INTRODUCTION
Worldwide, acne vulgaris is the most common skin condition among adolescents.1,2 This condition has been estimated to affect approximately 85-90% of teenagers.1,3 Of note, the prevalence of acne is increasing, and clinicians now see acne beginning in children as young as 8 or 9 years old.2 While much of the attention in medical literature has been given to facial acne, about 50% of patients with acne on their face also have lesions on their trunk (back or chest).4-6 To date, there are limited epidemiological studies of truncal acne that are specific to adolescents, but our clinical impression coincides with this finding.
Acne is a chronic disease with a relapsing and remitting natural course. Acne is often viewed as a relatively benign skin condition; however, it has been shown to have a detrimental effect on quality of life. Acne has been associated with poor self-image, depression, school absenteeism, anxiety, and even suicidality, an important consideration in the adolescent population which already has an elevated risk for these mental health issues.7-10 In addition, long-lasting problems due to acne can occur, including lesional hyperpigmentation and acne scarring.11-13 Underestimating the impact of acne on adolescents is a key roadblock to early and successful treatment.8 Further, earlier treatment and successful management may translate to improved clinical outcomes, lower risk for scarring, and a better overall quality of life.9 Having a care strategy in place can help busy practitioners offer appropriate initial care for this almost ubiquitous condition.14 Acne management guidelines recommend initiating efficacious therapy as soon as possible to minimize the potential impact on life quality and long-term sequelae.15,16
Effective acne management strategies include topical retinoids as a foundation of treatment.17 Retinoids are considered the core group of acne therapeutics due to multiple actions, including comedolytic and anti-inflammatory effects, a preventative effect by inhibiting formation of acne precursor lesions (microcomedones), and a maintenance effect by normalizing epidermal turnover.18-20 In addition, topical retinoids have well documented efficacy, safety, and tolerability.21 Retinoids are available for use in younger patients, and in a variety of formulations and concentrations. Topical administration offers the advantage of local, enhanced drug delivery to affected tissues with a low likelihood of systemic adverse effects.22
Acne is a chronic disease with a relapsing and remitting natural course. Acne is often viewed as a relatively benign skin condition; however, it has been shown to have a detrimental effect on quality of life. Acne has been associated with poor self-image, depression, school absenteeism, anxiety, and even suicidality, an important consideration in the adolescent population which already has an elevated risk for these mental health issues.7-10 In addition, long-lasting problems due to acne can occur, including lesional hyperpigmentation and acne scarring.11-13 Underestimating the impact of acne on adolescents is a key roadblock to early and successful treatment.8 Further, earlier treatment and successful management may translate to improved clinical outcomes, lower risk for scarring, and a better overall quality of life.9 Having a care strategy in place can help busy practitioners offer appropriate initial care for this almost ubiquitous condition.14 Acne management guidelines recommend initiating efficacious therapy as soon as possible to minimize the potential impact on life quality and long-term sequelae.15,16
Effective acne management strategies include topical retinoids as a foundation of treatment.17 Retinoids are considered the core group of acne therapeutics due to multiple actions, including comedolytic and anti-inflammatory effects, a preventative effect by inhibiting formation of acne precursor lesions (microcomedones), and a maintenance effect by normalizing epidermal turnover.18-20 In addition, topical retinoids have well documented efficacy, safety, and tolerability.21 Retinoids are available for use in younger patients, and in a variety of formulations and concentrations. Topical administration offers the advantage of local, enhanced drug delivery to affected tissues with a low likelihood of systemic adverse effects.22
