It is estimated that acne affects approximately 50-95% of teenagers in the Western world. In adults over age 25 years, the prevalence of relevant clinical manifestations can be around 40-50%.
A familiar predisposition is often detectable, even if the genetic mechanisms still have to be elucidated.
Acne lesions are heterogeneous, usually localized on the face and sometimes on the back and chest. They can be essentially divided in:
- non-inflammatory lesions, such as comedones (the so called “blackheads”) and microcysts
- inflammatory lesions, such as papules, pustule, nodules and abscesses
The predominant type of lesions and their extension are the main factors employed to classify acne as mild, moderate and severe.
The genesis of acne lesions can be explained by the hyperactivity of sebaceous glands, abnormal keratinization of hair follicle, bacterial colonization and exuberant inflammatory response.
The presence of acne lesions has a negative impact on mood, self-esteem and quality of life, increasing the risk of anxiety and depression. These mood disorders are more frequently observed in female patients, often related to a sense of frustration due to persistence of lesions and therapeutic failures.
The factors that should drive therapeutic choices are mainly the type of acne, the severity of lesions, the tendency to produce scars, patients’ quality of life and psychological implications related to the pathology.
It is also important to identify other triggering factors, such as metabolic or endocrinological dysfunctions and risk factors related to life habits, which could facilitate the persistence of acne lesions.
It is essential to start a therapy tailored to the needs of each person, through a clear communication and considering the expectations of patients, always keeping in mind the emotional burden that acne may have in everyday life.
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