The treatment of acne

Acne is common but not trivial. It affects up to 85% of adolescents to some extent. Less commonly, it occurs in infancy. The pathophysiology centres on occluded pilosebaceous follicles and is multifactorial. An underlying pathological cause is rare, and investigations are not usually indicated. The psychosocial impact of acne may be significant and it can affect employment opportunities. Quality of life indices indicate that its impact can be as high as diseases such as diabetes mellitus. Although treatment is often effective. it is slow to work and there are frequent minor side-effects; this may affect compliance. Early treatment may prevent scarring, and this is particularly important in severe nodulo-cystic acne. We will review the topical and oral treatments suitable for use in children and discuss how to tailor treatment depending on the severity of the acne and the types of lesion present.