In this community-based cross-sectional study, 1443 Japanese adolescents aged 13-19 years participated from two schools in Kagawa Prefecture. Students completed a self-administered questionnaire to assess the prevalence of acne, knowledge about acne, self-management of acne and emotional well-being. A five-item version of the Mental Health Inventory (MHI) subscale of the Short Form 36 was used to assess psychological health and depression status. Among respondents, 859 (59.5%) said they had acne (51.6% of the boys and 64.8% of the girls). A majority (56.8%) of those who said they had acne also reported a family history of acne. Of the 555 female respondents with acne, 39.1% reported experiencing acne flares in temporal proximity to menstruation. Less than half (38.8%) of respondents with acne had sought or were seeking treatment. The three most common factors believed to trigger or exacerbate acne were stress, lack of sleep and sweat. The mean MHI score of 847 students with acne was significantly lower than 475 students without acne. The mean MHI score of female students with acne was significantly lower than male students with acne. Students with acne were also significantly more depressed than those without acne and female students were significantly more depressed than male students. Acne is a common problem for Japanese teenagers and causes personal and social difficulties. Our results suggest the necessity of educational programs in school or public to ensure that adolescents are aware of acne and to encourage young people to improve their mental health through better acne treatment.

Cosmetic moisturisers were applied to one side of the face of 18 male Japanese patients with acne vulgaris who were treated with a topical administration of adapalene and clindamycin phosphate gels. We assessed the alleviating effect of the moisturisers on the side effects of the treatment. The severity of acne and the number of inflammatory and non-inflammatory lesions were measured at 0, 2, and 4 weeks. The water content in the stratum corneum and transepidermal water loss were measured by comparing the moisturiser-treated and untreated sides of the face. The sensation of skin dryness and irritation on both sides of the face were assessed by the subjects. We observed that the use of moisturisers did not impact the efficacy of the standard topical treatment and they significantly improved the water content in the stratum corneum and the sensation of dryness. These results suggested that the use of moisturisers in combination with the standard topical treatment may improve adherence to therapy by alleviating the sensation of dryness.

The efficacy of combined therapy with a retinoid and antibiotic for Japanese patients with acne vulgaris remains to be established. Further, maintenance strategies limiting the use of topical retinoids must be identified. The objectives of this study are to determine the efficacy of sequential application of topical adapalene and clindamycin phosphate and to assess the impact of this regimen on patients' quality of life. Sixty-six patients were recruited. The regimen comprised two phases. For the 4-week initial treatment, 1% clindamycin phosphate gel was applied twice daily and 0.1% adapalene gel, once. In the 4-week maintenance phase, patients were randomly assigned to the OD group (adapalene applied once daily) or the TW group (adapalene applied once daily on 2 days per week). The acne severity score, lesion counts, microcomedone count, and sebum amount were measured. Quality of life (QOL) was assessed using Skindex-16. All parameters improved significantly by week 4 of initial treatment. No statistically significant differences were found in the improvement of clinical findings between the groups. All QOL scores improved significantly and did not significantly differ between the groups. Our regimen may enable clinical control of acne in Japanese patients and improve their QOL. For limiting retinoid use, weekly application of adapalene during maintenance is suitable.

Skin manifestations can be major sources of stress for patients with skin diseases; hence, the effective use of makeup and cosmetic products for these patients has been established. The objective of this study was to determine if makeup can divert observers' gaze from areas of inflammatory acne lesions. Both base and point makeup were applied to two Japanese female patients with mild to moderate acne vulgaris to hide skin manifestations, as well as to accentuate the eyes and lips. Photographs of their faces were shown, at various stages of makeup application, to 22 observers (11 men and 11 women). The effects of makeup application, and other eye-diverting strategies (e.g., clothing, accessories, and hairstyle), used to draw observers' gaze away from acne lesions, were evaluated by analyzing observers' eye movements. As base makeup application proceeded, time to first fixation, total fixation duration, and fixation count changed. Compared to "no makeup", the time to first fixation, total fixation duration, and fixation count also decreased significantly after point makeup application. The additional eye-diverting strategies used also had significant gaze-diverting effects. Therefore, makeup can be useful for patients with acne to divert others' gaze from lesions. Therefore, it should be actively integrated into acne management.

In recent years, slightly acid formulas for cosmetics which remove follicular infundibulum obstruction of the hair follicle, have been devised. Therefore, few acne patients experience a problem with cosmetics use. On the other hand, cosmetics use differs from person to person. Thus, an investigation of actual conditions of cosmetics use was done among acne patients. Compared with healthy people, acne patients used more facial wash products more. It has been understood that treatment and skincare instruction are important for the improvement and prevention of acne. We examined skin physiology function and patient's QOL by using a skin care product for women for two months with skincare instruction from a dermatologist for 31 female patients this time. As a result, it was able to be confirmed that the physiology function of the skin and the patient's QOL were improved, and the skin care instruction by a leading dermatologist was useful as treatment assistance of the acne patient.