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Acne Classification and external resources
Acne of a 14-year-old boy during puberty
ICD-10	L70.0
ICD-9	706.1
DiseasesDB	10765
MedlinePlus	000873
eMedicine	derm/2

Acne vulgaris (commonly called Acne) is a skin disease, caused by changes in the pilosebaceous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Severe acne is inflammatory, but acne can also manifest in noninflammatory forms.^[1] Acne lesions are commonly referred to as pimples, spots, or zits. Image File history File links Question_book-3. ... Image File history File links Mergefrom. ... There are several forms of treatment for acne scars in current usage. ... Image File history File links Mergefrom. ... Look up Pimple in Wiktionary, the free dictionary. ... Acne is a group of skin rashes that have different causes. ... Wikipedia does not have an article with this exact name. ... Puberty refers to the process of physical changes by which a childs body becomes an adult body capable of reproduction. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // L00-L99 - Diseases of the skin and subcutaneous tissue (L00-L08) Infections of the skin and subcutaneous tissue (L00) Staphylococcal scalded skin syndrome (L01) Impetigo (L02) Cutaneous abscess, furuncle and carbuncle (L03) Cellulitis (L04) Acute lymphadenitis (L05) Pilonidal cyst (L08) Other local infections of skin and subcutaneous tissue (L081) Erythrasma... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... For other uses, see Skin (disambiguation). ... A hair follicle is part of the skin that grows hair by packing old cells together. ... Schematic view of a hair follicle with sebaceous gland. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... A pimple is a type of skin lesion caused by inflamed and/or obstructed pores. ...

Acne is most common during adolescence, affecting more than 85% of teenagers, and frequently continues into adulthood. ^[2] For most people, acne diminishes over time and tends to disappear, or at least decrease, after one reaches his or her early twenties. There is, however, no way to predict how long it will take for it to disappear entirely, and some individuals will continue to suffer from acne decades later, into their thirties and forties and even beyond.^[3] Teen redirects here. ...

The term acne comes from a corruption of the Greek άκμή (acme in the sense of a skin eruption) in the writings of Aëtius Amidenus. The most common form of acne is known as "acne vulgaris", meaning "common acne". Many teenagers get this type of acne. Aëtius Amidenus or Aëtius of Amida (Αέτιος Αμιδηνός) was the court physician of Justinian I. His Βιβλία Ιατρικά (#REDIRECT Libri medicinales) document the medical knowledge of the Late Antique period. ...

The face and upper neck are the most commonly affected, but the chest, back and shoulders may have acne as well. The upper arms can also have acne, but lesions found there are often keratosis pilaris, not acne. The typical acne lesions are comedones and inflammatory papules, pustules, and nodules. Some of the large nodules were previously called "cysts" and the term nodulocystic has been used to describe severe cases of inflammatory acne. ^[4] For other uses, see Face (disambiguation). ... Male Chest The chest is a part of the anatomy of humans and various other animals. ... Illustration of a human back from Grays Anatomy. ... This article is about the body part. ... Look up ARM in Wiktionary, the free dictionary. ... Keratosis pilaris (KP) is a very common genetic follicular condition that is manifested by the appearance of rough bumps on the skin and hence colloquially referred to as chicken skin. It most often appears on the back and outer sides of the upper arms (though the lower arms can also... A cyst (soft c, rhymes with list) is a cloed sac having a distinct membrane and division on the nearby tissue. ...

Aside from scarring, its main effects are psychological, such as reduced self-esteem^[5] and, according to at least one study, depression or suicide.^[6] Acne usually appears during adolescence, when people already tend to be most socially insecure. Early and aggressive treatment is therefore advocated by some to lessen the overall impact to individuals.^[5] In psychology, self-esteem or self-worth is a persons self-image at an emotional level; circumventing reason and logic. ... On the Threshold of Eternity. ... For other uses, see Suicide (disambiguation). ... Teen redirects here. ...

Different types of Acne Vulgaris: A: Cystic acne on the face, B: Subsiding tropical acne of trunk, C: Extensive acne on chest and shoulders.

Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ...

Causes of acne

Acne develops as a result of blockages in follicles. Hyperkeratinization and formation of a plug of keratin and sebum (a microcomedo) is the earliest change. Enlargement of sebaceous glands and an increase in sebum production occur with increased androgen (DHEA-S) production at adrenarche. The microcomedo may enlarge to form an open comedo (blackhead) or closed comedo (whitehead). In these conditions the naturally occurring largely commensual bacteria Propionibacterium acnes can cause inflammation, leading to inflammatory lesions (papules, infected pustules, or nodules) in the dermis around the microcomedo or comedo, which results in redness and and may result in scarring or hyperpigmentation.^[7] Hyperkeratinization is a disorder of the cells lining the inside of a hair follicle. ... Not to be confused with kerogen or carotene. ... Schematic view of a hair follicle with sebaceous gland. ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ... Dehydroepiandrosterone (DHEA), is a natural steroid prohormone produced from cholesterol by the adrenal glands, the gonads, adipose tissue, brain and in the skin (by an autocrine mechanism)]. DHEA is the precursor of androstenedione, testosterone and estrogen. ... Adrenarche refers to a stage of maturation of the cortex of the human adrenal glands. ... This article is about the skin condition. ... Whiteheads are the direct result of skin pores becoming clogged with sebum (naturally occurring oil) and dead skin cells. ... Binomial name (Gilchrist 1900) Douglas & Gunter 1946 Propionibacterium acnes is a relatively slow growing, typically aerotolerant anaerobic gram positive bacterium that is linked to the skin condition acne; it can also cause chronic blepharitis and endophthalmitis, the latter particularly following intraocular surgery. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... A papule is a small, solid and usually conical elevation of the skin. ... The dermis is a layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. ... This article does not cite any references or sources. ... In dermatology, hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin. ...

Primary causes

Acne of an older teenager.

Exactly why some people get acne and some do not is not fully known. It is known to be partly hereditary. Several factors are known to be linked to acne: Image File history File linksMetadata Acne_face. ... Image File history File linksMetadata Acne_face. ...

• Family/Genetic history. The tendency to develop acne runs in families. For example, school-age boys with acne have other members of their family with acne. A family history of acne is associated with an earlier occurrence of acne and an increased number of retentional acne lesions. ^[8]
• Hormonal activity, such as menstrual cycles and puberty. During puberty, an increase in male sex hormones called androgens cause the glands to get larger and make more sebum. ^[9]
• Stress, through increased output of hormones from the adrenal (stress) glands.
• Hyperactive sebaceous glands, secondary to the three hormone sources above.
• Accumulation of dead skin cells.
• Bacteria in the pores. Propionibacterium acnes (P. acnes) is the anaerobic bacterium that causes acne. In-vitro resistance of P. acnes to commonly used antibiotics has been increasing. ^[10]
• Skin irritation or scratching of any sort will activate inflammation.
• Use of anabolic steroids.
• Any medication containing halogens (iodides, chlorides, bromides), lithium, barbiturates, or androgens.
• Exposure to certain chemical compounds. Chloracne is particularly linked to toxic exposure to dioxins, namely Chlorinated dioxins.

Several hormones have been linked to acne: the androgens testosterone, dihydrotestosterone (DHT) and dehydroepiandrosterone sulfate (DHEAS), as well as insulin-like growth factor 1 (IGF-I). In addition, acne-prone skin has been shown to be insulin resistant^{[citation needed]}. Not to be confused with Mensuration. ... Puberty refers to the process of physical changes by which a childs body becomes an adult body capable of reproduction. ... In mammals, the adrenal glands (also known as suprarenal glands) are the triangle-shaped endocrine glands that sit on top of the kidneys; their name indicates that position (ad-, near or at + -renes, kidneys). They are chiefly responsible for regulating the stress response through the synthesis of corticosteroids and catecholamines... The sebaceous glands are glands found in the skin of mammals. ... Schematic view of a hair follicle with sebaceous gland. ... Crystal structure of human sex hormone-binding globulin, transporting 5-alpha-dihydrotestosterone. ... The halogens are a chemical series. ... This article is about the chemical element. ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ... Chloracne is an acne-like eruption of blackheads, cysts, and pustules associated with over-exposure to certain halogenic aromatic hydrocarbons, such as chlorinated dioxins and dibenzofurans. ... Dioxins form a family of toxic chlorinated organic compounds that bioaccumulate in humans and wildlife due to their fat solubility. ... Dioxin in its original usage denoted the organochemical heterocyclic compound with the general chemical formula C4H4O2 in which two CH groups of a benzene ring were replaced (endocyclic substitution) by oxygen atoms, of which two isomers were possible, the ortho (o) and the para (p) variety: 1,2-dioxin and... For other uses, see Hormone (disambiguation). ... Testosterone is a steroid hormone from the androgen group. ... For other uses, see DHT (disambiguation). ... Dehydroepiandrosterone (DHEA), is a natural steroid prohormone produced from cholesterol by the adrenal glands, the gonads, adipose tissue, brain and in the skin (by an autocrine mechanism)]. DHEA is the precursor of androstenedione, testosterone and estrogen. ... Insulin-like growth factor 1 (IGF-1) is a polypeptide protein hormone similar in molecular structure to insulin. ... Not to be confused with inulin. ...

Development of acne vulgaris in later years is uncommon, although this is the age group for Rosacea which may have similar appearances. True acne vulgaris in adults may be a feature of an underlying condition such as pregnancy and disorders such as polycystic ovary syndrome or the rare Cushing's syndrome. Menopause-associated acne occurs as production of the natural anti-acne ovarian hormone estradiol fails at menopause. The lack of estradiol also causes thinning hair, hot flashes, thin skin, wrinkles, vaginal dryness, and predisposes to osteopenia and osteoporosis as well as triggering acne (known as acne climacterica in this situation). Rosacea (IPA: ) is a common but often misunderstood condition that is estimated to affect over 45 million people worldwide. ... Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects approximately one in ten women. ...

Diet

Milk

A recent study, based on a survey of 47,335 women, did find a positive epidemiological association between acne and consumption of partially skimmed milk, instant breakfast drink, sherbet, cottage cheese, and cream cheese.^[11] The researchers hypothesize that the association may be caused by hormones (such as several sex hormones and bovine IGF-I) present in cow milk. Though there is evidence of an association between milk and acne, the exact cause is unclear. Most dermatologists are awaiting confirmatory research linking diet and acne but some support the idea that acne sufferers should experiment with their diets, and refrain from consuming such fare if they find such food affects the severity of their acne.^[12] A glass of cows milk. ... Insulin-like growth factor 1 (IGF-1) is a polypeptide protein hormone similar in molecular structure to insulin. ...

Seafood

Seafood often contains relatively high levels of iodine. Iodine is known to make existing acne worse but there is probably not enough to cause an acne outbreak.^[13] Still, people who are prone to acne may want to avoid excessive consumption of foods high in iodine. Spaghetti with seafood (Spaghetti allo scoglio). ... For other uses, see Iodine (disambiguation). ...

High carbohydrates/High GI

It has also been suggested that there is a link between a diet high in refined sugars and other processed foods and acne. The hypothesis is that rapidly digested carbohydrate food such as white bread and refined sugars produces an overload in metabolic glucose that is rapidly converted into the types of fat that can build up in sebaceous glands. According to this hypothesis, the startling absence of acne in non-westernized societies could be explained by the low glycemic index of these cultures' diets. Others have cited possible genetic reasons for there being no acne in these populations, but similar populations shifting to these diets do develop acne.^{[citation needed]} Note also that the populations studied consumed no milk or other dairy products.^[14] Further research is necessary to establish whether a reduced consumption of high-glycemic foods (such as soft drinks, sweets, white bread) can significantly alleviate acne, though consumption of high-glycemic foods should in any case be kept to a minimum, for general health reasons.^[15] Avoidance of 'junk food' with its high fat and sugar content is also recommended.^[16] The University of Pennsylvania and the US Naval Academy conducted experiments that fed subjects chocolate or a bar with similar amounts of macronutrients (fat, sugar etc.) and found that consumption of chocolate, frequent or not, had no effect on the developing of acne. ^[17] Glycemic index (also glycaemic index, GI) is a ranking system for carbohydrates based on their effect on blood glucose levels. ... This article is about the private Ivy League university in Philadelphia. ... Teamwork: Fourth Class Midshipmen lock arms and use ropes made from uniform items as they brace themselves climbing the Herndon Monument The United States Naval Academy, or USNA, is an institution for the undergraduate education of officers of the United States Navy and the United States Marine Corps. ...

A 2005 systematic review found "surprisingly little evidence exists for the efficacy or lack of efficacy of dietary factors, face-washing and sunlight exposure in the management of acne."^[18] A study in November 2006 in Australia gave a 50% reduction in 12 weeks in mild-moderate facial acne by introducing its subjects to a high protein, low GI diet. ^[19] Systematic reviews are named as the highest level of medical evidence, by evidence based medicine professionals. ...

The American Medical Association says chocolate does not contribute to acne. ^[20]

A recent study^[21] shows that a diet high enough in sugars triggers the liver to convert these sugars into lipid; as a side-effect this stops production of Sex hormone binding globulin- a chemical which reduces the level of testosterone in the blood. Since high testosterone levels generally trigger acne, the researchers believe that this can be a cause. Sex hormone-binding globulin (SHBG) is a glycoprotein that binds to sex hormones, specifically testosterone and estradiol. ...

Vitamins A and E

Studies have shown that newly diagnosed acne patients tend to have lower levels of vitamin A circulating in their bloodstream than those that are acne free.^[22] In addition people with severe acne also tend to have lower blood levels of vitamin E.^[23] The structure of retinol, the most common dietary form of vitamin A Vitamin A is an essential human nutrient. ... Tocopherol, or Vitamin E, is a fat-soluble vitamin in eight forms that is an important antioxidant. ...

Hygiene

Acne is not caused by dirt. This misconception probably comes from the fact that blackheads look like dirt stuck in the openings of pores. The black color is not dirt but simply oxidised keratin. In fact, the blockages of keratin that cause acne occur deep within the narrow follicle channel, where it is impossible to wash them away. These plugs are formed by the failure of the cells lining the duct to separate and flow to the surface in the sebum created there by the body. This article is about the skin condition. ... Not to be confused with kerogen or carotene. ...

Treatments

Available treatments

There are many products sold for the treatment of acne, many of them without any scientifically-proven effects. Generally speaking successful treatments give little improvement within the first week or two; and then the acne decreases over approximately 3 months, after which the improvement starts to flatten out. Many treatments that promise big improvements within 2 weeks are likely to be largely disappointing. However short bursts of cortisone can give very quick results, and other treatments can rapidly improve some active spots, but not usually all active spots.

Modes of improvement are not necessarily fully understood but in general treatments are believed to work in at least 4 different ways (with many of the best treatments providing multiple simultaneous effects:

• normalising shedding into the pore to prevent blockage
• killing P. acnes
• antinflammatory effects
• hormonal manipulation

A combination of treatments can greatly reduce the amount and severity of acne in many cases. Those treatments that are most effective tend to have greater potential for side effects and need a greater degree of monitoring, so a step-wise approach is often taken. Many people consult with doctors when deciding which treatments to use, especially when considering using any treatments in combination. There are a number of treatments that have been proven effective: Binomial name Propionibacterium acnes (Gilchrist 1900) Douglas & Gunter 1946 Propionibacterium acnes is a relatively slow growing, (typically) obligate anaerobe gram positive bacterium that is linked to the skin condition acne; it can also cause chronic blepharitis and endophthalmitis, the latter particularly following intraocular surgery. ...

Benzoyl peroxide cream.

Image File history File linksMetadata Download high resolution version (2048x1536, 761 KB) Licensing I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1. ... Image File history File linksMetadata Download high resolution version (2048x1536, 761 KB) Licensing I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1. ...

Topical bactericidals

Widely available OTC bactericidal products containing benzoyl peroxide may be used in mild to moderate acne. The gel or cream containing benzoyl peroxide is rubbed, twice daily, into the pores over the affected region. Bar soaps or washes may also be used and vary from 2 to 10% in strength. In addition to its therapeutic effect as a keratolytic (a chemical that dissolves the keratin plugging the pores) benzoyl peroxide also prevents new lesions by killing P.acnes. In one study, roughly 70% of participants using a 10% benzoyl peroxide solution experienced a reduction in acne lesions after 6 weeks.^[24]Unlike antibiotics, benzoyl peroxide has the advantage of being a strong oxidizer (essentially a mild bleach) and thus does not appear to generate bacterial resistance. However, it routinely causes dryness, local irritation and redness. A sensible regimen may include the daily use of low-concentration (2.5%) benzoyl peroxide preparations, combined with suitable non-comedogenic moisturisers to help avoid overdrying the skin.^[25] Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ... R-phrases , , S-phrases , , , Autoignition temperature 80°C RTECS number DM8575000 Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and references Tube of Basiron, a water-based 5% benzoyl peroxide preparation for the treatment of acne. ... Binomial name (Gilchrist 1900) Douglas & Gunter 1946 Propionibacterium acnes is a relatively slow growing, typically aerotolerant anaerobic gram positive bacterium that is linked to the skin condition acne; it can also cause chronic blepharitis and endophthalmitis, the latter particularly following intraocular surgery. ... A black head (technically known as a comedo) is a yellowish, reddish (with white cap) or blackish bump or plug on a skin. ...

Care must be taken when using benzoyl peroxide, as it can very easily bleach any fabric or hair it comes in contact with.

Other antibacterials that have been used include triclosan, or chlorhexidine gluconate but these are often less effective, but also give less side-effects. Triclosan (chemically 5-chloro-2-(2,4-dichlorophenoxy)phenol) is a potent wide spectrum antibacterial and antifungal agent. ... Chlorhexidine Gluconate is a chemical antiseptic, to combat both gram positive and gram negative microbes. ...

Prescription-strength benzoyl peroxide preparations do not necessarily differ with regard to the maximum concentration of the active ingredient (10%), but the drug is made available dissolved in a vehicle that more deeply penetrates the pores of the skin.

Topical antibiotics

Externally applied antibiotics such as erythromycin, clindamycin, Stiemycin or tetracycline aim to kill the bacteria that are harbored in the blocked follicles. While topical use of antibiotics is equally as effective as oral use, this method avoids possible side effects including upset stomach and drug interactions (e.g. it will not affect use of the oral contraceptive pill), but may prove awkward to apply over larger areas than just the face alone. Erythromycin is a macrolide antibiotic which has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. ... Clindamycin (rINN) (IPA: ) is a lincosamide antibiotic used in the treatment of infections caused by susceptible microorganisms. ... Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ...

Oral antibiotics

Oral antibiotics used to treat acne include erythromycin or one of the tetracycline antibiotics (tetracycline, the better absorbed oxytetracycline, or one of the once daily doxycycline, minocycline or lymecycline). Trimethoprim is also sometimes used (off-label use in UK). However, reducing the P. acnes bacteria will not, in itself, do anything to reduce the oil secretion and abnormal cell behaviour that is the initial cause of the blocked follicles. Additionally the antibiotics are becoming less and less useful as resistant P. acnes are becoming more common. Acne will generally reappear quite soon after the end of treatment—days later in the case of topical applications, and weeks later in the case of oral antibiotics. This article deals with the group of antibiotics known as the Tetracyclines . ... Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ... Oxytetracycline is known as a broad-spectrum antibiotic due to its activity against such a wide range of infections. ... Doxycycline (INN) (IPA: ) is a member of the tetracycline antibiotics group and is commonly used to treat a variety of infections. ... Minocycline hydrochloride, also known as minocycline, is a member of the broad spectrum tetracycline antibiotics, and has a broader spectrum than the other members. ... Lymecycline is a tetracycline broad-spectrum antibiotic. ... Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections (cystitis). ... Off-label use is the practice of prescribing drugs for a purpose outside the scope of the drugs approved label, most often concerning the drugs indication. ... In medicine, a topical medication is applied to body surfaces such as the skin or mucous membranes such as the vagina, nasopharynx, or the eye. ...

It has been found that sub-antimicrobial doses of antibiotics such as minocycline also improve acne. It is believed that minocycline's anti-inflammatory effect also prevents acne. These low doses do not kill bacteria and hence cannot induce resistance.

Hormonal treatments

In females, acne can be improved with hormonal treatments. The common combined oestrogen/progestogen methods of hormonal contraception have some effect, but the anti-testosterone, Cyproterone, in combination with an oestrogen (Diane 35) is particularly effective at reducing androgenic hormone levels. Diane-35 is not available in the USA, but a newer oral contraceptive containing the progestin drospirenone is now available with fewer side effects than Diane 35 / Dianette. Both can be used where blood tests show abnormally high levels of androgens, but are effective even when this is not the case. Along with this, treatment with low dose spironolactone can have anti-androgenetic properties, especially in patients with polycystic ovarian syndrome. For other uses, see Hormone (disambiguation). ... Estriol. ... Progestagens (also spelled progestogens or gestagens) are hormones which produce effects similar to progesterone, the only natural progestagen. ... Hormonal contraception refers to birth control methods that act on the hormonal system. ... Testosterone is a steroid hormone from the androgen group. ... Cyproterone acetate (Androcur®, Cyprostat®) is an antiandrogen, i. ... Oral contraceptives come in a variety of formulations. ... A progestin is a synthetic progestagen. ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ...

If a pimple is large and/or does not seem to be affected by other treatments, a dermatologist may administer an injection of cortisone directly into it, which will usually reduce redness and inflammation almost immediately. This has the effect of flattening the pimple, thereby making it easier to cover up with makeup, and can also aid in the healing process. Side effects are minimal, but may include a temporary whitening of the skin around the injection point; and occasionally a small depression forms, which may persist, although often fills eventually. This method also carries a much smaller risk of scarring than surgical removal. Cortisone (IPA:ˈkôrtəˌsōn) is a steroid hormone. ...

Biological Treatment

This section does not cite any references or sources. (April 2008) Please help improve this article by adding citations to reliable sources. Unverifiable material may be challenged and removed.

A number of biological treatments available when suffering from this skin condition contain mucin from the snail Helix Aspersa Müller. This substance contains glycoconjugates (complex glycan or sugar molecules bound to proteins, enzymes, co-enzymes, peptides and oligoelements). The enzymes unclog pores and get rid of debris and dead cells, the peptides act as antimicrobials and the glycomolecules are skin repairing substances that prevent and heal acne breakouts and acne skin lesions and scarring. The secretion from the Helix Aspersa Müller regulates the skin healing and how acne is formed.^{[citation needed]} These topical treatments focus on the creation of skin cells instead of aggravating the body´s inflammatory immune system response. The ingredients can saturate deep into the skin and promote cellular turnover.^{[citation needed]} The waste material is removed from the skin lesions so as to reduce inflammation, speed up the healing process and encourage regeneration of new tissue. Biological ingredients with active parts like antioxidants, anti-inflammatory, proteins, peptides, and enzymes can with rather little effort stimulate the speed in which the body heals the acne outbursts.^{[citation needed]} Image File history File links Question_book-3. ... Binomial name Helix aspersa (Müller, 1774) The brown garden snail (Helix aspersa) (syn. ...

Topical retinoids

A group of medications for normalizing the follicle cell lifecycle are topical retinoids such as tretinoin (brand name Retin-A), adapalene (brand name Differin) and tazarotene (brand name Tazorac). Like isotretinoin, they are related to vitamin A, but they are administered as topicals and generally have much milder side effects. They can, however, cause significant irritation of the skin. The retinoids appear to influence the cell creation and death lifecycle of cells in the follicle lining. This helps prevent the hyperkeratinization of these cells that can create a blockage. Retinol, a form of vitamin A, has similar but milder effects and is used in many over-the-counter moisturizers and other topical products. Effective topical retinoids have been in use over 30 years but are available only on prescription so are not as widely used as the other topical treatments. Topical retinoids often cause an initial flare up of acne and facial flushing (physiology). In medicine, a topical medication is applied to body surfaces such as the skin or mucous membranes such as the vagina, nasopharynx, or the eye. ... The Retinoids are a class of chemical compounds that are related chemically to vitamin A. Retinoids are used in medicine, primarily due to the way they regulate epithelial cell growth. ... Tretinoin is the acid form of vitamin A and so also known as all-trans retinoic acid or ATRA. It is a drug commonly used to treat acne vulgaris and keratosis pilaris. ... Adapalene is a topical retinoid primarily used in the treatment of acne and is also used (off-label) to treat keratosis pilaris as well as other skin conditions. ... Tazarotene (marketed as Tazorac®, Avage® and Zorac®) is a prescription topical retinoid sold as a cream or gel. ... The structure of retinol, the most common dietary form of vitamin A Vitamin A is an essential human nutrient. ... Hyperkeratinization is a disorder of the cells lining the inside of a hair follicle. ... Retinol, the animal form of vitamin A, is a yellow fat-soluble, antioxidant vitamin important in vision and bone growth. ... For a person to flush is to become markedly red in the face and often other areas of the skin, from various physiological conditions. ...

Oral retinoids

Main article: Accutane

A daily oral intake of vitamin A derivative isotretinoin (marketed as Accutane, Amnesteem, Sotret, Claravis) over a period of 4-6 months can cause long-term resolution or reduction of acne. It is believed that isotretinoin works primarily by reducing the secretion of oils from the glands, however some studies suggest that it affects other acne-related factors as well. Isotretinoin has been shown to be very effective in treating severe acne and can either improve or clear well over 80% of patients. The drug has a much longer effect than anti-bacterial treatments and will often cure acne for good. The treatment requires close medical supervision by a dermatologist because the drug has many known side effects (many of which can be severe). About 25% of patients may relapse after one treatment. In those cases, a second treatment for another 4-6 months may be indicated to obtain desired results. It is often recommended that one lets a few months pass between the two treatments, because the condition can actually improve somewhat in the time after stopping the treatment and waiting a few months also gives the body a chance to recover. Occasionally a third or even a fourth course is used, but the benefits are often less substantial. The most common side effects are dry skin and occasional nosebleeds (secondary to dry nasal mucosa). Oral retinoids also often cause an initial flare up of acne within a month or so, which can be severe. There are reports that the drug has damaged the liver of patients. For this reason, it is recommended that patients have blood samples taken and examined before and during treatment. In some cases, treatment is terminated or reduced due to elevated liver enzymes in the blood, which might be related to liver damage. Others claim that the reports of permanent damage to the liver are unsubstantiated, and routine testing is considered unnecessary by some dermatologists. Blood triglycerides also need to be monitored. However, routine testing are part of the official guidelines for the use of the drug in many countries. Some press reports suggest that isotretinoin may cause depression but as of September 2005 there is no agreement in the medical literature as to the risk. The drug also causes birth defects if women become pregnant while taking it or take it while pregnant. For this reason, female patients are required to use two separate forms of birth control or vow abstinence while on the drug. Because of this, the drug is supposed to be given to females as a last resort after milder treatments have proven insufficient. Restrictive rules (see iPledge Program) for use were put into force in the USA beginning in March 2006 to prevent misuse.^[26] This has occasioned widespread editorial comment.^[27] Isotretinoin is a drug used for the treatment of acne. ... The structure of retinol, the most common dietary form of vitamin A Vitamin A is an essential human nutrient. ... Isotretinoin (INN) (pronounced or [1]) is a medication used for the treatment of severe acne. ... Dermatology is a branch of medicine dealing with the skin, its structure, functions, and diseases (from Greek derma, skin), as well as its appendages (nails, hair, sweat glands). ... Adverse effect, in medicine, is an abnormal, harmful, undesired and/or unintended side-effect, although not necessarily unexpected, which is obtained as the result of a therapy or other medical intervention, such as drug/chemotherapy, physical therapy, surgery, medical procedure, use of a medical device, etc. ... The liver is the largest internal organ in the human body, and is an organ present in vertebrates and some other animals. ... On the Threshold of Eternity. ... For other uses, see Birth control (disambiguation). ... This article is about the practice of abstinence in general. ... The correct title of this article is iPledge. ...

Phototherapy

'Blue' and red light

It has long been known that short term improvement can be achieved with sunlight. However, studies have shown that sunlight worsens acne long-term. More recently, visible light has been successfully employed to treat acne (phototherapy) - in particular intense violet light (405-420nm) generated by purpose-built fluorescent lighting, dichroic bulbs, LEDs or lasers. Used twice weekly, this has been shown to reduce the number of acne lesions by about 64%;^[28] and is even more effective when applied daily. The mechanism appears to be that a porphyrin (Coproporphyrin III) produced within P. acnes generates free radicals when irradiated by 420nm and shorter wavelengths of light.^[29] Particularly when applied over several days, these free radicals ultimately kill the bacteria.^[30] Since porphyrins are not otherwise present in skin, and no UV light is employed, it appears to be safe, and has been licensed by the U.S. FDA.^[31] The treatment apparently works even better if used with red visible light (660 nanometer) resulting in a 76% reduction of lesions after 3 months of daily treatment for 80% of the patients;^[32] and overall clearance was similar or better than benzoyl peroxide. Unlike most of the other treatments few if any negative side effects are typically experienced, and the development of bacterial resistance to the treatment seems very unlikely. After treatment, clearance can be longer lived than is typical with topical or oral antibiotic treatments; several months is not uncommon. The equipment or treatment, however, is relatively new and reasonably expensive to buy initially, although the total cost of ownership can be similar to many other treatment methods (such as the total cost of benzoyl peroxide, moisturiser, washes) over a couple of years of use. Light therapy or phototherapy consists of exposure to specific ranges of light wavelengths (using lasers or LEDs), or very bright, full-spectrum light, for a prescribed amount of time. ... In optics, the term dichroic has two related but distinct meanings. ... External links LEd Category: TeX ... For alternative meanings see laser (disambiguation). ... Structure of porphine, the simplest porphyrin. ... In chemistry free radicals are uncharged atomic or molecular species with unpaired electrons or an otherwise open shell configuration. ... For other uses of terms redirecting here, see US (disambiguation), USA (disambiguation), and United States (disambiguation) Motto In God We Trust(since 1956) (From Many, One; Latin, traditional) Anthem The Star-Spangled Banner Capital Washington, D.C. Largest city New York City National language English (de facto)1 Demonym American... “FDA” redirects here. ...

Photodynamic therapy

In addition, basic science and clinical work by dermatologists Yoram Harth and Alan Shalita and others has produced evidence that intense blue/violet light (405-425 nanometer) can decrease the number of inflammatory acne lesion by 60-70% in 4 weeks of therapy, particularly when the P.acnes is pretreated with delta-aminolevulinic acid (ALA), which increases the production of porphyrins. However this photodynamic therapy is controversial and apparently not published in a peer reviewed journal. It has been suggested that this article or section be merged with 5-Aminolevulinic acid. ...

Laser treatment

Laser surgery has been in use for some time to reduce the scars left behind by acne, but research has been done on lasers for prevention of acne formation itself. The laser is used to produce one of the following effects: For other uses, see Laser (disambiguation). ...

• to burn away the follicle sac from which the hair grows
• to burn away the sebaceous gland which produces the oil
• to induce formation of oxygen in the bacteria, killing them

Since lasers and intense pulsed light sources cause thermal damage to the skin, there are concerns that laser or intense pulsed light treatments for acne will induce hyperpigmented macules (spots) or cause long-term dryness of the skin. This article is about the chemical element and its most stable form, or dioxygen. ...

In the United States, the FDA has approved several companies, such as Candela Corp. to use a cosmetic laser for the treatment of acne.^[33] However, efficacy studies have used very small sample sizes (fewer than 100 subjects) for periods of six months or less, and have shown contradictory results.^[34][35] Also, laser treatment being relatively new, protocols remain subject to experimentation and revision,^[36] and treatment can be quite expensive. Also, some Smoothbeam laser devices had to be recalled due to coolant failure, which resulted in painful burn injuries to patients.^[37] Motto: (traditional) In God We Trust (official, 1956–present) Anthem: The Star-Spangled Banner Capital Washington, D.C. Largest city New York City Official language(s) None at the federal level; English de facto Government Federal Republic  - President George W. Bush (R)  - Vice President Dick Cheney (R) Independence - Declared - Recognized... “FDA” redirects here. ...

Less widely used treatments

• Aloe vera: there are treatments for acne mentioned in Ayurveda using herbs such as Aloe vera,^[38] Aruna, Haldi (Turmeric),and Papaya.^[39] There is limited evidence from conventional medical studies on these products.^[40] Products from Rubia cordifolia, Curcuma longa (commonly known as Turmeric), Hemidesmus indicus (known as ananthamoola or anantmula), and Azadirachta indica (Neem) have been shown to have anti-inflammatory effects, but not aloe vera.^[41]
• Azelaic acid (brand names Azelex, Finevin, Skinoren) is suitable for mild, comedonal acne.^[42]
• Heat: local heating may be used to kill the bacteria in a developing pimple and so speed healing. ^[43]
• Naproxen or ibuprofen are used for some moderate acne for their anti-inflammatory effect.^[44]
• Nicotinamide, (Vitamin B3) used topically in the form of a gel, has been shown in a 1995 study to be more effective than a topical antibiotic used for comparison, as well as having fewer side effects.^[45] Topical nicotinamide is available both on prescription and over-the-counter. The property of topical nicotinamide's benefit in treating acne seems to be its anti-inflammatory nature. It is also purported to result in increased synthesis of collagen, keratin, involucrin and flaggrin.^{[citation needed]}
• Tea Tree Oil (Melaleuca Oil) has been used with some success, comparable to benzoyl peroxide but without excessive drying, and has been shown to be an effective anti-inflammatory in skin infections. ^[46][47][48]
• Rofecoxib was shown to improve premenstrual acne vulgaris in a placebo controlled study.^[49]
• Zinc: Orally administered zinc gluconate has been shown to be effective in the treatment of inflammatory acne, although less so than tetracyclines.^[50][51]

Binomial name (L.) Burm. ... Binomial name (L.) Burm. ... Binomial name Linnaeus Turmeric (Curcuma longa) is a rhizomatous herbaceous perennial plant of the ginger family, Zingiberaceae which is native to tropical South Asia. ... Binomial name L. This article is about the fruit. ... Species See text. ... Binomial name Curcuma longa Linnaeus Turmeric (Curcuma longa, also known as tumeric or curcumin) is a spice commonly used in curries and other south Asian cooking. ... Binomial name Synonyms Periploca indica Indian Sarsaparilla (Hemidesmus indicus) is a species of plant that is found in South Asia. ... Binomial name Azadirachta indica A. Juss. ... Azelaic acid is a saturated dicarboxylic acid found naturally in wheat, rye, and barley. ... For other uses, see Heat (disambiguation) In physics, heat, symbolized by Q, is energy transferred from one body or system to another due to a difference in temperature. ... Naproxen (INN) (IPA: ) is a non-steroidal anti-inflammatory drug (NSAID) commonly used for the reduction of mild to moderate pain, fever, inflammation and stiffness caused by conditions such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, injury (like fractures), menstrual cramps, tendonitis, bursitis, and the treatment of primary... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks, including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Burana (Finland), Ipren or Ibumetin (Denmark and Sweden), Ibuprom... Nicotinamide, also known as niacinamide, is the amide of niacin (vitamin B3) which has the chemical formula C6H6N2O. Niacinamide is a derivative of vitamin B-3 can be used for the treatment of arthritis by aiding the body in its production of cartilage. ... Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ... Tea Tree Oil (Melaleuca Oil) Tea tree oil is a yellowish green-tinged essential oil with a fresh camphoraceous odour. ... Rofecoxib (IPA: ) is a nonsteroidal anti-inflammatory drug (NSAID) developed by Merck & Co. ... General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ... General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ... Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ...

History of some acne treatments

This section needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (December 2007)

The history of acne reaches back to the dawn of recorded history. In Ancient Egypt, it is recorded that several pharaohs were acne sufferers^{[citation needed]}. From Ancient Greece comes the English word 'acne' (meaning 'point' or 'peak'). Acne treatments are also of considerable antiquity: Image File history File links Question_book-3. ...

• Ancient Rome^{[citation needed]}: bathing in hot, and often sulfurous, mineral water was one of the few available acne treatments. One of the earliest texts to mention skin problems is De Medicina by the Roman writer Celsus.
• 1800s: Nineteenth century dermatologists used sulphur in the treatment of acne. It was believed to dry the skin.
• 1920s: Benzoyl Peroxide is used
• 1930s: Laxatives were used as a cure for what were known as 'chastity pimples'. Radiation also was used.
• 1950s: When antibiotics became available, it was discovered that they had beneficial effects on acne. They were taken orally to begin with. Much of the benefit was not from killing bacteria but from the anti-inflammatory effects of tetracycline and its relatives. Topical antibiotics became available later.
• 1970s: Tretinoin (original Trade Name Retin A) was found effective for acne.^[52] This preceded the development of oral isotretinoin (sold as Accutane and Roaccutane) in 1980.^[53]
• 1980s: Accutane is introduced in America, and later found to be a teratogen, highly likely to cause birth defects if taken during pregnancy. In the United States more than 2,000 women became pregnant while taking the drug between 1982 and 2003, with most pregnancies ending in abortion or miscarriage. About 160 babies with birth defects were born.^{[54] [55]}
• 1990s: Laser treatment introduced
• 2000s: Blue/red light therapy

Aulus Cornelius Celsus Aulus Cornelius Celsus (25 BC—50) was a Roman encyclopedist and possibly, although not likely, a physician. ... R-phrases , , S-phrases , , , Autoignition temperature 80°C RTECS number DM8575000 Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and references Tube of Basiron, a water-based 5% benzoyl peroxide preparation for the treatment of acne. ... Laxatives (or purgatives) are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. ... Tretinoin is the acid form of vitamin A and so also known as all-trans retinoic acid or ATRA. It is a drug commonly used to treat acne vulgaris and keratosis pilaris. ... Isotretinoin (INN) (pronounced or [1]) is a medication used for the treatment of severe acne. ... Teratogenesis is a medical term from the Greek, literally meaning monster making. ... Miscarriage or spontaneous abortion is the natural or spontaneous end of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined in humans at a gestation of prior to 20 weeks. ...

Future treatments

A 2007 microbiology article reporting the first genome sequencing of a Propionibacterium acnes bacteriophage (PA6) said this "should greatly enhance the development of a potential bacteriophage therapy to treat acne and therefore overcome the significant problems associated with long-term antibiotic therapy and bacterial resistance."^[56] An agar plate streaked with microorganisms Microbiology is the study of microorganisms, which are unicellular or cell-cluster microscopic organisms. ... In biology the genome of an organism is the whole hereditary information of an organism that is encoded in the DNA (or, for some viruses, RNA). ... The term DNA sequencing encompasses biochemical methods for determining the order of the nucleotide bases, adenine, guanine, cytosine, and thymine, in a DNA oligonucleotide. ... Binomial name (Gilchrist 1900) Douglas & Gunter 1946 Propionibacterium acnes is a relatively slow growing, typically aerotolerant anaerobic gram positive bacterium that is linked to the skin condition acne; it can also cause chronic blepharitis and endophthalmitis, the latter particularly following intraocular surgery. ... An artists rendering of an Enterobacteria phage T4. ... A 3D rendering showing T4 type bacteriophages landing on a bacterium to inject genetic material. ... Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. ...

Preferred treatments by types of acne vulgaris

• Comedonal (non-inflammatory) acne: local treatment with azelaic acid, salicylic acid, topical retinoids, benzoyl peroxide.
• Mild papulo-pustular (inflammatory) acne: benzoyl peroxide or topical retinoids, topical antibiotics (such as erythromycin).
• Moderate inflammatory acne: benzoyl peroxide or topical retinoids combined with oral antibiotics (tetracyclines). Isotretinoin is an option.
• Severe inflammatory acne, nodular acne, acne resistant to the above treatments: isotretinoin also known as Acutane, can be prescribed by a doctor, or contraceptive pills with cyproterone for females with virilization or drospirenone.

A black head is a pore clogged with hard material such as skin-cells. ... Azelaic acid is a saturated dicarboxylic acid found naturally in wheat, rye, and barley. ... Salicylic acid (from the Latin word for the willow tree, Salix, from whose bark it can be obtained) is a beta hydroxy acid (BHA) with the formula C6H4(OH)CO2H, where the OH group is adjacent to the carboxyl group. ... The Retinoids are a class of chemical compounds that are related chemically to vitamin A. Retinoids are used in medicine, primarily due to the way they regulate epithelial cell growth. ... A papule is a small, solid and usually conical elevation of the skin. ... An abscess is a collection of pus collected in a cavity formed by the tissue on the basis of an infectious process (usually caused by bacteria or parasites) or other foreign materials (e. ... R-phrases , , S-phrases , , , Autoignition temperature 80°C RTECS number DM8575000 Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and references Tube of Basiron, a water-based 5% benzoyl peroxide preparation for the treatment of acne. ... Staphylococcus aureus - Antibiotics test plate. ... Erythromycin is a macrolide antibiotic which has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. ... R-phrases , , S-phrases , , , Autoignition temperature 80°C RTECS number DM8575000 Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and references Tube of Basiron, a water-based 5% benzoyl peroxide preparation for the treatment of acne. ... Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ... Isotretinoin (INN) (pronounced or [1]) is a medication used for the treatment of severe acne. ... Isotretinoin (INN) (pronounced or [1]) is a medication used for the treatment of severe acne. ... Cyproterone acetate (Androcur®, Cyprostat®) is an antiandrogen, i. ... In biology and medicine, virilization refers to the development of changes which make a male body different from a female body. ... A progestin is a synthetic progestagen. ...

Acne scars

See Acne scarring.

Acne often leaves small scars where the skin gets a "volcanic" shape. Acne scars are difficult and expensive to treat, and it is unusual for the scars to be successfully removed completely.^{[citation needed]} This article does not cite any references or sources. ...

Physical acne scars are often referred to as "Icepick" scars. This is because the scars tend to cause an indentation in the skin's surface. There are a range of treatments available.

Although quite rare, the medical condition Atrophia Maculosa Varioliformis Cutis results in "acne like" depressed scars on the face. Atrophia Maculosa Varioliformis Cutis (AMVC) is a condition involving the spontaneous appearance of depressed scars on the face[1] occurring over a period of months to years. ...

Image File history File links No higher resolution available. ...

Ice pick scars - Deep pits, that are the most common and a classic sign of acne scarring.
Box car scars - Angular scars that usually occur on the temple and cheeks, and can be either superficial or deep, these are similar to chickenpox scars.
Rolling scars - Scars that give the skin a wave-like appearance.
Hypertrophic scars - Thickened, or keloid scars. ^[57]

Pigmentation

Pigmented scars is a slightly misleading term, suggesting a change in the skin's pigmentation, and that they are true scars. Neither is true. Pigmented scars are usually the result of nodular or cystic acne (the painful 'bumps' lying under the skin). They often leave behind an inflamed red mark. Often, the pigmentation scars can be avoided simply by avoiding aggravation of the nodule or cyst. When sufferers try to 'pop' cysts or nodules, pigmentation scarring becomes significantly worse, and may even bruise the affected area. Pigmentation scars nearly always fade with time taking between 3 months to two years to do so, although rarely can persist.

On the other hand, some people, particularly people with naturally tanned skin do develop brown hyperpigmentation scars which is caused by a local increased production of the pigment melanin. These too typically fade over time. In dermatology, hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin. ... Broadly, melanin is any of the polyacetylene, polyaniline, and polypyrrole blacks and browns or their mixed copolymers. ...

Grading scale

There are multiple grading scales for grading the severity of acne vulgaris,^[58] three of these being: Leeds acne grading technique: Counts and categorises lesions into inflammatory and non-inflammatory (ranges from 0-10.0). 'Cook's acne grading scale: Uses photographs to grade severity from 0 to 8 (0 being the least severe and 8 being the most severe). Pillsbury scale: Simply classifies the severity of the acne from 1 (least severe) to 4 (most severe).

See also

• Blackhead
• Keratosis pilaris
• Rosacea
• Chloracne
• Feline acne

This article is about the skin condition. ... Keratosis pilaris (KP) is a very common genetic follicular condition that is manifested by the appearance of rough bumps on the skin and hence colloquially referred to as chicken skin. It most often appears on the back and outer sides of the upper arms (though the lower arms can also... Rosacea (IPA: ) is a common but often misunderstood condition that is estimated to affect over 45 million people worldwide. ... Chloracne is an acne-like eruption of blackheads, cysts, and pustules associated with over-exposure to certain halogenic aromatic hydrocarbons, such as chlorinated dioxins and dibenzofurans. ...

Footnotes

The New England Journal of Medicine (New Engl J Med or NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. ... Year 1998 (MCMXCVIII) was a common year starting on Thursday (link will display full 1998 Gregorian calendar). ... is the 156th day of the year (157th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 147th day of the year (148th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 260th day of the year (261st in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 129th day of the year (130th in leap years) in the Gregorian calendar. ... “FDA” redirects here. ... Year 2001 (MMI) was a common year starting on Monday (link displays the 2001 Gregorian calendar). ... is the 205th day of the year (206th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 174th day of the year (175th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... The Journal of Bacteriology is an academic journal published by the American Society for Microbiology. ...

Further reading

Review articles and guidelines

• Webster GF (2002). "Acne vulgaris". BMJ 325 (7362): 475-9. PMID 12202330. 
• Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden JJ, Shalita AR, Thiboutot D; Global Alliance to Improve Outcomes in Acne (2003). "Management of acne: a report from a Global Alliance to Improve Outcomes in Acne". J Am Acad Dermatol 49 (1 Suppl): S1-37. PMID 12833004. 
• Feldman S, Careccia RE, Barham KL, Hancox J (2004). "Diagnosis and treatment of acne". Am Fam Physician 69 (9): 2123-30. PMID 15152959. 
• Haider A, Shaw JC (2004). "Treatment of acne vulgaris". JAMA 292 (6): 726-35. PMID 15304471. 
• Katsambas AD, Cunliffe WJ (eds.) (2004). "Acne and its treatment". Clin Dermatol 22 (5): 359-447. 
• James WD (2005). "Clinical practice. Acne". N Engl J Med 352 (14): 1463-72. PMID 15814882. 
• "Drugs for acne, rosacea and psoriasis" (2005). Treat Guidel Med Lett 3 (35): 49-56. PMID 15961971. 
• Sinclair W, Jordaan HF; Global Alliance to Improve Outcomes in Acne (2005). "Acne guideline 2005 update". S Afr Med J 95 (11 Pt 2): 881-92. PMID 16344888. 
• Zaenglein AL, Thiboutot DM (2006). "Expert committee recommendations for acne management". Pediatrics 118 (3): 1188-99. PMID 16951015. 
• Purdy S, de Berker D (2006). "Acne". BMJ 333 (7575): 949-53. PMID 17082546. 
• Strauss JS, Krowchuk DP, Leyden JJ, Lucky AW, Shalita AR, Siegfried EC, Thiboutot DM, Van Voorhees AS, Beutner KA, Sieck CK, Bhushan R; American Academy of Dermatology/American Academy of Dermatology Association (2007). "Guidelines of care for acne vulgaris management". J Am Acad Dermatol 56 (4): 651-63. PMID 17276540. 

The British Medical Journal (BMJ) is a medical journal published weekly in the United Kingdom by the British Medical Association (BMA)which published its first issue in 1845. ... The American Family Physician is a medical journal of the American Academy of Family Physicians. ... JAMA, published continuously since in 1883, is an international peer-reviewed general medical journal published 48 times per year. ... The New England Journal of Medicine (New Engl J Med or NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. ... Treatment Guidelines from The Medical Letter is published monthly (12 issues/year) by The Medical Letter, Inc. ... Pediatrics is an official peer-reviewed journal of the American Academy of Pediatrics. ... The British Medical Journal (BMJ) is a medical journal published weekly in the United Kingdom by the British Medical Association (BMA)which published its first issue in 1845. ... The American Academy of Dermatology (AAD) is the largest organization of dermatologists in the world. ...

Reference books and chapters

• Plewig, Gerd; Kligman, Albert M. (2000). Acne and rosacea, 3rd ed., New York: Springer-Verlag. ISBN 3-540-66751-2. 
• Cunliffe, William J.; Gollnick, Harald P. M. (2001). Acne : diagnosis and management. London: Martin Dunitz. ISBN 1-85317-206-5. 
• Thiboutot, Diane M.; Strauss, John S. (2003). "Diseases of the sebaceous glands", in Burns, Tony; Breathnach, Stephen; Cox, Neil; Griffiths, Christopher: Fitzpatrick's dermatology in general medicine, 6th ed., New York: McGraw-Hill, pp. 672-87. ISBN 0-07-138076-0. 
• Zaenglein, Andrea L.; Thiboutot, Diane M. (2003). "Acne vulgaris", in Bolognia, Jean L.; Jorizzo, Joseph L.; Rapini, Ronald P. (eds.): Dermatology. London: Mosby, pp. 531-44. ISBN 0-32302-4092. 
• Habif, Thomas P. (2004). "Acne, rosacea, and related disorders", Clinical dermatology : a color guide to diagnosis and therapy, 4th ed., Edinburgh: Mosby, pp. 162-208. ISBN 0-323-01319-8. 
• Simpson, Nicholas B.; Cunliffe, William J. (2004). "Disorders of the sebaceous glands", in Burns, Tony; Breathnach, Stephen; Cox, Neil; Griffiths, Christopher: Rook's textbook of dermatology, 7th ed., Malden, Mass.: Blackwell Science, pp. 43.1-75. ISBN 0-632-06429-3. 
• James, William D.; Berger, Timothy G.; Elston, Dirk M. (2006). "Acne", Andrews' diseases of the skin : clinical dermatology, 10th ed., Philadelphia: Saunders Elsevier, pp. 231-50. ISBN 0-7216-2921-0. 

External links

Wikimedia Commons has media related to:

Acne

• Acne vulgaris: more than skin deep (on the psychological effects of acne)
• Acne Library of publications
• Acne photo library at Dermnet
• Story on Acne from the Better Health Channel (Quality assured by the Victorian government, Australia)
• AcneNet. American Academy of Dermatology. - Dermatologist-reviewed information about acne.
• Q&A about Acne, from the National Institutes of Health.