Skip to main content
SpringerLink
Log in

Acne

  • Chapter
  • First Online:
European Handbook of Dermatological Treatments

  • 141 Accesses

Abstract

Acne vulgaris is a chronic inflammatory skin disease. Key events that contribute to acne pathogenesis include hyperseborrhea, hyperkeratinization of the pilosebaceous follicle, the loss of diversity of Cutibacterium acnes (C. acnes) phylotypes, inflammation, and exposome (external factors such as nutrition, pollutants, lifestyle). Acneiform eruptions that may need to be differentiated from acne are: acne cosmetica, perioral dermatitis, drug-induced acneiform eruptions, and rosacea. The management of acne is based on the clinical classification depending on the predominant lesions, severity and presence of scarring, and further depends on the psychological impact of acne, the age, and medical history of the patient. Treatments are usually combinations of topical agents, such as retinoids, azelaic acid, benzoyl peroxide, antibiotics and fixed-dose combination formulations, and/or systemic agents, such as antibiotics, zinc, isotretinoin, and for females only, hormonal therapies. Furthermore, the recommendations of the current European guidelines are discussed and therapeutic algorithms for the treatment of acne according to age group are presented.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 349.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 449.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abdel Fattah NS, Darwish YW. In vitro antibiotic susceptibility patterns of Propionibacterium acnes isolated from acne patients: an Egyptian university hospital-based study. J Eur Acad Dermatol Venereol. 2013;27(12):1546–51.

    Article  CAS  PubMed  Google Scholar 

  • Albuquerque RG, Rocha MA, Bagatin E, Tufik S, Andersen ML. Could adult female acne be associated with modern life? Arch Dermatol Res. 2014;306(8):683–8.

    Article  CAS  PubMed  Google Scholar 

  • Antoniou C, Dessinioti C, Stratigos AJ, Katsambas AD. Clinical and therapeutic approach to childhood acne: an update. Pediatr Dermatol. 2009;26(4):373–80.

    Article  CAS  PubMed  Google Scholar 

  • Aubert J, Piwnica D, Bertino B, et al. Nonclinical and human pharmacology of the potent and selective topical retinoic acid receptor-gamma agonist trifarotene. Br J Dermatol. 2018;179(2):442–56.

    CAS  PubMed  Google Scholar 

  • Blume-Peytavi U, Fowler J, Kemeny L, et al. Long-term safety and efficacy of trifarotene 50 mug/g cream, a first-in-class RAR-gamma selective topical retinoid, in patients with moderate facial and truncal acne. J Eur Acad Dermatol Venereol. 2020;34(1):166–73.

    Article  CAS  PubMed  Google Scholar 

  • Carmina et al. Female adult acne and androgen excess: a report from the multidisciplinary androgen excess and PCOS committee. J Endocr Soc. 2022;6:bvac003.

    Google Scholar 

  • Carlavan I, Bertino B, Rivier M, et al. Atrophic scar formation in patients with acne involves long-acting immune responses with plasma cells and alteration of sebaceous glands. Br J Dermatol. 2018;179(4):906–17.

    Article  CAS  PubMed  Google Scholar 

  • Chen W, Obermayer-Pietsch B, Hong JB, et al. Acne-associated syndromes: models for better understanding of acne pathogenesis. J Eur Acad Dermatol Venereol. 2011;25(6):637–46.

    Article  CAS  PubMed  Google Scholar 

  • Chernyshov PV, Zouboulis CC, Tomas-Aragones L, et al. Quality of life measurement in acne. Position paper of the European academy of dermatology and venereology task forces on quality of life and patient oriented outcomes and acne, rosacea and hidradenitis Suppurativa. J Eur Acad Dermatol Venereol. 2018;32(2):194–208.

    Article  CAS  PubMed  Google Scholar 

  • Claudel JP, Auffret N, Leccia MT, Poli F, Dreno B. Acne and nutrition: hypotheses, myths and facts. J Eur Acad Dermatol Venereol. 2018;32(10):1631–7.

    Article  CAS  PubMed  Google Scholar 

  • Claudel JP, Auffret N, Leccia MT, Poli F, Corvec S, Dreno B. Staphylococcus epidermidis: a potential new player in the physiopathology of acne? Dermatology. 2019;235(4):287–94.

    Article  PubMed  Google Scholar 

  • Collier CN, Harper JC, Cafardi JA, et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58(1):56–9.

    Article  PubMed  Google Scholar 

  • Cunliffe WJ, Gould DJ. Prevalence of facial acne vulgaris in late adolescence and in adults. Br Med J. 1979;1(6171):1109–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dagnelie MA, Corvec S, Saint-Jean M, et al. Decrease in diversity of Propionibacterium acnes phylotypes in patients with severe acne on the Back. Acta Derm Venereol. 2018;98(2):262–7.

    Article  CAS  PubMed  Google Scholar 

  • Dagnelie MA, Corvec S, Saint-Jean M, Nguyen JM, Khammari A, Dreno B. Cutibacterium acnes phylotypes diversity loss: a trigger for skin inflammatory process. J Eur Acad Dermatol Venereol. 2019;33(12):2340–8.

    Article  CAS  PubMed  Google Scholar 

  • Del Rosso JQ et al. Management of truncal acne with oralsarecycline: Pooled results from two phase-3 clinical trials. J Drugs Dermtol. 2021;20:634–40.

    Google Scholar 

  • Dessinioti C, Katsambas AD. The role of Propionibacterium acnes in acne pathogenesis: facts and controversies. Clin Dermatol. 2010;28(1):2–7.

    Article  PubMed  Google Scholar 

  • Dessinioti C, Katsambas A. Difficult and rare forms of acne. Clin Dermatol. 2017a;35(2):138–46.

    Article  PubMed  Google Scholar 

  • Dessinioti C, Katsambas A. Propionibacterium acnes and antimicrobial resistance in acne. Clin Dermatol. 2017b;35(2):163–7.

    Article  PubMed  Google Scholar 

  • Dessinioti C, Antoniou C, Katsambas A. Acneiform eruptions. Clin Dermatol. 2014;32(1):24–34.

    Article  PubMed  Google Scholar 

  • Dessinioti C, Zisimou C, Platsidaki E, Katsambas A, Antoniou C. A cross-sectional study of clinical factors associated with acne facial scarring in patients with active acne. J Eur Acad Dermatol Venereol. 2018a;32(6):e212–4.

    Article  CAS  PubMed  Google Scholar 

  • Dessinioti C, Platsidaki E, Zisimou C, Tzanetakou V, Katsambas A, Antoniou C. A cross-sectional study of the perceptions about triggering factors in acne patients. J Eur Acad Dermatol Venereol. 2018b;32(4):e137–9.

    Article  CAS  PubMed  Google Scholar 

  • Dessinioti C, Zouboulis CC, Bettoli V, Rigopoulos D. Comparison of guidelines and consensus articles on the management of patients with acne with oral isotretinoin. J Eur Acad Dermatol Venereol. 2020;34:2229.

    Article  CAS  PubMed  Google Scholar 

  • Dreno B. Treatment of adult female acne: a new challenge. J Eur Acad Dermatol Venereol. 2015;29(Suppl 5):14–9.

    Article  CAS  PubMed  Google Scholar 

  • Dreno B. What is new in the pathophysiology of acne, an overview. J Eur Acad Dermatol Venereol. 2017;31(Suppl 5):8–12.

    Article  CAS  PubMed  Google Scholar 

  • Dreno B, Layton A, Zouboulis CC, et al. Adult female acne: a new paradigm. J Eur Acad Dermatol Venereol. 2013;27(9):1063–70.

    Article  CAS  PubMed  Google Scholar 

  • Dreno B, Bagatin E, Blume-Peytavi U, Rocha M, Gollnick H. Female type of adult acne: physiological and psychological considerations and management. J Dtsch Dermatol Ges. 2018a;16(10):1185–94.

    PubMed  Google Scholar 

  • Dreno B, Bettoli V, Araviiskaia E, Sanchez Viera M, Bouloc A. The influence of exposome on acne. J Eur Acad Dermatol Venereol. 2018b;32(5):812–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dreno B, Bordet C, Seite S, Taieb C, Registre AD. Acne relapses: impact on quality of life and productivity. J Eur Acad Dermatol Venereol. 2019;33(5):937–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Eichenfield LF, Krakowski AC, Piggott C, et al. Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics. 2013;131(Suppl 3):S163–86.

    Article  PubMed  Google Scholar 

  • Eichenfield et al. J Am Acad Dermatol. 2020;83:477–85.

    Google Scholar 

  • Fitz-Gibbon S, Tomida S, Chiu BH, et al. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol. 2013;133(9):2152–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gonzalez R, Welsh O, Ocampo J, et al. In vitro antimicrobial susceptibility of Propionibacterium acnes isolated from acne patients in northern Mexico. Int J Dermatol. 2010;49(9):1003–7.

    Article  PubMed  Google Scholar 

  • Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad Dermatol. 1999;41(4):577–80.

    CAS  PubMed  Google Scholar 

  • Isvy-Joubert A, Nguyen JM, Gaultier A, et al. Adult female acne treated with spironolactone: a retrospective data review of 70 cases. Eur J Dermatol. 2017;27(4):393–8.

    Google Scholar 

  • Hebert et al. Efficacy and safety of topical clascoterone cream, 1% for treatment in patients with facial acne. JAMA Dermatol. 2020;156:621–30.

    Google Scholar 

  • Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001;45(1):109–17.

    Article  CAS  PubMed  Google Scholar 

  • Kim JE, Park AY, Lee SY, Park YL, Whang KU, Kim HJ. Comparison of the efficacy of azithromycin versus doxycycline in acne vulgaris: a meta-analysis of randomized controlled trials. Ann Dermatol. 2018;30(4):417–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Layton AM, Henderson CA, Cunliffe WJ. A clinical evaluation of acne scarring and its incidence. Clin Exp Dermatol. 1994;19(4):303–8.

    Article  CAS  PubMed  Google Scholar 

  • Layton AM, Dreno B, Gollnick HP, Zouboulis CC. A review of the European directive for prescribing systemic isotretinoin for acne vulgaris. J Eur Acad Dermatol Venereol. 2006;20(7):773–6.

    Article  CAS  PubMed  Google Scholar 

  • Moradi Tuchayi S, Makrantonaki E, Ganceviciene R, Dessinioti C, Feldman SR, Zouboulis CC. Acne vulgaris. Nat Rev Dis Primers. 2015;1:15029.

    Article  PubMed  Google Scholar 

  • Nakase K, Hayashi N, Akiyama Y, Aoki S, Noguchi N. Antimicrobial susceptibility and phylogenetic analysis of Propionibacterium acnes isolated from acne patients in Japan between 2013 and 2015. J Dermatol. 2017;44(11):1248–54.

    Article  CAS  PubMed  Google Scholar 

  • Nast A, Dreno B, Bettoli V, et al. European evidence-based (S3) guideline for the treatment of acne—update 2016—short version. J Eur Acad Dermatol Venereol. 2016;30(8):1261–8.

    Article  CAS  PubMed  Google Scholar 

  • O’Neill AM, Nakatsuji T, Hayachi A, et al. Identification of a human skin commensal bacterium that selectively kills Cutibacterium acnes. J Invest Dermatol. 2020;140(8):1619–28.

    Article  PubMed  PubMed Central  Google Scholar 

  • Paugam C, Corvec S, Saint-Jean M, et al. Propionibacterium acnes phylotypes and acne severity: an observational prospective study. J Eur Acad Dermatol Venereol. 2017;31(9):e398–9.

    Article  CAS  PubMed  Google Scholar 

  • Platsidaki E, Dessinioti C. Recent advances in understanding Propionibacterium acnes (Cutibacterium acnes) in acne. F1000Res. 2018;7:1953.

    Article  CAS  Google Scholar 

  • Poli F, Dreno B, Verschoore M. An epidemiological study of acne in female adults: results of a survey conducted in France. J Eur Acad Dermatol Venereol. 2001;15(6):541–5.

    Article  CAS  PubMed  Google Scholar 

  • Ross JI, Snelling AM, Carnegie E, et al. Antibiotic-resistant acne: lessons from Europe. Br J Dermatol. 2003;148(3):467–78.

    Article  CAS  PubMed  Google Scholar 

  • Saint-Jean M, Corvec S, Nguyen JM, et al. Adult acne in women is not associated with a specific type of Cutibacterium acnes. J Am Acad Dermatol. 2019;81(3):851–2.

    Article  PubMed  Google Scholar 

  • Scholz CFP, Kilian M. The natural history of cutaneous propionibacteria, and reclassification of selected species within the genus Propionibacterium to the proposed novel genera Acidipropionibacterium gen. nov., Cutibacterium gen. nov. and Pseudopropionibacterium gen. nov. Int J Syst Evol Microbiol. 2016;66(11):4422–32.

    Article  PubMed  Google Scholar 

  • Soon CWM, Pincus LB, Ai WZ, McCalmont TH. Acneiform presentation of primary cutaneous follicle center lymphoma. J Am Acad Dermatol. 2011;65(4):887–9.

    Article  PubMed  Google Scholar 

  • Tan J, Kang S, Leyden J. Prevalence and risk factors of acne scarring among patients consulting dermatologists in the USA. J Drugs Dermatol. 2017;16(2):97–102.

    PubMed  Google Scholar 

  • Tan J, Thiboutot D, Popp G, et al. Randomized phase 3 evaluation of trifarotene 50 mug/g cream treatment of moderate facial and truncal acne. J Am Acad Dermatol. 2019;80(6):1691–9.

    Article  CAS  PubMed  Google Scholar 

  • Thiboutot DM, Dreno B, Abanmi A, et al. Practical management of acne for clinicians: an international consensus from the global alliance to improve outcomes in acne. J Am Acad Dermatol. 2018;78(2 Suppl 1):S1–S23 e21.

    Article  PubMed  Google Scholar 

  • Xu J et al. Management of acne vulgaris: summary of NICE guidance. BMJ. 2021;374:n1800.

    Google Scholar 

  • Xia et al. JAMA Dermatol. 2022;158:942–48.

    Google Scholar 

  • Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945–973 e933.

    Article  PubMed  Google Scholar 

  • Zhu T, Zhu W, Wang Q, et al. Antibiotic susceptibility of Propionibacterium acnes isolated from patients with acne in a public hospital in Southwest China: prospective cross-sectional study. BMJ Open. 2019;9(2):e022938.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zouboulis CC, Dessinioti C, Tsatsou F, Gollnick HPM. Anti-acne drugs in phase 1 and 2 clinical trials. Expert Opin Investig Drugs. 2017;26(7):813–23.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 1st Department of Dermatology, Andreas Syggros Hospital, University of Athens, Athens, Greece

    Clio Dessinioti

  2. Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, Nantes, France

    Brigitte Dreno

Authors
  1. Clio Dessinioti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brigitte Dreno
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Andreas Syggros Hospital, Athens State University, Athens, Greece

    Andreas D. Katsambas

  2. Research Center CSRMR, Marconi University, Rome, Roma, Italy

    Torello M. Lotti

  3. Andreas Syggros Hospital, Athens State University, Athens, Greece

    Clio Dessinioti

  4. Dermatoloy Unit, Livorno Hospital, Livorno, Italy

    Angelo Massimiliano D'Erme

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dessinioti, C., Dreno, B. (2023). Acne. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D'Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-15130-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-15130-9_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-15129-3

  • Online ISBN: 978-3-031-15130-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation