Acne vulgaris (or simply acne) is a common human skin disease, characterized by areas of seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), nodules (large papules), pimples, and possibly scarring. Aside from scarring, its main effects are psychological, such as reduced self-esteem and in very extreme cases, depression or suicide. One study has estimated the incidence of suicidal ideation in patients with acne as 7.1%.
In adolescence, acne is usually caused by an increase in androgens such as testosterone, which occurs during puberty, regardless of sex. Acne more often affects skin with a greater number of oil glands; these areas include the face, the upper part of the chest, and the back. Severe acne is inflammatory, but acne can also manifest in noninflammatory forms. The skin changes are caused by changes in pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland, changes that require androgen stimulation.
Many different treatments exist. Eating fewer simple carbohydrates like sugar may help. Medications for acne include benzoyl peroxide, antibiotics (either topical or by pill), retinoids, antiseborrheic medications, anti-androgen medications, hormonal treatments, salicylic acid, alpha hydroxy acid, azelaic acid, nicotinamide, and keratolytic soaps. Early and aggressive treatment is advocated by some to lessen the overall long-term impact to individuals.
Acne occurs most commonly during adolescence, affecting an estimated 80–90% of teenagers in the Western world. Lower rates are reported in some rural societies. In 2010 it was estimated to be the 8th most common disease globally affecting 650 million people. For most people, acne diminishes over time and tends to disappear – or at the very least decreases – by age 25. There is, however, no way to predict how long it will take to disappear entirely, and some individuals will carry this condition well into their thirties, forties, and beyond.
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