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Acne vulgaris, also known as acne, is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin.[1] It is characterized by blackheads or whiteheads, pimples, greasy skin, and possible scarring.[2][3][4] It primarily affects areas of the skin with a relatively high number of oil glands, including the face, upper part of the chest, and back.[5] The resulting appearance can lead to anxiety, reduced self-esteem and, in extreme cases, depression or thoughts of suicide.[6][7]
Genetics is thought to be the cause of acne in 80% of cases.[3] The role of diet and cigarette smoking is unclear, and neither cleanliness nor exposure to sunlight appear to play a part.[3][8][9] During puberty, in both sexes, acne is often brought on by an increase in hormones such as testosterone.[10] Excessive growth of the bacterium Propionibacterium acnes, which is normally present on the skin, is often involved.[10]
Many treatment options for acne are available, including lifestyle changes, medications, and medical procedures. Eating fewer simple carbohydrates such as sugar may help.[11] Treatments applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid, are commonly used.[12] Antibiotics and retinoids are available in formulations that are applied to the skin and taken by mouth for the treatment of acne.[12] However, resistance to antibiotics may develop as a result of antibiotic therapy.[13] Several types of birth control pills help against acne in women.[12] Isotretinoin pills are usually reserved for severe acne due to greater potential side effects.[12] Early and aggressive treatment of acne is advocated by some in the medical community to decrease the overall long-term impact to individuals.[7]
In 2013, acne was estimated to affect 660 million people globally, making it the 8th most common disease worldwide.[14][15] Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world.[16][17][18] Lower rates are reported in some rural societies.[18][19] Children and adults may also be affected before and after puberty.[20] Although acne becomes less common in adulthood, it persists in nearly half of people into their twenties and thirties and a smaller group continue to have difficulties into their forties.[3]