Centre of Evidence Based Dermatology, University of Nottingham, Room A103, King's Meadow Campus, Lenton Lane, Nottingham NG7 2NR, UK.
Br J Dermatol. 2013 Mar;168(3):474-85. doi: 10.1111/bjd.12149.
Despite acne being an almost universal condition in younger people, relatively little is known about its epidemiology. We sought to review what is known about the distribution and causes of acne by conducting a systematic review of relevant epidemiological studies. We searched Medline and Embase to the end of November 2011. The role of Propionibacterium acnes in pathogenesis is unclear: antibiotics have a direct antimicrobial as well as an anti-inflammatory effect. Moderate-to-severe acne affects around 20% of young people and severity correlates with pubertal maturity. Acne may be presenting at a younger age because of earlier puberty. It is unclear if ethnicity is truly associated with acne. Black individuals are more prone to postinflammatory hyperpigmentation and specific subtypes such as 'pomade acne'. Acne persists into the 20s and 30s in around 64% and 43% of individuals, respectively. The heritability of acne is almost 80% in first-degree relatives. Acne occurs earlier and is more severe in those with a positive family history. Suicidal ideation is more common in those with severe compared with mild acne. In the U.S.A., the cost of acne is over 3 billion dollars per year in terms of treatment and loss of productivity. A systematic review in 2005 found no clear evidence of dietary components increasing acne risk. One small randomized controlled trial showed that low glycaemic index (GI) diets can lower acne severity. A possible association between dairy food intake and acne requires closer scrutiny. Natural sunlight or poor hygiene are not associated. The association between smoking and acne is probably due to confounding. Validated core outcomes in future studies will help in combining future evidence.
尽管痤疮在年轻人中几乎是一种普遍的病症，但对其流行病学的了解相对较少。我们旨在通过对相关的流行病学研究进行系统综述，来回顾痤疮的分布和病因。我们检索了 Medline 和 Embase 数据库，检索截止日期为 2011 年 11 月。痤疮丙酸杆菌在发病机制中的作用尚不清楚：抗生素具有直接的抗菌和抗炎作用。中重度痤疮影响大约 20%的年轻人，严重程度与青春期成熟度相关。痤疮可能因为青春期提前而更早出现。种族是否真的与痤疮有关还不清楚。黑人更容易出现炎症后色素沉着过度，以及特定的亚型如“发油痤疮”。大约有 64%和 43%的人分别会在 20 多岁和 30 多岁时仍持续存在痤疮。一级亲属中痤疮的遗传性几乎为 80%。有家族史的人痤疮发病更早、更严重。与轻度痤疮相比，重度痤疮患者更易出现自杀意念。在美国，痤疮每年的治疗费用和生产力损失超过 30 亿美元。2005 年的一项系统综述发现，没有明确证据表明饮食成分会增加痤疮的风险。一项小型随机对照试验表明，低血糖指数（GI）饮食可以降低痤疮的严重程度。乳制品摄入与痤疮之间的可能关联需要进一步研究。天然阳光或不良卫生条件与痤疮无关。吸烟与痤疮之间的关联可能是由于混杂因素所致。在未来的研究中，验证核心结局指标将有助于整合未来的证据。
