Teenagers and Acne: The Role of the Pharmacist

Joshua J. Pray, Pharm.D. Candidate, W.Steven Pray, Ph.D., R.Ph.

US Pharmacist. 2003;28(6) 

In This Article

Introduction

Before the advent of Accutane (isotretinoin), acne vulgaris (common acne) was a ubiquitous scourge of adolescence. In the worst case, a formerly well-adjusted preadolescent might become the object of scorn and derision solely because of the onset of treatment-resistant acne vulgaris. Countless adults can poignantly attest to the ravages of acne through the scars they carry. Further, teasing and taunting can cause scars that may run deeper than the epidermis.

Acne vulgaris is responsible for more dermatologist visits than any other condition.[1] In western societies, the prevalence of acne is extremely high, with a reported incidence of 79% to 95% in adolescents.[2] In those 25 and older, the incidence drops to 40% to 54% for facial acne. Only 3% of men and 12% of women still have acne by middle age. Acne is present in whites, African-Americans, Hispanics, and Asians.[3] Acne occurs slightly earlier in girls than in boys (age 12.1 vs 12.8, respectively).[4]

While many people do not think culture affects acne prevalence, researchers studying acne in two groups of non-Westerners have found otherwise.[2] After examining 1,200 Kitavan Islanders of Papua New Guinea (300 were ages 15 to 25) and 115 Aché hunter-gatherers of Paraguay (15 were ages 15 to 25), they failed to find a single case of acne, even in the mildest form. They conceded that some disparity in prevalence might be expected based on differing genetics in the distinct racial groups but also concluded that the magnitude of the difference made that hypothesis unlikely. Instead, the researchers speculated that environmental factors were responsible and urged further work to identify them.

The change of seasons has been traditionally thought to affect acne, with many people stating that acne worsens in the winter and improves in the summer.[5] Exploring this truism, researchers surveyed 452 patients with acne about seasonal symptom variations.[5] Although half of the patients noted such a variation, 56% stated that their symptoms increased in the summer, opposing the prevailing myth. However, symptoms worsened in winter for only 11%. The researchers hypothesized that factors present more often in the summer (eg, heat, humidity, sweating) might be responsible.

Another myth with little basis is the connection between diet -- particularly fried foods, chocolate, and cola drinks -- and acne.[6] While such foods might have other negative health effects, little evidence shows that they cause acne.

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