Acne is a chronic disease of the skin affecting approximately 60 million people in the US, making it the most common skin disorder in that country. Acne typically develops in adolescence and is present to varying degrees in approximately 85% of individuals aged between 15 to 24 years. In men and women older than 25 years, 40% to 54% have some degree of facial acne with clinical facial acne persisting in middle age in 3% of males and 12% of females. Being so readily visible (affecting the face in 99% of cases), acne can be a cause of great distress leading to psychological and social problems, particularly in adolescents. Affected adolescents report more social isolation, self-consciousness, unhappiness, anxiety and dissatisfaction with their facial appearance than their unaffected peers. Severe acne leads to scarring which can cause devastating long-term psychic trauma and may be a risk factor for suicide, particularly in men.
The major cause of acne is the excessive production of sebum, the oily secretion made by the skin’s sebaceous glands. Sebum combines with dead skin cells forming a plug which, in association with other pathologic processes, develops into acne lesions.
The role sebum production/secretion plays in the development of acne has been clearly demonstrated in numerous studies over the past 40 years. Researchers have observed a strong correlation between sebum excretion and acne severity, and individuals with severe acne have much higher sebum excretion rates than those without.
Currently the most effective marketed treatment is an orally administered drug, isotretinoin (known commercially as Accutane® or Roaccutane® among other brand names), that works by inhibiting sebum secretion. Isotretinoin is generally only prescribed for individuals with severe acne and is strictly regulated by many government agencies due to its high potential to cause birth defects. There are also other side effects of isotretinoin which further limit its use.
There are currently no approved topical products that suppress sebum production or secretion.