Acne-A Chronic Disease with Effective Treatments
Update of the Global Alliance to Improve Outcomes in Acne
Aug 27, 2009
A lot of misconceptions prevail regarding acne, not only among the lay public, but also among the non dermatologist doctors. Most think that acne is a self limiting condition of the teenagers. Many parents and friends advice the affected youngsters just to leave it alone and that the zits will go away by themselves!
Nothing can be farthest from the truth. Acne is the commonest skin disease, affecting almost 85% of young people. If not treated early and properly, acne can cause life long blemishes and scars on the face and body. The effect of acne on the adolescents can be devastating, with far reaching psychological and social repercussions. Anxiety, depression and introvert behavior are all fallouts of the acne problem in youngsters. Ineffective, or, at times, even harmful, self administered acne home remedies could compound the problem.
The Global Alliance to Improve Outcomes in Acne
A Global Alliance to Improve Outcomes in Acne published their recommendations for the management of acne as a supplementary to the Journal of the American Academy of Dermatology in 2003. The earlier recommendations and latest trends in the treatment of acne were reviewed and new insights into the management of acne were published as a supplement to the May 2009 issue of the journal.
This updates discuss the evidence that acne is a chronic disease with frequent recurrences and change in the distribution and severity in acne sufferers. The Global Alliance to Improve Outcomes in Acne includes around two dozen dermatologists from around the world headed by Diane Thiboutot from Pennsylvania University College of Medicine and Harald Gollnick from Otto-von-Guericke University, Magdeburg, Germany. The update also discusses the current information on the pathogenesis and treatment of acne and its implications in the public health scenario.
Can Acne be Considered a Chronic Disease?
Acne has many characteristics in common with other chronic diseases:
- Acne starts at puberty and runs a prolonged course, even into the thirties in many sufferers.
- Acne vulgaris shows the typical pattern of relapses or recurrences.
- The disease course is punctuated with acute outbreaks at times and gradual onsets at others
- Acne causes serious psychological and social impact in the affected.
- Delayed or improper treatment of the pimples can result in unwanted sequelae, like scarring, pigmentation and permanent disfiguration of the face and skin of the other affected areas.
What are the Factors Responsible for the Chronicity of Acne?
In addition to the genetic predisposition, stress induced hyper production of adrenal androgens (which are responsible for the induction of pimples), colonization with Propionibacterium acnes, specific subtypes of acne like the acne conglobata, acne inversa, keloidal acne, androgenic acne, scalp folliculitis and chloracne contribute to the chronic nature of acne. The global alliance advocates further studies to determine the relationship between these factors and acne to determine ways to limit the prolonged course and consequences of the zits.
What is the Advantage of Approaching Acne as a Chronic Disease?
In addition to giving acne its proper place and prominence as one of the commonest diseases to affect the human race, there are many advantages in considering acne as a chronic disease.
- The realization that acne warrants early and aggressive treatment will save many youngsters from permanent scarring due to delayed and improper treatments.
- Being a chronic disease, acne requires maintenance therapy for optimal control of the disease activity.
- More research and clinical studies will be carried out by the medical fraternity to contain this common skin disease with psychologically damaging sequelae.
Some Pertinent Observations Made by the Global Alliance to Improve Outcome in Acne
- Acne needs to be taken seriously as it affects the adolescent age group, who are vulnerable both psychologically and socially than other age groups.
- Early and aggressive treatment of active acne will limit chances of physical and psychological scarring.
- There are many highly effective treatments for acne available.
- Acne treatment is required for many months, sometimes years.
- 60% of acne is mild in severity and require the active treatment only in the beginning, which can be followed up with topical acne maintenance therapy to avoid relapses.
- Around 50% of teenage acne persists into adult years.
The Global Alliance to Improve Outcome in Acne has also stressed the need for creating awareness among the insurers and governmental bodies regarding the importance of acne. Insurers should be encouraged to provide reimbursement for the treatment of acne.
The ultimate goal of the Global Alliance on Improvement of Outcomes in Acne is the improvement of patient care by bringing the latest scientific advances in acne management to the masses.
Related Articles
Sources
- Gollnick H, Finlay AY, Shear N. Can we define acne as a chronic disease? If so, how and when?Am J Clin Dermatol, 2008;9:279-84.
- Diane T, Gollnick H et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol, 2009;60:S1-50.
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