstrated. The activity of alkaline phosphatase (ALP), which increases physiologically in growing children and adolescents, in the pilosebaceous unit has been reported. However, the correlation between the serum level of ALP and the number of acne lesions has not been studied.
Objective:
The present cross-sectional study was designed to evaluate the correlation between serum level of ALP and the numbers of non-inflammatory and inflammatory acne lesions in children and adolescents.
Methods:
For this study, 202 pediatric and adolescent patients clinically diagnosed with acne vulgaris were included. Age, sex, serum level of ALP, number of non-inflammatory acne lesions, number of inflammatory acne lesions, and number of total acne lesions were evaluated. Additionally, the serum level of dehydroepiandrosterone sulfate was evaluated in 117 patients. Multiple regression analysis was performed. Multicollinearity was quantified using the variance inflation factor.
Results:
In the 202 patients, serum level of ALP was the only independent factor that significantly affected both the number of non-inflammatory acne lesions and of total acne lesions (regression coefficient=0.089 and 0.086, respectively, p<0.001).
Conclusion:
There was a significant correlation between serum level of ALP and the extent of acne (non-inflammatory acne lesions and total acne lesions).
... In this study the most frequently used non-medical source to gain knowledge about acne was the internet, however another study showed that non-medical sources included magazines (44%), television (44%), parents (31%), and friends (28%) were most frequently used [18]. ...
... Akne patogenezi ve tedavisi bilinir olmasına karşın hastaların çoğu doktora ya hiç başvurmamakta ya da geç başvurarak gerekli tedaviyi almaya geç başlamaktadır. [5][6][7][8][9] Klinik bulgular bireylerde kozmetik yakınmalara neden olduğu kadar, psikolojik sorunlara da yol açmaktadır. Ancak bu durumun yaratacağı duygusal etkinin düzeyini ve şeklini önceden tahmin etmek oldukça güçtür. ...
Objective: Acne vulgaris, a chronic disorder of pilosebaceous units, is common in adolescents. Early detection and appropriate treatment of acne is essential in the prevention of severe acne and scarring, and the consequent adverse psychosocial disabilities resulting from feelings of embarrassment, frustration and poor self-esteem. Emotional issues in young individuals with acne must be identified appropriately. Material and method: This was a cross-sectional survey involving students applied to a University Medical Center. They were administered a questionnaire including socio-demographical properties, general knowledge about acne and Rosenberg Self-Esteem Scale’s first ten questions. SPSS 15.0 program was used for statistical analysis and p<0.05 was accepted as statistical significant. Results: Two hundred and forty seven students were included and 63.6% (n.157) were women. Mean age was 21.40±2.38. Majority of the students (99.3%) had acne but 41.3% of acne problems had lasted before three months. Acne was defined as an illness by 53.4% of the students and 38.1% visited a doctor for acne treatment. Conclusion: Despite the high prevalence of acne, there is still much deficiency of knowledge and wrong beliefs about acne. This indicates that there is a need for education about etiopathogenesis, potential complications and importance of effective treatment for acne. Amaç: Akne vulgaris, pilosebase birimlerin ergenlerde yaygın olarak görülen kronik bir hastalığıdır. Aknenin erken tanısı ve uygun tedavisi, şiddetli akne ile yara izi oluşumunun utanç, hayal kırıklığı, düşük benlik saygısı duygularından kaynaklanan, olumsuz psikososyal sorunların önlenmesinde önemlidir. Akneli genç bireylerde, duygusal konular, uygun teşhis edilmelidir. Yöntem: Bu çalışma, bir üniversitenin medikososyal hizmetler birimine başvuran öğrencilerin yer aldığı kesitsel bir çalışmadır. Katılımcılara, sosyodemografik özellikler, akne hakkında genel bilgiler ve Rosenberg Benlik Saygısı Ölçeği ilk on sorusunu içeren bir anket uygulanmıştır. Veri analizinde SPSS 15.0 kullanılmış ve p<0.05 anlamlı kabul edilmiştir. Bulgular: Çalışmaya 247 öğrenci dâhil edilmiş olup % 63,6’sı (n=157) kadındır. Yaş ortalaması 21.40±2.38 (Min=18, Maks=32) olan öğrencilerin çoğunluğunda (%99,3) akne görüldüğü, %41,3’ünde üç aydan az sürdüğü belirtilmiştir. Öğrencilerin %53,4’ü akneyi bir hastalık olarak tanımlamış ve %38,1’i akne tedavisi için doktora başvurmuştur. Sonuç: Üniversite öğrencileri arasında akne görülme sıklığı yüksek olmasına rağmen, akne hakkındaki bilgi düzeyleri düşük bulunmuştur. Konuyla ilgili olarak etiyopatogenez, potansiyel komplikasyonlar ve uygun tedavinin önemi açısından gerekli bilgilendirmenin yarar sağlayabileceği düşünülmektedir.
... [5][6][7][8] The Western-type diet disrupts FoxO1mediated gene regulation, high glycemic load and consumption of milk proteins increase both insulin and IGF-1 signaling, which increases in puberty, providing an additional load. 5,[7][8][9][10] Insulin index measures the effect of food on insulin levels in blood two hours after a meal. On the other hand, glycemic index measures the effect of carbohydrates in food on glucose levels in the blood. ...
Objective: Acne vulgaris is a chronic, inflammatory
disease of the pilosebaceous unit. Dietary factor is considered to be
one of the factors that can trigger acne vulgaris as it is reported associated
with Western type nutrition. In this study, it is aimed to evaluate
the effect of insulin index and dietary factors in patients with acne
vulgaris. Material and Methods: Two hundred two consecutive patients
with acne vulgaris and 172 patients with a control group were
included in this study. The dietary habits in patients with acne vulgaris
were statistically compared to the control group. Results: The
risk for acne was detected increased in those consuming more than 3
servings per week for cola (Odds ratio (OR) 1.57; 1.00-2.46), instant
coffee with powdered milk (OR 1.67; 1.03-2.72), feta cheese (OR
1.63; 1.00-2.65) and 1 serving per week for peanut (OR 1.62; 1.02-
2.58) while risk for acne was decreased in those consuming more than
3 servings per week for chicken meat (OR 0.65; 0.43-0.99), pasta (OR
0.59; 0.37-0.95), and 1 serving per week for sujuk (OR 0.60; 0.38-
0.94) (p<0.05). Conclusion: In this study, the consumption of foodstuffs
with a higher insulin index value than glycemic index such as
cola, feta cheese, and peanuts was significantly higher in patients with
acne vulgaris. It may be useful to take into consideration the value of
insulin index along with the glycemic index value for some foodstuffs
to evaluate relationship between acne vulgaris and dietary factors.
... Simple comparison between the perceptions of youths in this country and elsewhere regarding studies also based only on adolescents with acne, 5,6,8,9 dating back to 1983, objectively revealed some similarities as well as major disagreements in adolescents' perspectives. However, it is believed that the concordance of estimated acne-related perceptions with objective literature data regarding specific factors that may influence acne aggravation or acne regression is more applicable for health care educational programs and reforms, and moreover, they could be implemented in an office-based dermatologist-oriented approach. ...
Background:
Acne vulgaris is recognized as the third most prevalent skin disease worldwide, with highest prevalence among adolescents. Beliefs and perceptions of adolescents about acne are incoherent in the literature.
Objectives:
To assess the most frequently reported acne-related beliefs in adolescents in order to focus on misconceptions and develop proper recommendations.
Methods:
A cross-sectional community-based study on representative sample of 2516 schoolchildren was conducted in six randomly selected secondary schools in Belgrade, Serbia. Only schoolchildren with present or past acne history participated. Factors believed to aggravate or ameliorate acne were recorded and analyzed, and the comparisons between girls and boys were evaluated using Pearson's chi-squared test.
Results:
A total of 1452 schoolchildren with acne participated, aged 14-18 years, among them 801 (55.2%) girls and 651 (44.8%) boys. Boys significantly more frequently believed that sweating, exercise, and dairy foods aggravate acne, whereas girls significantly more frequently blamed emotional stress, sweets, fatty foods, sun, and lack of sleep. The top four amelioration factors were as follows: comedone extraction, healthy diet, sun exposure, and increased water consumption. Acne regression was more frequently perceived to be linked with cigarettes in boys, but with sun exposure and weight loss in girls.
Study limitations:
The narrow age span of adolescents (14-18 years) and exclusion of acne-free adolescents are limitations due to study design.
Conclusion:
This survey is part of the first epidemiological study on a representative sample in the Western Balkan region. The significance of the most frequent acne-related beliefs is discussed and myths about acne are highlighted.
... The knowledge level about acne was previously studied in patients with acne vulgaris. (Rasmussen & Smith, 1983;Tan, Vasey, & Fung, 2001). Few studies involved only students (Green & Sinclair, 2001;Pearl, Arroll, Lello, & Birchall, 1998) some involved patients and physicians (Brajac, Bili c-Zulle, Tkalci c, Loncarek, & Gruber, 2004). ...
There are some studies on the knowledge, beliefs and perceptions of patients about acne vulgaris, however there is not sufficient data on patients' beliefs about oral isotretinoin treatment (OIT). The aim of this study was to assess the knowledge, beliefs, and perceptions of the patients with acne vulgaris about the therapy of OIT and its side effects.
A total of 214 patients with acne vulgaris in our outpatient clinic were included. Patients who were planned to treat with OIT were asked whether they had information about the treatment and its side effects. It was noted whether the patients accepted treatment after being informed both verbally and written about the OIT details.
The study consisted of 133 female and 81 male aged 12‐57 years. Most of the patients (78%) stated that they had heard of OIT. The most common source of the information on isotretinoin therapy was friends (57.6%). The dryness was the best known side effect. While 86.4% of patients (n: 185) accepted OIT, the group (14.4%) stated that "I have knowledge about side effects." refused to use the treatment. Most of patients agreed to the treatment after explanation of dermatologist.
Patients may be educated and informed via reliable medical sources to prevent bias and improve compliance to the treatment.
This article is protected by copyright. All rights reserved.
... In general, participants agreed that the PDA was an adequate length (n = 9), had the right amount of information (n = 9), and that the content did Previous research has shown that acne patients have low levels of knowledge regarding the management of acne and acne treatment options. 5,6 Our results demonstrate that this PDA improved participants' knowledge about acne and treatment options. Furthermore, they indicated that it was useful and made their treatment decisions easier. ...
... The number of adults with acne, including people over 25 years, is increasing; the reasons for this increase are uncertain [11]. Some authors confirm that the cumulative incidence of acne is 91% in males and 79% in females during adolescence, that drops to 3% in males and 12% in females during adulthood [12]. Different studies reported an acne incidence of 55% in males and 45% in females aged 14 to 16 years [7]. ...
A pandemia de COVID-19 trouxe inúmeras alterações de rotina, em especial o uso de equipamentos de proteção como máscaras que, apesar de indispensáveis, podem trazer alterações na pele decorrente do seu uso prolongado. Assim, o objetivo deste trabalho foi avaliar a percepção da comunidade em geral sobre o impacto do uso de máscara no desenvolvimento de lesões de acne e oleosidade da pele. Utilizou-se um delineamento transversal e uma amostragem por conveniência. Todos os participantes entre 18 e 50 anos residentes do Rio Grande do Sul/Brasil eram elegíveis a participar do estudo. Um questionário autorrespondente foi aplicado a partir da plataforma de Formulários do Google para a coleta de dados. As variáveis foram expressas em frequências e porcentagens e as associações foram analisadas pelo teste Qui Quadrado e Exato de Fisher (p<0,05). O uso de máscara por 4-8h ou mais se mostrou significativo para o aparecimento de lesões de acne e o uso de máscara cirúrgica foi associada ao aumento de oleosidade cutânea. Alteração associada à oleosidade foi maior em trabalhadores da saúde. Histórico de acne prévia foi significativo para o aparecimento de lesões de acne e alterações de oleosidade cutânea. Mais da metade (59,6%) dos respondentes sente não saber manejar a pele frente ao aparecimento de lesões de acne. Por fim, apesar de indispensável, o uso de máscara por período prolongado, bem como o tipo de máscara utilizada, favorecem ao aparecimento de lesões de acne e alterações cosmiátricas na pele na comunidade em geral.
Background:
Acne vulgaris is a common condition that often results in secondary cutaneous damage in the form of scarring. Scars require shape-specific scaffolds. Recently, a new 3D gel derived from plasma rich in growth factors technology (PRGF) has been developed with the aim of overcoming these limitations.
Objective:
The aim of this study was to preliminarily assess the clinical performance of the combination therapy with PRGF-gel (PG) and fractional ablative laser for post-acne scar amelioration.
Materials and methods:
Nine patients suffering from post-acne scars received a combination of PG and fractional ablative laser therapy. Macrophotographs were taken and patients completed a satisfaction survey. Images were also analyzed following the ECCA score. Clinicians were also asked to fulfill a clinical improvement score and any undesired side effects were recorded.
Results:
Patients were referred to be highly satisfied as an 8.7 ± 0.9 satisfaction score was achieved. Healthcare specialists objectivated that the scar reduction and overall skin quality at the end of the study had noticeably improved. The ECCA score showed a significant 55% of improvement compared with baseline. No major side effects were recorded, and the tolerance of the treatment was excellent.
Conclusion:
The combined therapy with PG and fractional ablative laser might help in the management of post-acne scars and overall skin rejuvenation.
Acne occurs in up to 90% of young adolescents, but prior research has found that this population exhibits a limited understanding of acne and is vulnerable to myths and misinformation accumulated from family members, friends, and social media. We created a virtual presentation on skin hygiene, acne prevention, and acne‐associated stigma for adolescent youth (aged 9–13) to improve acne health literacy, which was reviewed by three board‐certified dermatologists. A descriptive cross‐sectional study using data collected for quality improvement (n = 209, total) revealed that approximately half (n = 102/202, 50.5%) of all students believed that acne could not be treated with medications, only 34.0% (n = 67/197) believed acne could impact their mental health, and most students incorrectly believed that dirt buildup (n = 124/209, 59.3%) and poor hygiene (n = 125/209, 59.8%) were pathogenic for acne. Our results stress the necessity of early evidence‐based educational interventions as a cornerstone to breaking self‐perpetuating myths and misinformation that may lead to acne mismanagement, delayed access to healthcare, and permanent scarring later in life.
INTRODUÇÃO:
A acne é uma patologia crónica inflamatória da pele que apresenta elevada prevalência e um forte impacto psicossocial. O papel da alimentação, nomeadamente dos laticínios, na acne é incerto.
OBJETIVOS:
Com esta revisão pretende-se determinar se existe relação entre o consumo de produtos lácteos e a acne.
METODOLOGIA:
Pesquisa sistemática não quantitativa (revisão baseada em evidência) da evidência científica publicada entre 2010 e 2021 em bases de dados electrónicas, utilizando os termos MeSH “Dairy Products” ou “Milk” ou “Cheese” ou “Yogurt” e “Acne Vulgaris" e “Humans”.
RESULTADOS:
Encontraram-se 36 artigos, dos quais sete cumpriram os critérios de inclusão: uma recomendação, duas Revisões Sistemáticas com Meta-análise, um estudo observacional transversal e três estudos caso-controlo. Três artigos mostraram uma associação entre o consumo de laticínios (sem discriminação) e acne. Cinco dos seis artigos que avaliaram o consumo de leite de forma individualizada mostraram uma associação entre o consumo de leite e a presença de acne. Dos quatro artigos que avaliaram o consumo de iogurte de forma isolada, apenas um encontrou uma associação com desenvolvimento de acne. A evidência foi contraditória no caso do queijo.
CONCLUSÕES:
Parece existir uma associação entre o consumo de leite e desenvolvimento de acne. Porém, a evidência é inconsistente relativamente a outros derivados do leite pelo que são necessários mais estudos que clarifiquem esta relação.
Acne is one of the most common skin diseases in the world, and there has been a debate about the connection between acne and diet over the past decades. A pioneering observational study became a turning point in this long controversy and resulted in the change of paradigm. Since then, many articles have been published that food is associated with acne outbreaks and worsening. High glycemic load diet including chocolate, high amount of fat, leucine, milk, and dairy products seems to be associated with high prevalence of acne. The ingestion of these foods induces hormonal cascade including insulin and IGF-1, which results in the proliferation of keratinocytes and sebocytes and the activation of mTORC1. Activation of mTORC1 leads to increased lipid synthesis and enhanced inflammation, which are important in acne pathogenesis. Because we cannot test all foods, it would be appropriate to advise patients to avoid foods that they believe would worsen acne.
Barriers to healthcare access are healthcare inequities that have been widely studied across different medical specialties. No studies have previously evaluated the state of barriers to healthcare access research in pediatric dermatology. A systematic review was conducted to examine the types of barriers identified within pediatric dermatology literature. Relevant information was extracted and categorized into the themes of systemic, sociocultural, or individual barriers. The systemic barriers we found include finances, wait times, and geography. The sociocultural barriers included culture beliefs and communication. Patient beliefs and health knowledge were found as individual barriers. The small number and limited scope of studies we identified suggest that barriers to healthcare access in pediatric dermatology remain an understudied topic. Additional research is needed to further characterize these barriers to dermatologic care, as well as the impact of any interventions designed to overcome them.
La recherche de molécules naturelles dans de nombreux domaines industriels se développe dans une optique d’éco-responsabilité, notamment en cosmétique. Les macroalgues sont une ressource intéressante, riche en de nombreux métabolites tels que les composés phénoliques qui présentent des activités photoprotectrices, antioxydantes ou encore anti-âge. L’objectif de ce travail de thèse était d’analyser les algues brunes bretonnes en termes de composés phénoliques au stade précoce ou au stade macroscopique, obtenir des fractions enrichies en composés phénoliques actifs, les identifier et les inclure dans des formulations cosmétiques. Les résultats de ces travaux ont montré des teneurs élevées en composés phénoliques notamment chez les Fucales et une variation saisonnière de leur teneur pouvant varier selon les espèces.Cette étude a montré que les méthodes alternatives éco-responsables d’extraction et de purification des composés phénoliques permettent d’obtenir des fractions enrichies en ces composés de manière similaire voire supérieure aux méthodes classiques.D’autre part, une analyse HPLC a permis de séparer nos composés d’intérêt, devant cependant être couplée à une méthode de spectrométrie de masse pour permettre l’identification des composés. Enfin, ce travail a mis en évidence la capacité de valorisation en cosmétique des composés phénoliques par leur activité anti-âge et leur stabilité à l’état sec. Leur stabilité au sein de formulation cosmétique reste à être validée dans différentes galéniques, la stabilité d’une seule ayant été testée dans cette étude.
Acne is a common chronic inflammatory condition involving the pilosebaceous apparatus pilosebaceous unit peaking itself in the teens. The fables and fallacies surround not only the common man but also students in a medical college who are yet to get hold of the etiopathogenesis and treatment in acne. Our mission was set forth to survey the factors influencing knowledge, attitude and practices to acne vulgaris among pupils of a medical school. This is a cross sectional survey carried out in the period of March-June 2020. One hundred MBBS students in 17 to 24 age group having zits were enrolled in the study. Our study showed that 60% had good knowledge. More than 50% of the students had false notion that eating foodstuffs high in fats and spices and consuming chocolates gave acne but more than 60% of these students had fair understanding about the etiology and exacerbating factors that it turns bad by pressing the lesions (78%), found on greasy skin (79%), use of cosmetics (72%) and associated with premenstrual flare (56%).The undergraduate medical students also follow poor practices and have relatively unfavorable attitude in spite of having better chances of being more knowledgeable than the public. Depression does not spare the medical students too, despite knowing that it is quite common and easily amenable for treatment
Over 70% of patients with acne vulgaris wait at least 1 year before seeing a dermatologist and instead use over-the-counter (OTC) acne treatments. This study determined the association between product characteristics (ingredients, vehicles, and marketing claims) and consumer-reported positive and negative features of top-rated acne OTCs. This cohort study evaluated the top 1% of acne OTCs across the five largest online retailers. Products were analyzed for product characteristics and consumer-reported features. Artificial intelligence data scraper software was utilized to collect reviews, and a natural language processing algorithm was used to tag key phrases within reviews and categorize them based on characteristics and sentiment (positive or negative). An inter-rater reliability test compared reliability of results between a human rater and the software. In this cohort of 149 products, the most frequent ingredients were salicylic acid (33.6%) and benzoyl peroxide (19.5%). Over one-third of top-selling products contained solely “natural” ingredients. Product ingredients, over product vehicle, price, marketing claims, or packaging, were most associated with consumer-reported product effects. Products with active ingredients were reported more frequently as effective in treating acne (p < 0.001) and with side effects, such as erythema (p = 0.054) and hypersensitivity reactions (p = 0.0016). Products with “natural” ingredients were associated with improving skin texture (p = 0.008) and application ease (p = 0.04). Product ingredients, over vehicle, price, marketing claims, and packaging were the greatest indicator of a consumer’s experience with acne OTCs. Given the wide array of and heavy reliance on OTCs to treat acne, information on product experience inform dermatologists on consumer preferences.
Background
Neutrophilic folliculitis is an inflammatory condition of hair follicles. In some neutrophilic folliculitis, such as acne and hidradenitis suppurativa, follicular hyperkeratosis is also observed. Neutrophilic folliculitis is often induced and/or exacerbated by high-fat diet (HFD). However, the molecular mechanisms by which HFD affects neutrophilic folliculitis are not fully understood.
Objective
To elucidate how HFD promotes the development of neutrophilic folliculitis.
Methods
Mice were fed with HFD, and the skin was subjected to histological, RNA-sequencing and imaging mass spectrometry analyses. Phorbol 12-myristate 13-acetate (PMA) was used as an irritant to the skin to examine the effect of HFD on neutrophil accumulation around the hair follicles.
Results
Histological analysis revealed follicular hyperkeratosis in the skin of HFD-fed mice. RNA-sequencing analysis showed that genes related to keratinization, especially in upper hair follicular keratinocytes, were significantly upregulated in HFD-fed mice. Application of PMA to the skin induced neutrophilic folliculitis in HFD-fed mice, but not in normal diet (ND)-fed mice. Accumulation of neutrophils in the skin and around hair follicles was dependent on CXCR2 signaling, and CXCL1, a CXCR2 ligand, was produced mainly by hair follicular keratinocytes. Imaging mass spectrometry analysis revealed an increase of fatty acids in the skin, including oleic acids and palmitoleic acids in HFD-fed mice. Application of these fatty acids to the skin induced follicular hyperkeratosis, and caused PMA-induced neutrophilic folliculitis even in ND-fed mice.
Conclusion
HFD can facilitate the development of neutrophilic folliculitis with the induction of hyperkeratosis of hair follicles and increased neutrophil infiltration around the hair follicles via CXCR2 signaling.
Background:
The psychological impact of acne is comparable to that experienced by patients with severe diseases; however, most of the people does not consider acne as a true disease. We evaluated beliefs, sources of information and knowledge about acne in Italian adolescents and their mothers.
Methods:
This survey was carried out in 2327 acne patients and their mothers (4654 subjects) by means of a self-administered questionnaire. The questionnaire was based on ten questions: seven questions for the patients and three questions for their mothers.
Results:
All the 2327 patients and their mothers completed the survey. Approximately 75% of patients declared that acne has a negative influence on their self-esteem and relationships; furthermore, 87% of patients stated that acne limits their social life. Finally, 65% of patients declared that they are under treatment, but only in 20% of cases the treatment was prescribed by a dermatologist. The mothers considered pollution, wrong diet and hyperseborrhea as the most important etiological factors. They considered the treatment suggested by a cosmetologist and contraceptive pill as the best one; only 8% of mothers reported that they regularly took their children to the dermatologist.
Conclusions:
In order to improve the treatment and the quality of life in acne patients, there is a need to improve awareness about this disease and its causes and to highlight the role and importance of dermatologists.
Background
Acne vulgaris is a highly prevalent skin condition associated with considerable psychological burden. Acne and its sequelae can affect many domains of life leading to social dysfunction, psychiatric issues and educational shortcomings. Psychiatric conditions like depression is found to be more prevalent in acne patients as compared to general population.
Aims
To evaluate importance of screening for depression in acne patients since screening tools in outpatient departments can help dermatologists assess the psychological state of the patient.
Method
Papers selected for the review included review articles in English language and all original research relevant to the topic, in the form of cohort studies, and case–control studies.
Conclusions
This article studies the impact of acne across the various aspects of life and highlights the importance of a timely diagnosis and referral. This can be helpful in preventing the long‐term consequences of acne in terms of physical as well as psychological health.
Paediatric skin disease may impart a psychological, physical and functional burden on afflicted children and their families. Much of the work on this burden of skin disease, both quantitative and qualitative, has been focused on atopic dermatitis, acne and infantile haemangiomas. Of note, burden varies based on the age of the affected child and the type of skin disease. Valuable resources for coping with disease burden include patient advocacy groups and psychology services.
Acne is a long-standing inflammation of the hair-oil gland structure. Although the causes of acne are not fully
known, there is a relationship between acne and nutrition. Because the diet can change the amount and content of
sebum secretion in the skin.
Objective: The purpose of this review is to discuss the effects of nutrients and nutrients (milk and dairy products,
green tea, dietary glycemic load glycemic index, fatty acids, antioxidants, vitamin A and zinc) on the course of
acne vulgaris.
Consumption of milk, contributes to the formation of acne. The use of polyphenol extracts obtained from green
tea in the treatment of acne reduced the the number of acne. A diet with low glycemic index-glycemic load has
been found to cause a significant reduction in acne severity. Inadequate consumption of essential fatty acids leads
to inadequate sebum production in the skin. Serum malondialdehyde and serum glutathione peroxidase levels were
reported to be lower in individuals with acne complaints. Low A vitamin levels may be a risk factor for acne and
acne lesions. It is also stated that serum zinc levels of individuals with acne complaints are significantly lower.
Conclusion: Milk restriction for people with acne complaints, consumption of green tea, low glycemic indexglycemic diet can be recommended. It may also be advisable to pay attention to the fat content of foods and the
intake level of essential fatty acids. The use of vitamins A and E with vitamins A and B may show therapeutic
supportive effects.
We summarize basic empirical themes from studies of adherence to medical regimens and propose a self-regulatory model for conceptualizing the adherence process. The model posits that self-regulation is a function of the representation of health threats and the targets for ongoing coping (symptom reduction, temporal expectancies for change) set by the representation, the procedures to regulate these targets, and the appraisal of coping outcomes. The underlying cognitive mechanism is assumed to function at both a concrete (symptom-based schemata) and abstract level (disease labels), and individuals often engage in biased testing while attempting to establish a coherent representation of a health threat. It also is postulated that cognitive and emotional processes form partially independent processing systems. The coherence of the system, or the common-sense integration of its parts, is seen as crucial for the maintenance of behavioral change. The coherence concept is emphasized in examples applying the model to panic and hypochondriacal disorders.
Guy F. Webster, MD, PhD, obtained his AB in biology from the University of Pennsylvania in 1977, his PhD in pathology in 1981, and his MD in 1985 at the same institution. He served a medical internship at the Hospital of the University of Pennsylvania and a dermatology residency at New York University Skin and Cancer Institute. He has been a member of the faculty of Jefferson Medical College in Philadelphia since 1989 and holds the rank of associate professor in the Department of Dermatology, adjunct associate professor in the Division of Clinical Pharmacology in the Department of Medicine, and is the director of the Center for Cutaneous Pharmacology.
• A questionnaire was completed by 178 patients and relatives with dermatologic conditions as the first phase of a two-part study of the interrelationships between understanding and treatment compliance. Substantial numbers of those surveyed had ideas about cause, treatment, and prognosis that might adversely affect therapy. Diet, dirt, soap and water, topically applied acne gels, and realistic expectations for cures seem to be the most important subjects to emphasize in the written or oral "teaching" of patients with acne.
(Arch Dermatol 1983;119:570-572)
To determine the effects of acne vulgaris on the quality of life of adult dermatology patients.
Cross-sectional and longitudinal questionnaire study.
Sixty patients with acne vulgaris attending appointments with their dermatologists.
Findings using Skindex, a validated 29-item instrument to measure the effects of skin disease on patients' quality of life. Results are reported as 3 scale scores (functioning, emotions, and symptoms) and a composite score (average scale score). In addition, dermatologists rated the clinical severity of patients' skin disease, and patients responded to a global question about how they are bothered by acne. Higher Skindex scores indicate greater effects on quality of life.
Patients with acne experienced functioning and emotional effects from their skin disease comparable with those of patients with psoriasis, but experienced fewer symptoms (for patients with acne and psoriasis, respectively, Skindex functioning scores of 14.9 and 22.8 [P=.08]; emotion scores, 39.2 and 38.9 [P=.95]; and symptoms scores, 29.5 and 42.1 [P<.05]). Skindex scores were higher in older patients than in younger patients, and patients aged 40 years or older were less likely to report improvement in their acne after 3 months (43% vs 85%; P<.05). Among patients reporting no improvement in their acne, older patients reported greater effects of their acne on their quality of life. Furthermore, in multivariate analyses, older adults reported more effects of acne on their quality of life than younger adults, even after controlling for sex and acne severity as judged by the dermatologist.
Acne vulgaris significantly affects patients' quality of life. Regardless of the severity of acne, older adults were more affected by their acne.
To describe the psychosocial impact of acne on adolescents, and, in particular, to assess whether self-concept is affected by medical treatment, we evaluated 39 teenagers presenting for care to a community-based dermatologist. Prior to and following treatment, subjects completed a self-assessment questionnaire, the Piers-Harris self-concept scale, and underwent an objective assessment of acne severity. Fifty-eight percent of subjects were dissatisfied with their facial appearance and this in turn was correlated with feelings of embarrassment and social inhibition (for each, r = 0.48, P less than or equal to 0.005). Subjects' rating of acne severity, but not the dermatologist's, was correlated with dissatisfaction with facial appearance (r = 0.45, P less than or equal to 0.005). Despite these findings, the mean Piers-Harris total t-score (55.4 +/- 7.4) was within the normal range. Fourteen subjects (36%) returned for follow-up and 71% of these were judged by both the dermatologist and themselves to have improved. Following therapy, significant reductions in the adverse consequences of acne were observed with 42% of subjects reporting that their facial appearance was more acceptable to peers, 50% being less embarrassed, and 58% feeling less socially inhibited. Minimal improvement in mean Piers-Harris total t-score was observed (54.6 to 57.4, P = 0.004, paired t-test). Our data demonstrate that acne is perceived by adolescents to have important negative personal and social consequences, and that improvement in these areas may accompany medical treatment.
A family study of hidradenitis suppurativa was undertaken based on 26 subjects with the disease. The probands were obtained from Hospital Activity Analysis (HAA) records for a three year period (1980 to 1983) and by direct referral from hospital specialists over a six month period (1983 to 1984). Family pedigree information was collected by home visits or hospital interviews and confirmation of the disease in relatives was obtained by examination where possible or by telephone contact and hospital/GP records. A total of 62 affected persons was eventually ascertained, 40 females and 22 males. In 11 families there was evidence in favour of a genetic aetiology with single gene transmission. In another three families there was historical evidence of familial occurrence and in nine families no family history was obtained at the time of enquiry. Problems of ascertainment, including variability of age of onset and psychosocial factors, were noted and could be responsible for false negative family histories or underestimation of affected persons.
A questionnaire was completed by 178 patients and relatives with dermatologic conditions as the first phase of a two-part study of the interrelationships between understanding and treatment compliance. Substantial numbers of those surveyed had ideas about cause, treatment, and prognosis that might adversely affect therapy. Diet, dirt, soap and water, topically applied acne gels, and realistic expectations for cures seem to be the most important subjects to emphasize in the written or oral "teaching" of patients with acne.
To assess the prevalence and severity of acne vulgaris in adolescent students.
867 students in Auckland sixth and seventh form classes were interviewed on the subject of acne vulgaris. Of these 847 students were examined and graded for severity of their acne using a modification of the Leeds technique which ranks severity according to number, extent and nature of the acne lesion.
Ninety-one percent of males and 79% of females had some acne. Severe acne was present in 6.9% males and 1.1% females. Severe and moderately severe acne was significantly more common in males (OR = 2.6 95% Cl 1.73 < OR < 3.9). In the univariate analysis there was no association of moderately severe and severe acne with parental occupational group nor ethnicity.
Moderate and severe acne is a common finding in Auckland senior high school classes with males being more affected than females.
Despite scarring being a recognized sequel of acne, the actual extent and incidence of residual scarring remains unknown. One hundred and eighty-five acne patients were included in this study (101 females, 84 males). Patients were selected from acne clinics and their acne scarring was examined. The scarring was quantified according to a lesion count and allocated a score. The type and extent of scarring was correlated to the age and sex of the patient, the site of the acne, the previous acne grade according to the Leeds Technique, acne type (noted in clinic at the original referral time) and duration of acne, before adequate therapeutic measures had been instituted. Results indicate that facial scarring affects both sexes equally and occurs to some degree in 95% of cases. Total scarring on the trunk was significantly greater in males, as was hypertrophic and keloid scarring in these sites (P < 0.05). There were significant correlations between the initial acne grade and the overall severity of scarring in all sites and in both sexes (P < 0.01). Superficial inflamed papular acne lesions as well as nodular lesions were capable of producing scars. A time delay up to 3 years between acne onset and adequate treatment related to the ultimate degree of scarring in both sexes and in all three sites. This emphasizes the need for earlier adequate therapy in an attempt to minimize the subsequent scarring caused by acne.
Acne vulgaris, or acne, as it is generally called, is the most common skin disease, affecting nearly 80 percent of persons at some time between the ages of 11 and 30 years.1 It can persist for years and result in disfigurement and permanent scarring, and it can have serious adverse effects on psychosocial development, resulting in emotional problems, withdrawal from society, and depression.2 The pathogenesis of acne is multifactorial, and therapy can now be directed at many of these factors. This review summarizes current concepts of the rational treatment of acne vulgaris. Pathophysiology of Acne Acne vulgaris is the result . . .
Acne vulgaris is a common inflammatory dermatosis capable of producing significant psychological and physical scarring. The following work describes the benefit of using a questionnaire as a clinical tool to identify acne patients who have developed psychological sequelae as a result of the disease process. In addition, the benefit of isotretinoin on psychological impact has also been highlighted by this work. A prospective clinical study examines the early use of isotretinoin in acne and demonstrates the beneficial effect of early therapy in minimising acne scarring. In summary, oral isotretinoin (Roaccutane/Accutane) provides a very effective therapy to prevent acne patients being 'scarred for life'!
Although viral warts are common, their exact frequency in the community is often underestimated and not well recorded. A random sample of 2491 students from schools throughout the State of Victoria, Australia were examined by dermatologists and dermatology registrars to record the prevalence of common, plantar and plane warts. The overall prevalence of warts adjusted for the age and sex of Victorian school children was 22% (95% confidence interval (CI) 20.1-20.7) varying from 12% (95% CI 9.4-15.7) in 4-6 year olds to 24% (95% CI 18.3-30.4) in 16-18 year olds. Common warts were the most frequent (16%) compared with plantar warts (6%) and plane warts (2%). There was no difference in the overall frequency of warts between males and females and there was no difference in frequency between those who had eczema and those who did not. Almost 40% of those found to have warts on examination had indicated on the survey questionnaire that they did not have any of these lesions. Of those who knew that they had warts, only 38% had used any treatment for them. These data, the first community-based prevalence data on warts ever published from Australia, confirm that warts are indeed common. They suggest the need for education programmes in schools on the nature of these lesions and the treatment available.
To assess adolescent students' attitudes to, perceptions and knowledge of acne and to assess the effect of acne on daily living.
Students from Auckland sixth and seventh form classes were selected from ten Auckland secondary schools using a randomisation process which ensured proportional representation by socioeconomic group and gender. Eight hundred and forty-seven students completed a written questionnaire on the subject of acne vulgaris and had their acne examined. Their acne was graded using a modification of the Leeds system which determines severity on the basis of number, extent and nature of the skin lesions.
Acne was present in 91% of males and 79% of females. Students' perceptions of the severity of their acne were significantly related to objective clinical assessment (p=0.00001). Severity of acne determined the extent of embarrassment (p<0.00001) and the lack of enjoyment of and participation in social activities (p<0.00002). These analyses were significant for both males and females. Students had misconceptions regarding the causes of acne. Parental occupation and ethnic group were related to knowledge of treatment for acne.
Acne causes personal and social difficulties for a large number of adolescent students. There is a need for all students to have access to appropriate information and health services so that the social and psychological consequences of acne are minimised.
The prevalence, severity and disability related to facial acne (comprising acne on the head and neck) was assessed in a randomized sample of 2491 students (aged 4-18 years) from schools throughout the State of Victoria in Australia. Students were diagnosed clinically by a dermatologist or dermatology registrar. The overall prevalence (including 4-7 year olds) was 36.1% (95% confidence intervals, CI 24.7-47.5), ranging from 27.7% (95% CI 20.6-34.8) in 10-12 year olds to 93.3% (95% CI 89.6-96.9) in 16-18 year olds. It was less prevalent among boys aged 10-12 years than girls of the same age; however, between the ages of 16 and 18 years, boys were more likely than girls to have acne. Moderate to severe acne was present in 17% of students (24% boys, 11% girls). Comedones, papules and pustules were the most common manifestations of acne, with one in four students aged 16-18 years having acne scars. Twelve per cent of students reported a high Acne Disability Index score. This tended to correlate with clinical severity, although there was some individual variation in perception of disability. Seventy per cent of those found to have acne on examination had indicated in the questionnaire that they had acne. Of those, 65% had sought treatment, a substantial proportion of which (varying with who gave the advice) was classified as being likely to have no beneficial effect. This is the first population-based prevalence study on clinically confirmed acne published from Australia. The results show that acne is a common problem. They suggest the need for education programmes in schools to ensure that adolescents understand their disease, and know what treatments are available and from whom they should seek advice.
Acne is principally a disorder of adolescence but persists into middle age in a small minority of individuals. There is some evidence, primarily from twin studies, to suggest that acne may be an inherited disease. We have carried out an investigation of the familial risk of persistent adult acne by studying the occurrence of this condition in first-degree relatives of patients with adult persistent acne compared with the relatives of unaffected matched controls. Two hundred and four patients over the age of 25, referred to our department with facial acne which had persisted from adolescence, were included in the study. For each patient, a detailed pedigree which included all first-degree relatives was drawn up. For all relatives over the age of 25, demographic details and the presence or absence of facial acne was recorded. One hundred and forty-four unaffected controls were recruited. These were matched with the patient group in terms of age, social class and ethnic origin. The same questions were asked of controls as of the cases, and they provided the same information on their first-degree relatives. In total, 204 acne cases and 144 non-acne control volunteers were studied, contributing 1203 and 856 first-degree relatives, respectively. Two hundred and three first-degree relatives of cases were affected with facial acne, compared with 42 first-degree relatives of volunteers. The risk of adult acne occurring in a relative of a patient with adult acne was significantly greater than for the relative of an unaffected individual (odds ratio 3.93, 95% confidence interval 2.79-5.51; P < 0.001). Our study suggests that familial factors are important in determining individual susceptibility to adult persistent facial acne. Genetic factors may determine the failure of acne-prone follicles to evolve into acne-resistant follicles in early adult life.
Acne is usually considered a disorder of adolescence, and a number of studies have examined the prevalence of this condition in the adolescent population. There are, however, relatively few data on the prevalence of acne in the adult population.
A community-based study was carried out to investigate the current prevalence of facial acne in adults.
Seven hundred forty-nine persons older than 25 years were examined for facial acne by means of the Leeds acne-grading technique.
A degree of facial acne was recorded in 231 women and 130 men, giving an overall prevalence of 54% (95% confidence interval [CI], 49-58) in women and 40% (95% CI, 35-45) in men (P <.001). The acne observed in volunteers consisted principally of physiological acne, but clinical facial acne (grade > 0.75) was recorded in 3% (95% CI, 1.2-4.8) of men and in 12% (95% CI, 9-15) of women (P <.001). The prevalence of acne did not substantially decrease until after the age of 44 years (P <.001).
This study shows a prevalence of clinical facial acne in women of 12%, which is likely to persist into middle age.