Acne is a common skin condition associated with significant physical and psychological morbidity that affects people from prepubescence to middle age. Treatment should be individualised according to the patient’s history, severity of disease and contraindications. The psychological impact of acne should be acknowledged and considered when developing a treatment plan.
- Acne is not just an adolescent condition; it is also common in prepubertal children and middle-aged adults.
- There is psychological harm associated with having acne and this may not correlate with disease severity.
- GPs play an important role in helping to dispel common myths surrounding the causes of acne.
- Taking an accurate history, identifying patient concerns and evaluating psychological impact are key to successful acne management.
- GPs should set guidelines for treatment, have a plan to review treatment outcomes and establish realistic expectations with their patients.
- Treatments should be individualised according to the patient's history, acne severity and contraindications, and patients referred when necessary.
- Acne scarring can be avoided through early intervention.
GPs are at the frontline for managing acne in patients from prepubescence to middle age. Year by year, there are more acne treatments available and the minefield of information, especially on the internet and social media, can make management confusing. This article guides the reader to consider treatment options for acne to help address patients’ needs and concerns.
Since the last published article on acne in Medicine Today in 2015,1 there have been many developments in acne treatment – new products, new procedures and promising new medications currently on trial. There is even a new name for Propionibacterium acnes, the bacterium linked to acne, which is now called Cutibacterium acnes.
Epidemiology: is acne really that common?
Acne is a common skin condition that is associated with significant physical and psychological morbidity. International studies have shown about 85% of people between the ages of 12 and 24 years experience at least minor acne.2 It is particularly commonplace in teenagers in Australia, with a prevalence of 93.3% among those aged 16 to 18 years.3 Although commonly thought of as a teenage disease, acne can start in prepubertal children and may coincide with an earlier onset of puberty.4 Acne can also be considered a chronic disease.5,6 It may extend from adolescence, through the 20s, and even to middle age. The prevalence has been noted to be 64% in those aged 20 to 29 years and 43% in the 30- to 39-year age group.3