Acne vulgaris is a common dermatological disorder that predominantly affects teenagers, but can also affect preadolescents and post-teen individuals. Despite the fact that acne vulgaris is the most common skin disorder encountered in ambulatory dermatology practice in the United States, there has been limited research on the epidermal permeability barrier in untreated skin of people with acne vulgaris and also after use of acne therapies. This article reviews the research results and discusses the available literature on this subject area. The importance of proper skin care as a component of the management of acne vulgaris is supported by the information that is currently available.
This study examined the experiences of teenagers seeking and receiving care for depression from primary care providers. We investigated teens’ perceived barriers in obtaining care to determine how primary care can effectively address depressed teens’ stated needs. In-depth individual (n = 15) and focus group (n = 7) interviews with adolescents were conducted and analyzed using grounded theory and prominent themes were identified. Teenagers reported faring best when providers actively considered and reflected upon the teenagers’ developmentally appropriate desires to be normal, to feel connected, and to be autous. These goals are achieved by providers establishing rapport, exchanging information about depression etiology and treatment, and helping teens make decisions about their treatment. To the extent that providers improve efforts to help teens feel normal, autonomous, and connected, the teens report they are more likely to accept treatment for depression and report success in treatment.
depression; adolescents; identity; primary care; patient-provider communication
Although there is literature about adults’ experiences of depression, little research has focused on teenagers’ experiences. In this article, the authors describe how a sample of adolescents makes sense of depression and responds to a depression diagnosis. Twenty-two adolescents participated in in-depth individual or focus group interviews. Teens discussed their experiences with depression and getting health care for depression, and described a trajectory similar to that found among adults: a slow growth of distress, a time of being in a funk, and a time of consideration of whether they are depressed. Teens who received a diagnosis from a medical provider then sought to make sense of their depression. Teens understood a depression diagnosis as a helpful label, a chronic medical problem, or a significant part of their identity. Understanding the subjective experience of adolescents who are depressed might increase health care providers’ empathy and improve their communication with teens.
depression; adolescents; treatment; attitudes; primary care; meaning
Acne, the most common problem that presents to dermatologists, can persist beyond teen years. Although its physical and psychosocial impact is studied in teen years, it is poorly understood in the Indian adult population.
To study the physical and psychosocial impact of acne in adult females.
Settings and Design:
This exploratory study was done in the university setting.
Materials and Methods:
Eleven adult, unmarried females, between the age group of 18 and 25 years, having (mild-to-moderate), acne, for two consecutive years, were interviewed using a semi-structured clinical interview of the Skindex, a quality-of-life measure for patients with skin disease, developed by Chren et al., along with some open-ended questions. Both qualitative and quantitative analysis was done to analyze the data.
The results indicated a higher level of emotional and social impairment, in terms of the feelings of physical discomfort, anger, and the intermingling impact of these, among the participants.
Acne is a common problem among adults and appears to have a considerable impact on the mental health, therefore, for the treatment to be successful, a sympathetic approach by doctors and significant others, with the basic psychosomatic treatment, are necessary.
Acne; adults; psychosocial impact
It is unknown if teenagers and caregivers give similar responses when interviewed about the teen’s asthma. We analyzed data for 63 urban African-American teen-caregiver pairs. Caregivers underestimated teen smoking by 30%, gave lower estimates for teen exposure to passive smoke, and disagreed with teens on controller medication usage. Teen-caregiver responses were not significantly different for estimates of symptom-days, activity limitations, or nights awakened; nor were they significantly different for report of emergency department visits or hospitalizations. Agreement was weak for perceived asthma control and severity. Teen-caregiver agreement on asthma depends on the type of information being sought.
adolescents; asthma; kappa statistic; teenagers; urban
This paper uses new data from the Los Angeles Family and Neighborhood Survey (L.A. FANS) to examine how neighborhood norms shape teenagers’ substance use. Specifically, it takes advantage of clustered data at the neighborhood level to relate adult neighbors’ attitudes and behavior with respect to smoking, drinking, and drugs, which we treat as norms, to teenagers’ own smoking, drinking, and drug use. We use hierarchical linear models to account for parents’ attitudes and behavior and other characteristics of individuals and families. We also investigate how the association between neighborhood norms and teen behavior depends on: (1) the strength of norms, as measured by consensus in neighbors’ attitudes and conformity in their behavior; (2) the willingness and ability of neighbors to enforce norms, for instance, by monitoring teens’ activities; and (3) the degree to which teens are exposed to their neighbors. We find little association between neighborhood norms and teen substance use, regardless of how we condition the relationship. We discuss possible theoretical and methodological explanations for this finding.
The objective of this study was to determine how accurately teens can report miles driven. Participants were 118 drivers in Connecticut (average age 17½ years; average time licensed 11 months). Half had their own vehicle; half shared family vehicles. Teens completed a telephone survey about their preceding week's driving, then completed a daily trip log for the next week and a second survey about the details of the logged week's trips and miles. Teens with their own vehicle provided odometer readings. Summing the miles for every trip was generally consistent with estimates from odometer readings. Overall mileage estimates were 20–30% lower than those from trip-by-trip listings, except for very low estimates for the first week by teens who shared vehicles. The results indicate that single overall estimates frequently understate total miles driven, but that prompted reviews of each trip can provide valid and detailed information.
Acne vulgaris can severely affect social and psychological functioning.
The aim of this study was to investigate the impact of acne vulgaris and its severity on Quality of Life of young adolescents in Greece.
We conducted a questionnaire based survey among 1560 adolescent between the ages
of 11 and 19 years old and 1531 of these were completed. Adolescents with acne
filled all the questions including the Children Dermatology Life Quality Index.
Adolescents without acne filled the questions about age, family history of acne,
stress and smoking. Data were analyzed with Pearson Chi Square test.
Acne prevalence was 51.2% affecting both sexes equally. Self reported mild acne
was present in 71.2% and moderate-severe acne in 28.8% of the study population.
The mean age of the study population was 15.77y. The median score of Children
Dermatology Life Quality Index was 4.02. The impact of acne on quality of life is
associated with the severity of the acne (p<0.0001). Patients with
moderate/severe acne experience greater psychosocial and emotional impairment
(p<0.0001). Body image is modified proportionally to the severity of acne
(p<0.0001). Symptoms and treatment of acne are factors that also influence
their quality of life. Girls and boys are equally affected. Stress and heredity
are correlated with acne and its severity (p<0.0001). We didn't find any
correlation between smoking and acne.
Acne affects Quality of Life of young adolescents in Greece. The impact is
proportional to the severity of acne. More severe acne is associated with greater
effect on quality of life with implications for self esteem, body image and
relationships with others.
Acne vulgaris; Adolescent; Health of institutionalized adolescents; Quality of life
Problems that may bring teenagers to the family physician's office include bizarre behavior such as drug or alcohol intoxication, psychosis, panic or anxiety attacks and stealing; being dangerous to themselves or to others; sexual emergencies including pregnancy, rape and incest; a crisis involving key people such as parents' divorce or illness; school phobia, and anxiety or other reactions to sickness, surgery or death. When evaluating troubled teens and their families, the physician should first see adolescents alone, so he is not biased by parents' complaints that prevent `accused' teens from expressing themselves. An evaluation should end with the teenager and adults together so the physician can summarize what happened in the interview and give treatment plans. The doctor should anticipate that he will need extra time in counselling teens about their problems, because it is also important to inform, support and direct parents, teachers and counsellors.
Cutaneous propionibacteria are important commensals of human skin and are implicated in a wide range of opportunistic infections. Propionibacterium acnes is also associated with inflammatory acne vulgaris. Bacteriophage PA6 is the first phage of P. acnes to be sequenced and demonstrates a high degree of similarity to many mycobacteriophages both morphologically and genetically. PA6 possesses an icosahedreal head and long noncontractile tail characteristic of the Siphoviridae. The overall genome organization of PA6 resembled that of the temperate mycobacteriophages, although the genome was much smaller, 29,739 bp (48 predicted genes), compared to, for example, 50,550 bp (86 predicted genes) for the Bxb1 genome. PA6 infected only P. acnes and produced clear plaques with turbid centers, but it lacked any obvious genes for lysogeny. The host range of PA6 was restricted to P. acnes, but the phage was able to infect and lyse all P. acnes isolates tested. Sequencing of the PA6 genome makes an important contribution to the study of phage evolution and propionibacterial genetics.
Teenage drivers, especially males, have higher rates of motor vehicle crashes and engage in riskier driving behavior than adults. Motor vehicle deaths disproportionately impact youth from poor and minority communities and in many communities there are higher rates of risky behaviors among minority youth. In this paper, the authors review the data on teens, risky driving behaviors, and morbidity and mortality. They identify areas in which known disparities exist, and examine strategies for changing teen driving behavior, identifying what has worked for improving the use of seat belts and for reducing other risky behaviors. A multifaceted, multilevel model based on ecological theory is proposed for understanding how teens make choices about driving behaviors, and to understand the array of factors that can influence these choices. The model is used to create recommendations for comprehensive intervention strategies that can be used in minority communities to reduce disparities in risk behaviors, injury, disability, and death.
disparities; ecological theory; minority communities; risky behaviors; teen driving
Postpartum depression (PPD) is a mood disorder that affects 10–20 percent of women, and can begin any time during first year after delivery lasting for months. Social support may decrease risk of depression during pregnancy for women. However, literature shows that the amount of social support received during and after pregnancy is different for teen mothers and adult mothers. This study examined the effects of social support received during and after pregnancy on PPD among Canadian women and identified if the relationship was different for teen mothers compared to adult mothers.
The study was based on secondary analysis of the Maternity Experiences Survey. A total of 6,421 women with singleton live births, aged 15 years and older were analyzed. Teen mothers were identified as 15–19 years old and adult mothers were identified as 20 years and older. The main outcome of the study was PPD, which was evaluated using the Edinburg Postnatal Depression Scale. The main independent variable was social support received during pregnancy and after birth. Logistic regression was computed to assess the relationship between social support and PPD after adjusting for confounding variables and age as an interaction term. Adjusted Odds Ratios and 95% Confidence Intervals were reported.
PPD was experienced by 14.0% among teen mothers and 7.2% among adult mothers (p < .001). Overall, teen mothers reported receiving more support during pregnancy and after birth than adult mothers (p < .010). The relationship between social support and PPD did not significantly differ for teen compared to adult mothers. Both teen and adult mothers were approximately five times more likely to experience PPD if they received no support or minimal support after the birth of the baby (95% CI, 3.51-7.36).
Receiving social support especially after birth is important for mothers of all ages to reduce the risk of PPD.
Social support; Postpartum depression; Teenage pregnancy
Research on families with Huntington Disease (HD) has primarily focused on adult decision-making surrounding predictive genetic testing and caregiver stress. Little is known about the experiences of teens living in these families. This qualitative study explored the experiences of 32 teens living in families with HD. Six focus groups were conducted across the U.S. and Canada. Data were analyzed using descriptive qualitative analysis. HD appeared to cast a shadow over the experiences described by teens. Four themes were identified: Watching and waiting; Alone in the midst of others; Family life is kind of hard; and Having to be like an adult. These experiences highlight the need for genetic counselors, health care providers, and school personnel to be aware of issues facing teens living in families with HD. Recognizing patterns of teen experiences may help health care providers develop strategies to support coping by teens in HD families.
Huntington disease; adolescent; qualitative research; focus groups
Background and Objectives:
Acne vulgaris is a distressing skin condition, which can carry with it significant psychological disability. Oxidant/antioxidant imbalance leads to increased production of free radicals, that cause many diseases. Some nutrients, along with systemic oxidative stress, have been implicated in acne vulgaris. The goal of the present study was to assess oxidant and antioxidant status in correlation with the incidence of acne vulgaris in adolescent obese females.
Materials and Methods:
A total of 60 adolescent females (age 16-22 years) were divided into four groups (15 each) as follows: The first included obese females with acne; the second included obese females without acne; the third included non obese with acne and the fourth included non obese without acne. Fasting serum Malondialdehyde (MDA), β-carotene, and Vitamins A, E, and C were measured. In addition, platelet monoamineoxidase (MAO), and erythrocyte catechol-o-methyltransferase (COMT) activities were determined.
It was found that serum MDA was statistically significantly decreased in obese and non obese subjects with acne, as compared to those without acne (P<0.05, P<0.001) respectively. In contrast, the levels of β-carotene, vitamins A, E and C and the activity of MAO were significantly decreased in the obese and non obese with acne, as against the obese and non obese without acne.
In obese subjects, increased fat content facilitates free radical production and lipid peroxidation, as indicated by increased MDA level, which is scavenged by the antioxidant vitamins. The decreased activity of MAO may be inhibited by free radicals and this causes psychological depression in adolescents. However there were non significant changes in the activity of COMT among the studied groups.
The nutritional factors and a weakened antioxidant defense system may interplay, to increase the risk of psychological sequelae in acne vulgaris.
Acne vulgaris; adolescent; obese females; oxidative stress
Propionibacterium acnes is a commensal of human skin but is also known to be involved in certain diseases, such as acne vulgaris and infections of orthopaedic implants. Treatment of these conditions is complicated by increased resistance to antibiotics and/or biofilm formation of P. acnes bacteria. P. acnes can be infected by bacteriophages, but until recently little has been known about these viruses. The aim of this study was to identify and characterize inducible phages from P. acnes on a genetic and morphological basis.
More than 70% (65/92) of P. acnes isolates investigated have inducible phages, classified morphologically as Siphoviruses. The phages have a head of 55 nm in diameter and a tail of 145–155 nm in length and 9–10 nm in width. There was no difference in carriage rate of phages between P. acnes isolates from deep infections and isolates from skin. However, there was a significant lower carriage rate of phages in P. acnes biotype IB, mostly attributed to the low carriage rate of inducible phages in biotype IB isolated from deep tissue. Most phages have a strong lytic activity against all P. acnes isolates with inducible phages, but have less lytic activity against isolates that have no prophages. Phages only infected and lysed P. acnes and not other closely related propionibacteria. All phages could infect and lyse their non-induced parental host, indicating that these prophages do not confer superinfection immunity. The phages have identical protein pattern as observed on SDS-PAGE. Finally, sequencing of two phage genes encoding a putative major head protein and an amidase and showed that the phages could be divided into different groups on a genetic basis.
Our findings indicate that temperate phages are common in P. acnes, and that they are a genetically and functionally homogeneous group of Siphoviruses. The phages are specific for P. acnes and do not seem to confer superinfection immunity.
The human skin harbors a diverse community of bacteria, including the Gram-positive, anaerobic bacterium Propionibacterium acnes. P. acnes has historically been linked to the pathogenesis of acne vulgaris, a common skin disease affecting over 80% of all adolescents in the US. To gain insight into potential P. acnes pathogenic mechanisms, we previously sequenced the complete genome of a P. acnes strain HL096PA1 that is highly associated with acne. In this study, we compared its genome to the first published complete genome KPA171202. HL096PA1 harbors a linear plasmid, pIMPLE-HL096PA1. This is the first described P. acnes plasmid. We also observed a five-fold increase of pseudogenes in HL096PA1, several of which encode proteins in carbohydrate transport and metabolism. In addition, our analysis revealed a few island-like genomic regions that are unique to HL096PA1 and a large genomic inversion spanning the ribosomal operons. Together, these findings offer a basis for understanding P. acnes virulent properties, host adaptation mechanisms, and its potential role in acne pathogenesis at the strain level. Furthermore, the plasmid identified in HL096PA1 may potentially provide a new opportunity for P. acnes genetic manipulation and targeted therapy against specific disease-associated strains.
Acne vulgaris is a common skin disorder that can affect individuals from childhood to adulthood, most often occurring in the teenage years. Acne can have a significant physical, emotional, and social impact on an individual. Many different treatment options are available for the treatment of acne vulgaris. Commonly used topical treatments include benzoyl peroxide, antibiotics, sulfur and sodium sulfacetamide, azelaic acid, and retinoids. Systemic treatment is frequently used and includes the use of systemic antibiotics, oral contraceptives, antiandrogens, and retinoids. Other treatment modalities exist such as the use of superficial chemical peels as well as using laser and light devices for the treatment of acne. With the multitude of treatment options and the rapidly expanding newer technologies available to clinicians, it is important to review and be aware of the current literature and studies regarding the treatment of acne vulgaris.
acne vulgaris; treatment; benzoyl peroxide; antibiotics; retinoids; lasers
The normative influence of parents, close friends, and other peers on teens’ sexual behavior has been well documented. Yet, we still know little about the processes through which these oftentimes competing norms impact teens’ own sexual norms and behaviors. Drawing on qualitative data from 47 interviews conducted with college-bound teens, we investigate the processes through which perceived parental, close friend, and other peer norms about sex influenced teens’ decisions about whether and when to have sex. Although virtually all teens perceived that most of their peers were having sex and that parents were almost universally against teen sex, some teens had sex and others did not. Our findings demonstrate that teens who remained virgins and those who were sexually active during high school often negotiated different sets of competing norms. Differences in understandings of age norms, in close friends’ sexual norms and behaviors, and in communication about sex with parents, close friends and other peers were related to different levels of sexual behavior for teens who otherwise shared many similarities in social location (e.g.. class, race, and educational status). While virgins reported an individualized process of deciding whether they were ready for sex, we find that their behavior fits within a traditional understanding of an age norm because of the emphasis on avoiding negative sanctions. Sexually experienced teens, on the other hand, explicitly reported abiding by a group age norm that prescribed sex as normal during high school. Finally, parents’ normative objections to teen sex – either moral or practical – and the ways they communicated with their teen about sex had important influence on teens’ own sexual norms and behaviors during high school.
Age norms; sexual behavior; teenage sex; adolescence; communication; parental and peer influences
This study evaluated the psychometric properties of the ADDQoL-Teen, an innovative individualised, patient-centred questionnaire measuring perceived impact of diabetes mellitus on quality of life (QoL) of teenagers. Respondents rate all 30 life domains for frequency, and personally applicable domains for 'bother'. Two overview items measure present QoL and diabetes-dependent QoL. ADDQoL-Teen design was based on the ADDQoL (for adults with diabetes).
Interviews and discussion groups were conducted with 23 teenagers aged 13–16 years, during work to design the ADDQoL-Teen. The new questionnaire was then completed by 152 young people, (mean age 16.4 ± 2.4 years), attending diabetes clinics at six UK centres.
Five domains detracted from the measure's reliability and factor structure, four of which were analysed separately and one deleted. The 25-domain ADDQoL-Teen had high internal consistency reliability [Cronbach's alpha = 0.91, (N = 133)] and could be summed into an overall Average Weighted Impact score. There were two subscales: a 10-item Impact-Self subscale (measuring impact of diabetes and its treatment on the individual) and a 15-item Impact-Other subscale (measuring impact on interactions with others and the external world). Both subscales had good internal consistency reliability, [Cronbach's alpha coefficients of 0.82 (N = 142) and 0.88 (N = 138) respectively]. Domains reported as most severely (and negatively) impacted by diabetes were (mean weighted impact ± SD): lie in bed (-3.68 ± 3.41), interrupting activities (-3.5 ± 3.23), worry about the future (-3.45 ± 3.28), career (-3.43 ± 3.15) and sweets (-3.24 ± 3.24), (maximum range -9 to +3). Analysis of the overview items showed that although 72.5% considered that their present QoL was good or brilliant, 61.8% felt that having diabetes had a negative impact on QoL, but 35.6% reported no impact and 2.6% reported a positive impact on QoL.
The ADDQoL-Teen is a new measure of perceived impact of diabetes and its treatment on QoL of teenagers. It will help healthcare professionals and parents consider QoL issues as well as medical outcomes when caring for young people with diabetes. It may be used in clinical trials and for routine clinical monitoring in a context of continuing evaluation.
Little is known about the rates, correlates, and consequences of depression among a sample of first time mothers.
4-site prospective study of the first 3 years of life among first children born to teen (n = 396), low resource (n = 169) and high resource adult (n = 117). Mothers were administered the Beck Depression Inventory prenatally and 6 months postpartum. Measures of maternal and child behaviors were taken at 8 months.
Teen mothers displayed higher prenatal and 6-month rates of depression than low resource and high resource adult mothers, with significantly more teen mothers “consistently” depressed at the 2 time points than low resource and high resource adult mothers. Further, teen mothers were significantly more likely to become depressed after their babies were born than low resource or high resource adult mothers. Depression was negatively related to parenting practices and children’s behavior. As depression increased, mothers scored less favorably in maternal warmth and sensitivity, contingent responsiveness, and general verbalness; children scored less favorably in warmth seeking toward their mothers.
Findings signify the need for counseling and nurse-based intervention and prevention services geared at preparing pregnant teens for motherhood.
Depression; First time mothers; adolescent mothers
Using the National Longitudinal Study of Adolescent Health, factors associated with incongruence between parents’ and adolescents’ reports of teens’ sexual experience were investigated, and the consequences of inaccurate parental knowledge for adolescents’ subsequent sexual behaviors were explored. Most parents of virgins accurately reported teens’ lack of experience, but most parents of teens who had had sex provided inaccurate reports. Binary logistic regression analyses showed that many adolescent-, parent-, and family-level factors predicted the accuracy of parents’ reports. Parents’ accurate knowledge of their teens’ sexual experience was not found to be consistently beneficial for teens’ subsequent sexual outcomes. Rather, parents’ expectations about teens’ sexual experience created a self-fulfilling prophecy, with teens’ subsequent sexual outcomes conforming to parents’ expectations. These findings suggest that research on parent–teen communication about sex needs to consider the expectations being expressed, as well as the information being exchanged.
Objective: The purpose of this study was to determine the extent to which effects of exposure to a brief intervention designed to increase parental restrictions on teen driving privileges persisted over time.
Design: A total of 658 parents and their 16 year old adolescents were recruited from a local motor vehicle administration (MVA) site as adolescents successfully tested for provisional licenses. At the MVA, parents completed written surveys about expected teen driving during the first month of provisional licensure. Afterwards, on weeks assigned as intervention, parents watched a video and were given the video and a driving agreement to take home. Both parents and teens completed follow up telephone interviews about communication, amounts, and limits on teen driving at one month (579 dyads), four months (529 dyads), and nine months (528 dyads).
Results: The results indicated that both intervention parents and teens were much more likely to report using a driving agreement at each follow up during the nine month period. Significant treatment group differences persisted for communication about driving, but effects related to limits on teen driving that were evident at one month declined over time. Reports for passenger, road, and overall limits remained significant at four months; fewer were present at nine months. There were no differences in amounts of teen driving at four or nine months.
Conclusions: It is possible to reach parents through brief interventions at the MVA and successfully promote increases in initial parental restrictions on teen driving with modest persistence for at least four months.
This study examines transitions in schooling, sexual activity, and pregnancy for adolescents and young adults in urban South Africa. The study analyzes data from the Cape Area Panel Study (CAPS), a recently collected longitudinal survey of young adults and their families in metropolitan Cape Town. South African youth have high school enrollment rates through their teenage years, combined with relatively early sexual initiation, with most young people becoming sexually active while they are enrolled in school. Teen pregnancy rates are also relatively high, with almost all teen pregnancies being non-marital. We find that teen pregnancy is not entirely inconsistent with continued schooling, especially for African (black) women. Over 50% of African women who had a pregnancy at age 16 or 17 were enrolled in school the following year. We estimate probit regressions to identify the impact of individual and household characteristics on sexual debut, pregnancy, and school dropout between 2002 and 2005. We find that male and female students who performed better on a literacy and numeracy exam administered in 2002 were less likely to become sexually active and less likely to drop out of school by 2005. Surprisingly, 14-16 year-olds who had completed more grades in school in 2002, conditional on their age, were more likely to sexually debut by 2005, a potential indicator of peer effects resulting from the wide dispersion in age-for-grade in South African schools.
Propionibacterium acnes is a key pathogen involved in the progression of inflammation in acne vulgaris. We examined whether vaccination against P. acnes suppressed P. acnes-induced skin inflammation. Inactivation of P. acnes with heat was employed to create a P. acnes-based vaccine. Intranasal immunization in mice with this inactivated vaccine provoked specific antibodies against P. acnes. Most notably, immunization with inactivated vaccines generated in vivo protective immunity against P. acnes challenge and facilitated the resolution of ear inflammation in mice. In addition, antibodies elicited by inactivated vaccines effectively neutralized the cytotoxicity of P. acnes and attenuated the production of proinflammatory cytokine IL-8 in human sebocyte SZ95 cells. Intranasal immunization using heat-inactivated P. acnes-based vaccines provided a simple modality to develop acne vaccines. These observations highlight the concept that development of vaccines targeting microbial products may represent an alternative strategy to conventional antibiotic therapy.
Acne is one of the most prevalent skin conditions affecting teenagers. It is a disease of the pilosebaceous unit. Blockage of sebaceous glands and colonisation with Proionobacterium acnes leads to acne. Grading the severity of acne helps to determine the appropriate treatment. Treatment of acne should be started as early as possible to minimise the risk of scarring and adverse psychological effects. It should be tailored to the individual patient, the type of acne, its severity, the patient's ability to use the treatment, and the psychological state. Topical agents are the mainstay for treatment of mild acne. Moderate acne is treated with oral antibiotics. Resistance to antibiotics may be reduced by subsequent use of non‐antibiotic topical medications. Severe acne is treated with isotretinoin, and this can lead to permanent remission. With better education and care given by medical profession, acne treatment could be significantly improved.
acne vulgaris; propionobacterium acnes; acne grading; acne treatment; acne psychological effects