Talk:Acne vulgaris

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I was suprised to see that this common portmanteau for acne occuring on ones back was left out of a discussion about acne. I thought it would have its own article.


what the #13 has to do with benzoyl peroxide? the whole text just talk about it and then slap Isotretinoin references(and bad ones) out of nonwhere

Orange skin[edit]

Acne might cause small maccules of hyperpigmentation if there is scarring (which image does show) ... not sure this is described as orange skin...looks like the orange color might be an artifact of the lighting and color settings of the camera that took the pic. Lesion (talk) 17:14, 31 January 2014 (UTC)

Agree acne does not cause jaundice. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:18, 31 January 2014 (UTC)

[new paper] Diet and Acne Update: Carbohydrates Emerge as the Main Culprit[edit]

Fulltext available here: --Siddhant (talk) 19:48, 13 April 2014 (UTC)

Thanks. We more or less state this already. Will incorporate soon. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:39, 16 April 2014 (UTC)

. — Preceding unsigned comment added by Drole007 (talkcontribs) 10:44, 20 April 2014 (UTC)

GA Review[edit]

This review is transcluded from Talk:Acne vulgaris/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Bluerasberry (talk · contribs) 16:49, 3 February 2015 (UTC)

Review by bluerasberry[edit]

I am here in response to a request at WP:MED.

Per Wikipedia:Manual_of_Style/Medicine-related_articles#Diseases_or_disorders_or_syndromes, I expect to see a "society and culture" section when that is relevant to the disease. For this to be promoted, I wish to see some coverage of social stigma, economics of treatment, and something about class distinctions and global perspective. Currently there is no social coverage of this.

The management section does not have an explanation of the default treatment option, which is doing nothing in particular. Also I would like to see some ranking of the treatments to indicate which response is most common. Some of these treatments are probably not common.

  •  Done I think I've addressed this now. TylerDurden8823 (talk) 07:11, 17 February 2015 (UTC)

In the differential diagnosis section, I would like to see at least one differentiation made, perhaps between this condition and another common condition.

In all of these things I am happy with 1-2 sentence presentations and linking to a source. I expect that sources would be easy to find for all of these if someone checked PubMed and Google Scholar. Blue Rasberry (talk) 16:49, 3 February 2015 (UTC)

Fair points Blue, let's put it on hold and I'll make the necessary revisions. TylerDurden8823 (talk) 17:04, 3 February 2015 (UTC)
Can you clarify what you mean about the ranking of treatments to indicate which response is most common? Do you mean a ranking of the treatments in terms of how effective they are or which treatment has the highest response rates? TylerDurden8823 (talk) 06:21, 7 February 2015 (UTC)
The text does not make clear what most people do when experiencing acne. Just based on information presented in the article, it seems like people who experience acne might commonly respond by getting a prescription for retinoids followed by laser resurfacing, because about 15 treatments are presented without indicating which ones are odd or unusual. I have insight to know that acne is usually mild and requires no intervention from a health professional, and when there is a health intervention, some of these are more common in all cases, some are a response to severe acne, some are not common, and I am not sure that some are used at all. I would like to see these differentiated in some way between what is typical and what is unlikely to be of interest to most readers learning about this condition. Blue Rasberry (talk) 18:21, 7 February 2015 (UTC)
Okay, that's clearer. I'll see what I can do. TylerDurden8823 (talk) 07:42, 9 February 2015 (UTC)
  • Koo, JY; Smith, LL (September 1991). "Psychologic aspects of acne.". Pediatric dermatology 8 (3): 185–8. PMID 1836060. 
  • Niemeier, V; Kupfer, J; Gieler, U (December 2006). "Acne vulgaris--psychosomatic aspects.". Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG 4 (12): 1027–36. PMID 17176410. 
  • Goodman, G (August 2006). "Acne--natural history, facts and myths.". Australian family physician 35 (8): 613–6. PMID 16894437. 
  • Dréno, B (2006). "Assessing quality of life in patients with acne vulgaris: implications for treatment.". American journal of clinical dermatology 7 (2): 99–106. PMID 16605290. 
  • Thomas, DR (2004). "Psychosocial effects of acne.". Journal of cutaneous medicine and surgery. 8 Suppl 4: 3–5. PMID 15778823. 
  • Lowe, JG (undefined NaN). "The stigma of acne.". British journal of hospital medicine 49 (11): 809–12. PMID 8334485.  Check date values in: |date= (help)
  • Ou, HT; Feldman, SR; Balkrishnan, R (June 2010). "Understanding and improving treatment adherence in pediatric patients.". Seminars in cutaneous medicine and surgery 29 (2): 137–40. PMID 20579603. 
Blue Rasberry (talk) 17:24, 3 February 2015 (UTC)
Thanks, that'll save me some time. I'll probably be able to work on it possibly this evening or tomorrow. TylerDurden8823 (talk) 21:23, 3 February 2015 (UTC)

 Pass All the issues I raised have been addressed. It is my opinion that this article has coverage of all topics which are described in the medical manual of style and that the coverage is sufficient to meet the standards of a WP:GA health article. In my evaluation, I only checked for scope and extent of coverage, so for this article to pass GA, it needs to be evaluated from other perspectives. Blue Rasberry (talk) 15:51, 17 February 2015 (UTC)

Thanks blue, so what do I need to do now? I've searched more and I really don't seem to be able to find any reputable sources to verify that many people do not treat their acne and that the decision to treat it usually stems from the severity & duration of the problem. With respect to evaluating the article from other perspectives, are you saying additional reviewers are needed? Or are you saying the review is not yet done? I'm confused... TylerDurden8823 (talk) 17:45, 17 February 2015 (UTC)
TylerDurden8823 I am happy with the "doing nothing" section as it is, and in my opinion, a section like that can stay in a GA. I think that I was diligent in searching for sources on this issue and I know that you were too. I would be content if someone removed the section if they disagreed with it and noted this on the talk page, but unless that happens, I prefer to leave it as it is.
For this to pass GA it needs to be further reviewed. I think GAs work better when several people review the article, perhaps 3 total, and speaking only for myself I encourage multiple people to review parts rather than having one person review all. By Wikipedia:Good_article_criteria#The_six_good_article_criteria, I confirmed points 3 entirely and 4 in the parts we discussed. Someone else needs to sign off on the other parts, including "well written", "verifiable", "neutral" (for what I did not cover), "stable", and "illustrated". I trust you know how to solicit for more comments. For what I did, I continue to support he pass for GA, despite leaving in citation needed tags which I know is typically problematic but in this case I support WP:IAR because I think the article makes more sense and is improved with those in here. Blue Rasberry (talk) 20:13, 18 February 2015 (UTC)
Okay, I was unfamiliar with the idea of multiple people reviewing a single article for GA, but I'm fine with that as well and it makes good sense to me too as a form of checks/balances. I'll see if I can get additional reviewers on board to continue the process. Thanks for everything Blue! TylerDurden8823 (talk) 20:35, 18 February 2015 (UTC)
TylerDurden8823 has asked me to do some additional reviewing, as discussed above. This will be my first foray into this side of the review process, so please bear with me if I screw anything up. DoctorJoeE review transgressions/talk to me! 18:31, 24 February 2015 (UTC)

Review by DoctorJoeE[edit]

Apologize for the delay, but I have a lot on my plate at the moment. I will begin by recommending that the "doing nothing" section be struck completely. This is pure WP:OR, as freely admitted in the section immediately below this one ("It is my expectation...", etc.). And it's not true, to the best of my knowledge and belief. There is certainly no published data to support it. On the contrary, most teens and nearly all adults with acne vulgaris intervene in some way, if only with OTC products or whatever their friends are doing. Acne is not a self-limited disease in the same way that, say, traveler's diarrhea is -- years go by, typically, before it subsides, leaving behind scarring and other undesirable sequellae. The American Academy of Dermatology and American Academy of Pediatrics actively discourage doing nothing, because of the substantial scarring risk, among other factors. It may be true that a majority of people do not seek professional treatment or prescription products, but again, I can't cite a source for it. It may also be true that many people in third-world countries do not seek treatment due to higher priorities and a lack of financial resources -- but again, no data that I'm aware of. So I would strongly recommend taking this bit of pure speculation out of the article entirely. More suggestions to follow. DoctorJoeE review transgressions/talk to me! 20:58, 26 February 2015 (UTC)
I'm fine with this and doing it now. TylerDurden8823 (talk) 06:00, 27 February 2015 (UTC)
Are there any other changes to make or is this ready for GA? TylerDurden8823 (talk) 22:53, 2 March 2015 (UTC)
Any other suggestions @DoctorJoeE: or are we good? TylerDurden8823 (talk) 08:08, 4 March 2015 (UTC)
Again, apologies for delays. There are a few minor additions and modifications to content that I'd like to make myself, when I can free up some time to dig up the proper RS -- but for the review itself, I see no significant problems in the "well written", "verifiable", "neutral", "stable", or "illustrated" categories. I think we're good. DoctorJoeE review transgressions/talk to me! 18:48, 4 March 2015 (UTC)
Terrific! @Bluerasberry:, are we all in agreement that this is ready to be promoted to GA? Or do you feel further review is needed? Two reviewers should be sufficient don't you think? TylerDurden8823 (talk) 19:14, 4 March 2015 (UTC)
TylerDurden8823 Two is sufficient but I will not be the one to close this GA. Either DoctorJoeE can or a third can. Blue Rasberry (talk) 19:16, 4 March 2015 (UTC)
Okay, DoctorJoeE, ready to close? TylerDurden8823 (talk) 19:48, 4 March 2015 (UTC)
Ready. Anything specific I need to do? (I'm new to this.) DoctorJoeE review transgressions/talk to me! 01:47, 5 March 2015 (UTC)
Yes, it appears there are a few fairly easy steps for you to pass the article if you deem it ready for GA status. The instructions are on the WP:GAN page for reviewers and there are detailed instructions there (the steps seem to be pretty simple). I tried copying the instructions here but the formatting was screwy. Let me know if you need any help! Thanks again for reviewing! TylerDurden8823 (talk) 05:11, 5 March 2015 (UTC)

Your GA nomination of Acne vulgaris[edit]

The article Acne vulgaris you nominated as a good article has passed Symbol support vote.svg; see Talk:Acne vulgaris for comments about the article. Well done! If the article has not already been on the main page as an "In the news" or "Did you know" item, you can nominate it to appear in Did you know. DoctorJoeE review transgressions/talk to me! 02:42, 7 March 2015 (UTC)

Awesome! Thanks again to Bluerasberry and DoctorJoeE for all of your hard work reviewing the article and to Doc James for making the article better! TylerDurden8823 (talk) 04:53, 7 March 2015 (UTC)

Doing nothing as a treatment[edit]

Acne is a condition which sometimes gets no formal medical treatment and no alternative medicine which would be described as such.

In doing the good article review, I thought that there should be a section in treatment on "doing nothing". I checked for sources in Cochrane, PubMed, Google, and Google Scholar, and every paper I found talked about treating acne and nothing I found was about not treating acne.

It is my expectation that a large number of people with acne, probably the majority, do not have it severe enough to seek medical treatment for it. Because I did not want the article to convey that most people have to get treatment for acne, I put in a section about "doing nothing" even though I found no sources to support this. I tagged my statements as "citation needed".

I expect that there must be sources talking about the health consequences of not treating acne, and I think they should be used in this section, but I could not find them now. Blue Rasberry (talk) 15:49, 17 February 2015 (UTC)

I'll continue to look as well, but my search so far has basically been the same (that all papers generally recommend and discuss treating even mild acne as a preventive measure for the negative psychiatric sequelae of the disorder). I'm sure you're right that the reality of the situation is that many people do not seek treatment because their case is so mild and simply use an OTC cleanser, but so far I haven't come across a good source for that information. TylerDurden8823 (talk) 17:35, 17 February 2015 (UTC)
I've searched additional reviews and the consensus in the literature really seems to be that even mild cases of acne should be treated. At minimum, I'm seeing topical therapies being recommended for mild acne and I haven't seen any discussion (qualitative or quantitative with supporting statistics) discussing the idea that many people with acne do not seek treatment. I think we would be on safe ground to not include that in the article. I haven't been able to find a single reliable WP:MEDRS source yet that says this, have you? If not and we have given it a real effort, I would ask what else needs to be worked on before upgrading the article to GA class. TylerDurden8823 (talk) 06:57, 18 February 2015 (UTC)
  • My understanding of the literature is that in clinical trials, doing nothing performs no better than placebo, although this is because it is the placebo ;) GliderMaven (talk) 19:11, 19 February 2015 (UTC)
    • Doing nothing is slightly different than placebo. Placebo is doing something but with no therapeutic effect. Placebo's are often better than nothing. Doc James (talk · contribs · email) 21:40, 19 February 2015 (UTC)