Acne, the most common skin disorder in the United States, is an embarrassing problem for many teenagers, but it is not limited to that age group. It may develop before puberty in either sex, or it may first present in adulthood, particularly in women.
Acne is a disease of the pilosebaceous apparatus of the skin. Acne vulgaris, or common acne, begins in the teen or preteen years. In general, it becomes less active as adolescence ends but may continue into adulthood.
Acne that initially occurs in adulthood is designated postadolescent acne or adult-onset acne. Despite the clinical similarities and occasional overlapping of adolescent and postadolescent acne, the pathogenesis and treatment of each are somewhat different.
The pathogenesis and treatment of acne vulgaris, postadolescent acne, rosacea, drug-induced acne, and other acneiform conditions will be discussed in this chapter. Neonatal and infantile acne are discussed in Chapter 3: Acne.
 In this Chapter…
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Myth: Blackheads are caused by dirt. Fact: They are black because of oxidized melanin. Blackheads, or open comedones, are collections of sebum and keratin that form within follicular openings, and when exposed to air, become oxidized and turn black. Myth: Acne should disappear by the end of adolescence. Fact: Some women have acne that persists well past adolescence. Others have an initial episode in their 20s or 30s. Myth: Acne is caused, or worsened by certain foods, such as chocolate, sweets, and greasy junk food. Fact: Despite occasional personal anecdotes and persistent cultural myths, acne is probably not significantly influenced by diet. Myth: A dirty face exacerbates acne; therefore, scrubbing the face daily helps clear it up. Fact: Scrubbing and rubbing a face that has acne, particularly inflammatory acne, will only serve to irritate and redden an already inflamed complexion. Instead, the face should be washed daily with a gentle cleanser and patted (not rubbed) dry. Myth: Frequent facials are beneficial. Fact: Frequent professional facials and at-home scrubs, astringents, and masks are generally not recommended because they tend to aggravate acne.
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