Can We Define Acne as a Chronic Disease?
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There is widespread misunderstanding of acne amongst both the medical and lay community, who often perceive the condition to be a simple, self-limited affliction of adolescents. Because many think that the disease “will go away on its own,” they do not feel an urgency to aggressively treat acne. However, very often the reality is that acne treatment can be quite difficult. Furthermore, acne can be a devastating disease for the patient, since it manifests on visible body parts and in children near puberty, who are vulnerable both socially and psychologically. Most typically, acne is not an acute disease but rather a condition that continuously changes in its distribution and severity. Usually, acne treatment is necessary for many months and sometimes years. Despite treatment, acne may cause scarring and associated negative psychological effects. It is important for both patients and physicians to be aware that very effective treatments are available. It is also important to realize that new studies have proven the benefit of maintenance therapy with topical retinoids; these agents can minimize the potential for relapse, which is part of the natural history of acne. This article reviews the evidence suggesting that acne is a chronic disease in at least a subset of individuals. The members of the Global Alliance to Improve Outcomes in Acne believe that acne should be recognized and investigated as a chronic disease. This will change expectations of clinical trial design and treatment and will highlight gaps in the knowledge of acne epidemiology. The result should be an improvement in patient outcomes.
KeywordsAtopic Dermatitis Acne Maintenance Therapy Tazarotene Psychosocial Impact
This work was supported by an unrestricted educational grant from Galderma Laboratories, L.P. A grant for editorial assistance was supplied for this article by Galderma Laboratories, L.P., and was used to pay for the services of Valerie Sanders, a professional medical writer.
The Global Alliance to Improve Outcomes in Acne is an international committee of physicians and researchers in the field of acne. Membership: Harald Gollnick, MD, Chair; Diane Thiboutot, MD, Co-Chair; Diane Berson, MD; Biigitte Dreno, MD, PhD; Andrew Finlay, MD; James J. Leyden, MD; Alan R. Shalita, MD. Steering Committee: Vincenzo Bettoli, MD; Alejandro Cordero, MD; Chee Leok Goh, MD, MRCP, FRCP, FAMS; Maria Isabel Herane, MD; Sewon Kang, MD, MPH; Raj Kubba, MD; Alison Layton, MD; Yoshiki Miyachi, MD, PhD; Montserrat Perez, MD; Jaime Piquero-Martin, MD; Marcia Ramos-e-Silva, MD, PhD; Jo Ann See, MD; Neil Shear, MD; Vicente Torres Lozada, MD; John Wolf Jr, MD.
All three authors have acted as consultants to Galderma Laboratories, L.P. Professor Finlay has also acted as a consultant to York Pharma UK, Strakan, and Pierre Fabre, and the Department of Dermatology, University of Cardiff School of Medicine, Cardiff, Wales has received royalties for use of the Dermatology Life Quality Index.
- 1.Centers for Disease Control. National Center for Health Statistics: classifications of diseases and functioning and disability [online]. Available from URL: http://www.cdc.gov/nchs/about/otheract/icd9/icfhome.htm [Accessed 2008 Apr 22]
- 4.Cunliffe WJ. Acne. London: Martin Dunitz Ltd, 1989: 2–4Google Scholar
- 10.Zhang ZJ, Li LF, Tu YT, et al. A successful maintenance approach in inflammatory acne with adapalene gel 0.1% after an initial treatment in combination with clindamycin topical solution 1% or after monotherapy with clindamycin topical solution 1%. J Dermatolog Treat 2004; 15: 372–8PubMedCrossRefGoogle Scholar
- 29.Kligman AM. Postadolescent acne in women. Cutis 1992; 48: 218–22Google Scholar
- 30.Smith RN, Mann NJ, Braue A,et al. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol 2007; 57: 247–56PubMedCrossRefGoogle Scholar
- 36.Cunliffe WJ, Gollnick HPM. Acne: diagnosis and management. London: Taylor & Francis,2001Google Scholar
- 37.Giannetti A, Girolomoni G. Atopic dermatitis. In: Fritsch P, Burgdorf W, editors. EDF-white book: skin diseases in Europe. 2nd ed. Berlin: ABW-Wissenschaftsverlag, 2005: 69–71Google Scholar
- 38.Burgdorf W. Acne vulgaris. In: Fritsch P, Burgdorf W, editors. EDF-white book: skin diseases in Europe. 2nd ed. Berlin: ABW-Wissenschaftsverlag, 2005: 74–6Google Scholar