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
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.
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
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 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.
Research on teen condom use often focuses on the influence of parents, peers, and environmental factors. Although most sexually active teens have sex within dating relationships, we know little about how the characteristics of dating relationships are associated with consistent condom use.
Data on 269 teens in Wave 1 of the Toledo Adolescent Relationship Study who had sex in their most recent relationships were analyzed to examine how qualities of their relationship are associated with condom use. We present odds ratios based on logistic regression models predicting consistent condom use.
Drawing on the analytic sample of teens who had sex with their dating partner, relationship qualities were significantly related to consistent condom use. Both negative relationship dynamics (conflict, control, mistrust, jealousy, perceived partner inferiority) and positive qualities (love, enmeshment, salience, self-disclosure) were associated with consistent condom use (OR .65–.89). Similar to prior studies, demographic asymmetries (age, race, neighborhood) were not related to consistent condom use. Relationship duration was negatively associated with consistent condom use (OR .98–.99), but the effect of duration was explained by feelings of relationship importance. The role of relationship qualities was similar for males and females.
Although the relationship processes associated with consistent condom use are complex, such processes appeared to be more strongly associated with consistent condom use than were sociodemographic characteristics. The findings suggested programs should focus on relationship qualities and dynamics, recognizing that both negative and positive relationship features were associated with consistent condom use.
Cigarette smoking is the primary preventable cause of mortality and morbidity in the US. But in the mid-1990s, more than one-third of US teenagers were smokers, despite their awareness of the health risks and negative consequences of tobacco use. In 1996, as part of a three-year qualitative study to explore differences in adolescent smoking by gender and ethnicity, members of the Tobacco Control Network examined messages that teens receive about cigarette smoking. Consisting of 178 focus groups with 1,175 teenagers covering all levels of smoking experience, the study included teens from five ethnic groups, stratified by gender and ethnicity, from urban and rural areas across the US. The authors reviewed the sources and content of messages that teens reported were most influential in their decisions to smoke or not smoke cigarettes. Family and peers, school, television, and movies were the primary sources for both pro- and anti-smoking messages. The authors conclude that a lack of clear, consistent antismoking messages leaves teens vulnerable to the influences of pro-smoking messages from a variety of sources. Interventions need to be culture- and gender-specific. Family-based interventions appear to be needed and efficacious, but resource intensive. Building self-esteem may prove to be a promising intervention.
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
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
The broader context of relational aggression in adolescent romantic relationships was assessed by considering the ways such aggression emerged from prior experiences of peer pressure and was linked to concurrent difficulties in psychosocial functioning. Longitudinal, multi-reporter data were obtained from 97 adolescents and their best friends at age 15 and from adolescents and their romantic partners at age 18. Teens’ relational aggression and romantic partners’ victimization were predicted from levels of best friends’ pressuring behaviors toward teens in an observed interaction as well as from best friends’ ratings of how much pressure teens experienced from their peer group. Romantic partner relational aggression and teen victimization were predicted by pressure from teens’ peer group only. Adolescents’ romantic relational aggression and victimization were also associated with elevated levels of depressive symptoms and increased alcohol use. Results are discussed in terms of the connection of relational aggression in romantic relationships to the broader task of establishing autonomy with peers in psychosocial development.
Peer pressure; Autonomy; Romantic relationship; Relational aggression; Psychosocial functioning; Alcohol; Depression
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.
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 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.
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.
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.
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.
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.
Acne vulgaris is a distressing condition that affects the majority of adolescents, but the impact of acne vulgaris on the psychological aspects in this age group is poorly understood.
The purpose of this study was to determine the prevalence of acne, and the level of emotional, social, and functional impairments among Korean adolescents with acne.
Five hundred four middle school students (13~16 years) participated. The severity of acne was graded by visual examination using the Korean Acne Grading System. Self-reported questionnaires, including subjective acne severity rating, the Self Image Questionnaire, the Rosenberg Self-Esteem Questionnaire, the Index of Peer Relations, and the Beck Depression Inventory were used to assess psychologic status.
There was a prevalence of acne in 78.9% of the study samples, with 10.2% of students having moderate-to-severe acne. Acne was more prevalent and severe in boys than girls. Participants with severe acne and girls had higher levels of emotional and social impairments. The longer the acne persisted, the more stress the students felt. The degree of stress and extent of self-image impairment were related to subjective severity more than objective grading.
Acne is a common disorder among Korean adolescents and appears to have a considerable impact on mental health. Dermatologists should be aware of the importance of basic psychosomatic treatment in conjunction with early medical, educational intervention in the management of acne.
Acne vulgaris; Adolescents; Psychological stress; Psychosocial aspects
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
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 vulgaris is the most common skin disease worldwide, with many available treatment modalities, including oral and topical medications and laser therapy. Recently, a novel device (Isolaz, Pleasanton, CA, USA) that combines vacuum pressure and a broadband light source (400 nm to 1,200 nm) was developed for the treatment of acne.
To determine the clinical efficacy and safety of photopneumatic therapy for the treatment of acne vulgaris of the face.
Twenty adults with mild to moderate facial acne vulgaris received 4 successive treatments on one side of the face with a combined photopneumatic device (intense pulsed light: fluence=5.8 J/cm2; negative pressure=iMP mode) at 2 week intervals. Acne lesions on the opposite side of the face were not treated. Lesion counts were performed at baseline, prior to each treatment session, and at 3 months after the final treatment session.
Significant lesion improvements and reduced numbers of acne lesions were observed on the treated side of the faces. Most patients experienced global clinical improvement. No severe side effects occurred during the study, with only a few patients experiencing transient erythema, purpura and/or exacerbation of pre-existing acne.
Photopneumatic therapy is a safe and effective treatment for mild to moderate acne vulgaris.
Acne vulgaris; Intense pulsed light
Background: A gel combination treatment containing a retinoid (adapalene 0.1%) and an antimicrobial (benzoyl peroxide 2.5%) has been shown to be an effective treatment for acne vulgaris, addressing three of the four pathogenic factors (hyperkeratinization, Propionibacterium acnes proliferation, inflammation) without contributing to the incidence of Propionibacterium acnes antibiotic resistance as neither the retinoid nor benzoyl peroxide creates selective pressure for resistance. Objective: To evaluate the effectiveness of an adapalene-benzoyl peroxide gel combination in reducing antibiotic-sensitive and resistant strains of Propionibacterium acnes on the facial skin of volunteers. Methods: This four-week, open-label, single-center study included 30 healthy adults with high facial Propionibacterium acnes populations [>104 colony-forming units per square centimeter of skin (CFU/cm2)] and presence of subpopulations resistant to erythromycin, tetracycline, and clindamycin. The gel was applied once daily to the forehead. Cultures for total and antibiotic-resistant Propionibacterium acnes were obtained from the forehead area at screening, Baseline, Week 2, and Week 4. Results: Total Propionibacterium acnes counts decreased by 1.1 log10 CFU/cm2 after two weeks of treatment, and by 1.6 log10 CFU/cm2 after four weeks. All subjects had strains resistant to each of the five antibiotics at baseline. Mean counts of erythromycin and clindamycin resistant Propionibacterium acnes were high at baseline (5.37 and 5.28 log10 CFU/cm2, respectively) and decreased by ≥2.1 log10 by Week 4 (P<0.001). Mean counts of strains resistant to tetracyclines were lower at baseline (3.8 to 4.2 CFU/cm2) and decreased by 1.9 (tetracycline), 2.4 (minocycline), and 1.3 (doxycycline) log10 CFU/cm2 by Week 4 (P<0.001). Limitations: Although limited in scope, the results of the present study demonstrate that the fixed-dose combination gel containing adapalene 0.1% and benzoyl peroxide 2.5% effectively inhibited both antibiotic-susceptible and antibiotic-resistant Propionibacterium acnes. In addition to reducing population densities, therapy with adapalene-benzoyl peroxide eradicated some resistant strains entirely in some individual subjects. Conclusion: Topical adapalene-benzoyl peroxide gel effectively reduced skin colonization by antibiotic-sensitive and antibiotic-resistant Propionibacterium acnes after four weeks. This trial was registered with ClinicalTrials.gov (http://clinicaltrials.gov/), registry number NCT00907101.
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.