At a glance: Acne excoriée versus acne vulgaris

Acne excoriée may be a sign of psychological problems
Acne excoriée may be a sign of psychological problems

Acne excoriée
Presentation

  • Occurs more commonly in females than males.
  • Comedones are absent. Pustules are few.
  • Round or oval white scars. 

Cause

  • Lesions are caused as a result of picking.
  • Underlying psychological problems.

Treatment

  • Poor response to conventional acne treatment.
  • Counselling or even antidepressants can help.

Acne Vulgaris

Presentation

  • Occurs equally in both sexes with a peak incidence of 13–16 years old.
  • Face, chest, neck and back are affected.
  • Comedones and pustules are common.
  • Scarring and cysts may form in severe cases. 

Cause

  • Genetic factors are important in determining severity, duration and clinical pattern.
  • No relation to diet or cleanliness. Lesions start as blocked infected follicles. 

Treatment

  • OTC cleansers.
  • Topical/oral antibiotics or benzoyl peroxide.
  • Oral isotretinoin (Roaccutane, hospital only).

Contributed by Dr Nigel Stollery GP in Kibworth, Leicestershire and a clinical assistant in Dermatology at Leicester Royal Infirmary

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