BERLIN — Acne is a condition that's widely misunderstood by nondermatologist clinicians, insurers, and patients, according to a recent call to action by the Global Alliance to Improve Outcomes in Acne, a 20-member international panel of acne experts.
A key misconception is the notion that acne is a simple, self-limited rite of passage during adolescence. In fact, acne is more commonly a chronic disease marked by a prolonged course, recurrences, challenging management issues, and the potential for physical scarring and psychological consequences, Global Alliance cochair Dr. Harald P.M. Gollnick said at the annual congress of the European Academy of Dermatology and Venereology.
There is good evidence that acne persists into the adult years in up to 50% of affected patients. The reasons for this remain unclear and are a high priority for future study. Genetics, Propionibacterium acnes colonization, and stress-related production of adrenal androgens are among the factors that have been implicated, observed Dr. Gollnick, professor of dermatology and venereology at Otto von Guericke University, Magdeburg, Germany.
Skeptics regarding the concept of acne as a chronic disease need to consider the parallels between acne and another dermatologic disorder that's universally recognized as a chronic disease: atopic dermatitis, he continued.
Acne and atopic dermatitis share inflammation as a core pathophysiologic feature. Both disorders are believed to have polygenic influences. Both can range in duration from a few months to many years, even decades. Both are self-limited in about 80% of cases. And both disorders can result in physical scarring, accompanied by negative psychological and social effects.
The Global Alliance report (J. Am. Acad. Dermatol. 2009;60[suppl 5]:S1-50) spells out recommended treatment algorithms, Dr. Gollnick said.
Disclosures: The Global Alliance guidelines are supported by an educational grant from Galderma. Dr. Gollnick has served as an investigator, speaker, and adviser for the company, which makes skin care products.