This review summarizes important clinical developments in
acne vulgaris identified from 17 systematic reviews published between February 2011 and August 2012. Regarding causes, Demodex mites have been shown to be associated with both
acne vulgaris and
rosacea, although it is unclear if their eradication improves either disease. Some weak evidence has emerged that suggests a possible link between dairy produce and
acne, which warrants further research. With reference to the effects of
acne, there is good evidence that
acne negatively affects quality of life, self-esteem and mood in adolescents.
Acne is also associated with an increased risk of anxiety, depression and suicidal ideation, highlighting the importance of asking patients with
acne directly about psychological issues in order to identify those who might benefit from early psychiatric support. Regarding treatment, there seems to be no additional benefit to using higher strengths of
benzoyl peroxide, and lower strengths such as 2.5% have fewer side effects. Despite earlier concerns of increased mortality in those using topical
tretinoin for
skin cancer prevention, a systematic review on this topic has not found any convincing evidence of a link between such non-cutaneous events and once-daily application of 0.02-0.05%
tretinoin.
Combined oral contraceptives are of benefit in both inflammatory and non-inflammatory
acne. Current surveys suggest that implementation of the pregnancy prevention programme for
isotretinoin may not be stringent, and a high level of monitoring and audit is recommended. Ablative and non-ablative
laser resurfacing for the treatment of
acne scars may be beneficial, but further studies with a longer follow-up period are required.