It is an extremely common skin disorder, which affects nearly all adolescents and adults at least once during life [1, 2]. According to Brown et al (1998), the incidence of acne peaks at age 18; however, a substantial amount of men and women aged 20-40 are also affected by the disorder. Acne is a disease rarely associated with systemic medical problems; however, the importance and morbidity of acne should not be underestimated because its disfiguring can have important negative psychosocial consequences for affected individuals including diminished self-esteem, social embarrassment, social withdrawal, depression and even unemployment [1, 3].

Risk factors/Triggers

1.     Food/Diet

Foods such as nuts, cola, milk, cheese, fried foods and iodised salts have been implicated as triggers of acne vulgaris; however, the connections between nutrition and acne has not definitely been proven as they are rarely supported by good analytical, epidemiological or therapeutic studies [4, 5]. On the other hand, recurrent acne as noted by Niemeier et al (2006) may be a cutaneous sign of an underlying eating disorder.

2.     Genetics

A genetic background is supported by a case control study by Goulden et al, as noted by Rzany et al (2006). This stated that the risk of adult acne vulgaris in relatives of patients with acne as compared with those of patients without acne is significantly higher [4].

3.     Hormones

According to Rzany et al (2006), hormonal influences on acne vulgaris are undisputed as shown by the higher incidence of acne in male adolescents. Premenstrual flare has also been recorded as causing acne [5].

4.     Nicotine

Smoking has also been named as a risk factor for acne vulgaris; however, conflicting data exists as to the link between smoking and acne. Some population based studies have found links between smoking and acne whilst some others have not [4].