Acné en la adolescencia: como reconocerlo y abordarlo / Acne in adolescents: how to recognize it and treat it / Acne na adolescencia: como reconhecer-lo e tratá-lo

El acné una de las enfermedades dermatológicas crónicas más frecuentes, siendo la adolescencia donde se observa su mayor incidencia y prevalencia. Constituye un motivo de consulta frecuente y a pesar de que su abordaje inicial es de resorte del pediatra, dependiendo de la evolución y los tipos de acné requieren la derivación y tratamiento con dermatólogo. Es una enfermedad cutánea, de carácter inflamatorio y que involucra la unidad pilosebácea. Su etiología es multifactorial y el diagnóstico es clínico al constatar las lesiones típicas. Teniendo en cuenta la importancia de la imagen corporal en esta etapa de la vida y el impacto de esta en la calidad de vida de los adolescentes, es imprescindible el reconocimiento precoz y tratamiento inicial por parte del pediatra. Existen posibilidades terapéuticas cada vez más novedosas, exigiendo a los profesionales de salud estar actualizados. Esta revisión pretende mostrar una puesta al día de la temática y ofrecer información actualizada sobre los tratamientos disponibles a nivel local.

Acne is one of the most common chronic dermatological diseases and it is primarily observed in adolescents. It is one of the causes of frequent consultation, and despite the fact that Its initial detection and approach is that of the pediatrician, depending on the evolution and the types of acne, referral and treatment by a dermatologist will be required. It is a skin disease, inflammatory in nature and involving the pilosebaceous unit. It has a multifactorial etiology and it requires clinical diagnosis when typical lesions are found. Considering importance of adolescents' image at this stage and the impact on their quality of life, early detection and treatment by the pediatrician are essential. There are increasing new therapeutic possibilities, which require health professionals to be updated. This review aims at showing an update of the subject and at providing updated information regarding the available treatments locally.

A acne é uma das doenças dermatológicas crônicas mais comuns, sendo a adolescência onde observase sua maior incidência e prevalência. Constitui motivo de consulta frequente e apesar de sua abordagem inicial é a do pediatra, dependendo da evolução e dos tipos de acne que necessitam de tratamento e encaminhamento feito por um dermatologista. É uma doença cutânea, de natureza inflamatória e que envolve a unidade pilossebácea. Sua etiologia é multifatorial e o diagnóstico é clínico quando são encontradas lesões típicas. Tendo em conta a importância da imagem corporal nesta fase da vida e o impacto dela na qualidade de vida dos adolescentes, o reconhecimento inicial pelo pediatra e o tratamento precoces são essenciais. Existem cada vez mais novas possibilidades terapêuticas, exigindo que os profissionais de saúde estejam atualizados. Este papertem como objetivo mostrar uma atualização do assunto e fornecer informação atualizada sobre os tratamentos disponíveis a nível local.

Revisión del papel de las plantas medicinales en el tratamiento del acné / A review on the role of medicinal plants in treatment of acne

Antecedentes: el acné vulgar es un trastorno cutáneo muy común que puede presentarse con lesiones inflamatorias y no inflamatorias principalmente en la cara, pero también puede ocurrir en la parte superior de los brazos, el tronco y la espalda. El tratamiento del acné es de gran importancia y el acné vulgar y, por lo tanto, la bacteria que causa el acné, P. acnes, se han estudiado intensamente y se han propuesto varias soluciones. Sin embargo, poca investigación se ha centrado en el uso de plantas medicinales para el tratamiento de esta enfermedad de la piel. Sin embargo, hay una serie de plantas medicinales que se utilizan tradicionalmente para tratar el acné, y esto proporciona el ímpetu para que los científicos exploren sus propiedades medicinales. Objetivo: Este trabajo tuvo como objetivo revisar los enfoques de tratamiento a base de plantas medicinales para el acné. Metodología: Se realizaron búsquedas en las bases de datos científicas en línea autorizadas, incluidas Pubmed, MEDLINE, Link of Springer, Online Library of Wiley, Science Direct of Elsevier, Cambridge Core y Cochrane, y se recopilaron, combinaron y analizaron los datos útiles asociados con el objetivo del presente estudio. luego categorizado en términos de plantas medicinales, acné, acné vulgar, hierbas. Conclusión: Actualmente existe un fuerte enfoque en las plantas medicinales a nivel de investigación y, por lo tanto, existe una fuerte motivación para el uso de estos ingredientes en productos para el cuidado cosmético que deben probarse como seguros y efectivos con la ayuda de la investigación clínica

Background: Acne Vulgaris is a very common skin disorder which can present with inflammatory and non-inflammatory lesions chiefly on the face but can also occur on the upper arms, trunk, and back. Treatment of acne is of a high importance and acne vulgaris and thus the acne-causing bacterium, P. acnes, have been intensively studied and several solutions have been proposed. Nevertheless, little research has focused on the use of medicinal plants for the treatment of this skin disease. However, there are a number of medicinal plants used traditionally to treat acne, and this provides the impetus for scientists to explore their medicinal properties. Objective: This work aimed to review medicinal plants-based treatment approaches for acne. Methodology: The authoritative online scientific databases including Pubmed, MEDLINE, Link of Springer, Online Library of Wiley, Science Direct of Elsevier, Cambridge Core, and Cochrane were searched and the useful data associated with the objective of present study were gathered, combined, and then categorized in terms of medicinal plants, acne, Acne Vulgaris, herbs. Conclusion: There is currently a strong focus on medicinal plants at a research level and therefore strong motivation exists for the use of these ingredients in cosmetic care products that need to be proven safe and effective with the aid of clinical research.

Avaliação do tratamento de alterações estéticas faciais com uso de um protocolo operacional desenvolvido para a aplicação de plasma rico em plaquetas / Evaluation of the treatment of changes aesthetic facial with the use of an operational protocol developed for the application of platelet rich plasm

Introdução: o plasma rico em plaquetas é definido como um concentrado de plaquetas autólogas, obtido por centrifugação de sangue total. Trata-se de uma técnica inovadora, simples e de baixo custo, que apresenta muitos benefícios, podendo ser aplicada em diferentes áreas da saúde. Objetivo: a presente pesquisa buscou desenvolver um protocolo operacional padrão para obtenção e aplicação do plasma sanguíneo rico em plaquetas para o tratamento de alterações estéticas faciais. Metodologia: o estudo tratou de uma pesquisa de campo experimental, de caráter qualitativo e quantitativo. Um processo seletivo foi realizado para recrutar pacientes voluntários para o estudo, que foram selecionados de acordo com os critérios de inclusão e exclusão. Através de testes foi possível chegar ao tempo de centrifugação e velocidade ideais para a produção do plasma rico em plaquetas e testá-lo no tratamento de alterações estéticas faciais. Resultados e discussão: as principais mudanças que foram notadas pelos pacientes durante e após o tratamento foram a redução das cicatrizes de acne e aumento da hidratação e viscosidade da pele. A melhora das alterações estéticas tratadas foi notada por 100% dos pacientes, não havendo piora em nenhum paciente. Conclusão: com base nos testes e resultados obtidos, foi possível padronizar um protocolo operacional padrão ideal para a obtenção e aplicação do plasma rico em plaquetas, comprovando sua eficácia no tratamento de alterações estéticas faciais como rugas, flacidez, linhas de expressões acentuadas, acne, cicatrizes de acne, além de ter-se observado uma melhora significativa na hidratação da pele e redução de poros dilatados.

Introduction: platelet-rich plasma is defined as a concentrate of autologous platelets, obtained by centrifuging whole blood. It is an innovative, simple and low-cost technique that has many benefits, and can be applied in different areas of health. Objective: the present research sought to develop a standard operating protocol for obtaining and applying platelet-rich blood plasma for the treatment of facial aesthetic changes. Metodology: the study was a qualitative and quantitative field research. A selection process was carried out to recruit volunteer patients for the study, who were selected according to the inclusion and exclusion criteria. Through tests it was possible to reach the ideal centrifugation time and speed for the production of platelet-rich plasma and to test it in the treatment of facial aesthetic changes. Results and discussion: the main changes that were noted by patients during and after treatment were the reduction of acne scars and increased hydration and skin viscosity. The improvement of the aesthetic changes treated was noticed by 100% of the patients, with no worsening in any patient. Conclusion: based on the tests and results obtained, it was possible to standardize an ideal standard operating protocol for obtaining and applying platelet-rich plasma, proving its effectiveness in the treatment of facial aesthetic changes such as wrinkles, sagging, accentuated expression lines, acne, scars from acne, in addition to a significant improvement in skin hydration and reduction of enlarged pores.

Aplicación móvil para diagnóstico, prevención y tratamiento estético del acné II / A Mobile Application for Diagnosis, Prevention and Cosmetic Treatments of Grade II Acne

Introducción: Algunos profesionales tienen dificultades para hacer la detección correcta de los signos y síntomas y para prescribir el tratamiento adecuado del acné II, que puede conducir a un tratamiento estético insatisfactorio. Por lo tanto, es necesario desarrollar tecnología educativa, por ejemplo, una aplicación. Objetivo: Desarrollar una aplicación multimedia en una plataforma móvil para el diagnóstico, prevención y tratamiento estético del acné grado II. Métodos: Las fases de desarrollo de la estructura de la aplicación fueron: Fase 1 - "Concepción: identificación de las necesidades del desarrollo de la aplicación". Fase 2 - "Elaboración del prototipo de aplicación": esta fase incluyó la revisión integradora de la literatura en las principales bases de datos. Fase 3- "Creación de la aplicación": esta fase consistió en desarrollar el algoritmo, estructurar la base de datos y desarrollar el software; Fase 4- "Transición": se realizaron las pruebas de funcionalidad de la aplicación. Resultados: La aplicación móvil consta de 10 pantallas descriptivas y 4 pantallas con videos explicativos, el cual se registró en el Instituto Nacional de Propiedad Industrial (Ministerio de Desarrollo, Industria y Comercio Exterior) con el número de protocolo: BR: 51 2018 0001475 y está disponible de forma gratuita en línea en Google Play Store con el nombre de Face Care. Conclusión: El estudio permitió describir las etapas de planificación y desarrollo de una aplicación multimedia en una plataforma móvil para el diagnóstico, prevención y tratamiento estético del acné grado II(AU)

Introduction: Some professionals have difficulties in correctly detecting signs and symptoms of acne II, as well as in prescribing the appropriate treatment for the condition, a fact that can lead to unsatisfactory cosmetic treatment. Therefore, it is necessary to develop educational technology; for example, an application. Objective: To develop a multimedia application on a mobile platform for diagnosis, prevention and cosmetic treatment of grade II acne. Methods: The application structure was developed in four phases: conception (identification of the application development needs), development of the application prototype (which included the integrative review of the literature from the main databases), creation of the application (which consisted in developing the algorithm, structuring the database and developing the software), and transition (during which the application's functionality tests were carried out). Results: The mobile application consists of ten descriptive screens and four screens with explanatory videos. It was registered within the National Institute of Industrial Property (Ministry of Development, Industry and Foreign Trade), with the protocol number BR: 51 2018 0001475. It is available online, for free, on the Google Play Store, under the name Face Care. Conclusion: This study allowed to describe the planning and development stages of a multimedia application on a mobile platform for the diagnosis, prevention and cosmetic treatment of grade II acne(AU)

Avaliação da qualidade de vida e perfil epidemiológico de mulheres adultas com acne facial / Evaluation of quality of life and epidemiological profile of adult women with facial acne

Introdução: A acne é uma doença inflamatória crônica da unidade sebácea. Embora acometa principalmente adolescentes, constata-se uma prevalência elevada em adultos, em especial nas mulheres. A acne feminina adulta tem sido associada a má qualidade de vida (QV) e é capaz de impactar tanto a autoestima como os relacionamentos pessoais e profissionais. Métodos: Trata-se de um estudo transversal de natureza quantitativa realizado através da aplicação de questionários para avaliar a QV e o perfil epidemiológico de mulheres adultas com acne facial entre 25 e 50 anos atendidas em um ambulatório clínico da Universidade do Extremo Sul Catarinense (UNESC). Resultados: Um total de 20 mulheres com acne facial participaram da pesquisa. A idade média foi de 32,45 anos, sendo a maioria branca, casada e com ensino superior incompleto. A maioria não realizou tratamento prévio, e o perfil mais encontrado foi de início da acne na adolescência e de sua persistência na idade adulta. Grande parte das mulheres utilizavam maquiagem. Além disso, foram observados baixos escores em cada um dos quatro domínios do questionário Acne-QoL, com resultados estatisticamente significativos correlacionando a idade com os domínios de autopercepção e de papel emocional. Conclusões: Os resultados destacam que a acne facial tem um impacto significativo na QV de mulheres adultas que a possuem. (AU)

Introduction: Acne is a chronic inflammatory disease of the sebaceous unit. Although adolescents are most commonly affected, there is a high prevalence in adults, especially in women. Acne in adult women has been linked to poor quality of life and may affect self-esteem and personal and professional relationships. Methods: This quantitative cross-sectional study consisted of the administration of a questionnaire to assess the quality of life and epidemiological profile of adult women with facial acne aged 25 to 50 years who were treated at an outpatient clinic at University of Southern Santa Catarina (UNESC). Results: In total, 20 women with facial acne participated in this study. Mean age was 32.45 years, and most participants were white, married, and did not complete their higher education studies. Most of them did not undergo a previous treatment, and the most common profile was acne onset in adolescence with persistence in adulthood. Most women reported using makeup. In addition, low scores were found in all four domains of the Acne-Quality of Life questionnaire, with statistically significant results correlating age with the domains of self-perception and emotional role. (AU)

Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology

Abstract Background: Isotretinoin is a synthetic retinoid, derived from vitamin A, with multiple mechanisms of action and highly effective in the treatment of acne, despite common adverse events, manageable and dose-dependent. Dose-independent teratogenicity is the most serious. Therefore, off-label prescriptions require strict criteria. Objective: To communicate the experience and recommendation of Brazilian dermatologists on oral use of the drug in dermatology. Methods: Eight experts from five universities were appointed by the Brazilian Society of Dermatology to develop a consensus on indications for this drug. Through the adapted DELPHI methodology, relevant elements were listed and an extensive analysis of the literature was carried out. The consensus was defined with the approval of at least 70% of the experts. Results: With 100% approval from the authors, there was no doubt about the efficacy of oral isotretinoin in the treatment of acne, including as an adjunct in the correction of scars. Common and manageable common adverse events are mucocutaneous in nature. Others, such as growth retardation, abnormal healing, depression, and inflammatory bowel disease have been thoroughly investigated, and there is no evidence of a causal association; they are rare, individual, and should not contraindicate the use of the drug. Regarding unapproved indications, it may represent an option in cases of refractory rosacea, severe seborrheic dermatitis, stabilization of field cancerization with advanced photoaging and, although incipient, frontal fibrosing alopecia. For keratinization disorders, acitretin performs better. In the opinion of the authors, indications for purely esthetic purposes or oil control are not recommended, particularly for women of childbearing age. Conclusions: Approved and non-approved indications, efficacy and adverse effects of oral isotretinoin in dermatology were presented and critically evaluated.

PsAPASH: a rare and recent autoinflammatory syndrome associated with hidradenitis suppurativa

Abstract Hidradenitis suppurativa is a chronic inflammatory skin disease, which affects 1% of the population, being more common in young, obese and smokers, and mainly affects armpits and groin, with formation of pustules, nodules, abscesses, scars and fistulas. Recently, its association with other autoimmune diseases such as psoriasis, psoriatic arthritis, pyoderma gangrenosum, pyogenic arthritis and ulcerative colitis have been reported. These associated forms are usually resistant to standard treatment, with immunobiologicals as promising therapy. The case of a rare form of association is reported, with only one case previously described in the literature: psoriasis arthritis, pyoderma gangrenosum, acne and hidradenitis suppurativa.

Demodex folliculorum infestations in common facial dermatoses: acne vulgaris, rosacea, seborrheic dermatitis

Abstract Background: Demodex mites are found on the skin of many healthy individuals. Demodex mites in high densities are considered to play a pathogenic role. Objective: To investigate the association between Demodex infestation and the three most common facial dermatoses: acne vulgaris, rosacea and seborrheic dermatitis. Methods: This prospective, observational case-control study included 127 patients (43 with acne vulgaris, 43 with rosacea and 41 with seborrheic dermatitis) and 77 healthy controls. The presence of demodicosis was evaluated by standardized skin surface biopsy in both the patient and control groups. Results: In terms of gender and age, no significant difference was found between the patients and controls (p > 0.05). Demodex infestation rates were significantly higher in patients than in controls (p = 0.001). Demodex infestation rates were significantly higher in the rosacea group than acne vulgaris and seborrheic dermatitis groups and controls (p = 0.001; p = 0.024; p = 0.001, respectively). Demodex infestation was found to be significantly higher in the acne vulgaris and seborrheic dermatitis groups than in controls (p = 0.001 and p = 0.001, respectively). No difference was observed between the acne vulgaris and seborrheic dermatitis groups in terms of demodicosis (p = 0.294). Study limitations: Small sample size is a limitation of the study. The lack of an objective scoring system in the diagnosis of Demodex infestation is another limitation. Conclusion: The findings of the present study emphasize that acne vulgaris, rosacea and seborrheic dermatitis are significantly associated with Demodex infestation. Standardized skin surface biopsy is a practical tool in the determination of Demodex infestation.

Effects of oral isotretinoin therapy on the nasal cavities / Efeitos nasais da terapia com isotretinoína oral

Abstract Introduction Isotretinoin (13 cis-retinoic acid) is the most effective treatment for acne vulgaris and is the only treatment option that can provide either remission or a permanent cure. Objective The aim of this study was to use both subjective and objective methods to assess the nasal complaints of patients with severe acne who received oral isotretinoin therapy. Methods Fifty-four subjects were enrolled in the study. All the subjects were assessed with subjective (NOSE and VAS questionnaires) and objective (rhinomanometry and saccharine) tests to determine the severity of their nasal complaints. Results The mean severity scores (min: 0; max: 100) for nasal dryness/crusting and epistaxis were 0.47 ± 1.48 (0-5); 0.35 ± 1.30 (0-5) at admission, 3.57 ± 4.45 (0-10); 2.26 ± 4.71 (0-20) at the first month, and 4.28 ± 6 (0-20); 2.26 ± 4.71 (0-20) at the third month of the treatment respectively. Total nasal resistance of 0.195 ± 0.079 (0.12-0.56) Pa/cm3/s at admission, 0.21 ± 0.084 (0.12-0.54) Pa/cm3/s at the first month, and 0.216 ± 0.081 (0.14-0.54) Pa/cm3/s at the third month. Conclusion Oral isotretinoin therapy can cause the complaint of nasal obstruction. In addition, nasal complaints, such as dryness/crusting and epistaxis, significantly increase in patients during the therapy schedule.

Resumo Introdução A isotretinoína (ácido-13 cis-retinóico) é o tratamento por via oral mais eficaz para acne vulgar e é a única opção de tratamento que pode produzir remissão ou cura permanente. Objetivo Usar métodos subjetivos e objetivos para avaliar as queixas nasais de pacientes com acne grave que receberam terapia com isotretinoína oral. Método Foram incluídos no estudo 54 indivíduos. Todos os indivíduos foram avaliados por meio de testes subjetivos (questionários NOSE e escala EVA) e objetivos (rinomanometria e teste de sacarina) para determinar a gravidade de suas queixas nasais. Resultados Os escores médios de gravidade (min: 0; max: 100) para ressecamento/crostas e epistaxe nasal foram de 0,47 ± 1,48 (0-5); 0,35 ± 1,30 (0-5) no início, 3,57 ± 4,45 (0-10); 2,26 ± 4,71 (0-20) no primeiro mês e 4,28 ± 6 (0-20); 2,26 ± 4,71 (0-20) no terceiro mês do tratamento, respectivamente. A resistência nasal total foi de 0,195 ± 0,079 (0,12 a 0,56) Pa/cm3/s no início, 0,21 ± 0,084 (0,12 a 0,54) Pa/cm3/s no primeiro mês e 0,216 ± 0,081 (0,14 a 0,54) Pa/cm3/s no terceiro mês. Conclusão A terapia com isotretinoína por via oral pode resultar em queixa de obstrução nasal. Além disso, queixas nasais, tais como ressecamento/formação de crostas e epistaxe, aumentam significativamente nos pacientes durante o esquema terapêutico.

Dosages of androgenic hormones in adolescent patients with severe acne

SUMMARY OBJECTIVE Acne vulgaris in female adolescents, when severe or accompanied by other signs of androgenization, may represent a sign of hyperandrogenemia often underdiagnosed, which will have harmful consequences for adult life. The objective of this cross-sectional and retrospective study was to demonstrate the incidence of hormonal changes in the cases of female adolescents with severe or extensive acne, with or without other signs of hyperandrogenism, and propose a hormonal research pattern which should be indicated in order to detect early hyperandrogenemia. METHODS The medical records of 38 female patients aged between 9 and 15 years old with grade II and/or III acne were analyzed. The dehydroepiandrosterone sulfate, dehydroepiandrostenedione, and androstenedione, total testosterone, and dihydrotestosterone sulfate hormones were required prior to initiation of treatment. The hormonal dosages were performed in the serum after at least 3 hours of fasting by means of radioimmunoassay tests. RESULTS Of the 38 patients included, 44.7% presented changes in androgen levels (hyperandrogenemia), and the two most frequently altered hormones were DHEA and androstenedione, with the same incidence (23.6%). CONCLUSIONS The correct and early diagnosis provides an effective and agile approach, including antiandrogen therapy, with the purpose of avoiding the reproductive and metabolic repercussions, besides controlling the inflammatory picture and avoid aesthetic complications.

RESUMO OBJETIVO A acne vulgar em adolescentes do sexo feminino, quando grave ou acompanhada de outros sinais de androgenização, pode representar um sinal de hiperandrogenemia muitas vezes subdiagnosticado, que acarretará consequências danosas para a vida adulta. O objetivo deste estudo transversal e retrospectivo foi demonstrar a incidência das alterações hormonais nos casos de adolescentes do sexo feminino com acne grave ou extensa, acompanhada ou não de outros sinais de hiperandrogenismo e propor um padrão de pesquisa hormonal que deve ser indicado com o intuito de detectar precocemente o quadro de hiperandrogenemia. MÉTODOS Foram analisados os prontuários de 38 pacientes do sexo feminino com idades entre 9 e 15 anos, portadoras de quadro de acne grau II e/ou III. Os hormônios sulfato de dehidroepiandrostenediona, dehidroepiandrostenediona, androstenediona, testosterona total e dehidrotestosterona foram solicitados antes do início do tratamento. As dosagens hormonais foram realizadas no soro após pelo menos 3 horas de jejum por meio de exames de radioimunoensaio. RESULTADOS Das 38 pacientes incluídas, 44,7% apresentaram alterações dos níveis de andrógenos (hiperandrogenemia), sendo que os dois hormônios mais frequentemente alterados foram o DHEA e androstenediona, com a mesma incidência (23,6%). CONCLUSÕES O diagnóstico correto e precoce propicia uma abordagem efetiva e ágil, incluindo a terapia antiandrogênica, com a finalidade de evitar as repercussões reprodutivas e metabólicas, além de controlar o quadro inflamatório e evitar complicações estéticas.

A Therapeutic Oral Vaccine Candidate against Propionibacterium acnes: Preparation and Immunological Evaluation of Nanoparticles Encapsulated Sialidase-CAMP Fusion Protein

Abstract Acne Vulgaris is a common skin disease caused by Propionibacterium acnes, an anaerobic microbiota of human skin that plays a vital role in the pathology of acne. The aim of this study was to prepare nanoparticles containing an acne recombinant protein and determine its ability as an oral acne vaccine in mice. The recombinant Sialidase-CAMP gene was expressed and purified in a prokaryotic host. The chitosan nanoparticles containing the recombinant protein were prepared, encapsulated, and administered by both oral and subcutaneous routes to Balb/c mice. Sera IgA and IgG and stool IgA titers were measured by ELISA, and the immunized mice were challenged against P. acnes. A 65 kDa recombinant protein was confirmed by SDS-PAGE and western blot. The size and zeta potential of nanoparticles were 80 nm and +18 mV, respectively. After oral immunization, the serum IgG and IgA titers were 1:3200 and 1:16, respectively, and the stool IgA titer was 1:8. In the subcutaneous route, the serum IgG titer was 1:51200. Immunized mice showed no inflammation in the ear of challenged mice. It is the first study that examines a chitosan-nanoparticulated acne fusion protein as an applicable acne vaccine candidate with appropriate immunogenicity potential. Further studies are required to validate the clinical usefulness of this vaccine candidate.

Adolescents' self perceived acne-related beliefs: from myth to science

Abstract Background: Acne vulgaris is recognized as the third most prevalent skin disease worldwide, with highest prevalence among adolescents. Beliefs and perceptions of adolescents about acne are incoherent in the literature. Objectives: To assess the most frequently reported acne-related beliefs in adolescents in order to focus on misconceptions and develop proper recommendations. Methods: A cross-sectional community-based study on representative sample of 2516 schoolchildren was conducted in six randomly selected secondary schools in Belgrade, Serbia. Only schoolchildren with present or past acne history participated. Factors believed to aggravate or ameliorate acne were recorded and analyzed, and the comparisons between girls and boys were evaluated using Pearson's chi-squared test. Results: A total of 1452 schoolchildren with acne participated, aged 14-18 years, among them 801 (55.2%) girls and 651 (44.8%) boys. Boys significantly more frequently believed that sweating, exercise, and dairy foods aggravate acne, whereas girls significantly more frequently blamed emotional stress, sweets, fatty foods, sun, and lack of sleep. The top four amelioration factors were as follows: comedone extraction, healthy diet, sun exposure, and increased water consumption. Acne regression was more frequently perceived to be linked with cigarettes in boys, but with sun exposure and weight loss in girls. Study limitations: The narrow age span of adolescents (14-18 years) and exclusion of acne-free adolescents are limitations due to study design. Conclusion: This survey is part of the first epidemiological study on a representative sample in the Western Balkan region. The significance of the most frequent acne-related beliefs is discussed and myths about acne are highlighted.