The costs and social impact of acne are substantial. In the United States, acne vulgaris is responsible for more than 5 million doctor visits and costs over US$2.5 billion each year in direct costs.[13] Similarly, acne vulgaris is responsible for 3.5 million doctor visits each year in the United Kingdom.[20] Sales for the top ten leading acne treatment brands in the US in 2015, have been reported as amounting to $352 million.[176]
Credit card details: If you make a purchase online and choose to pay by credit card, you will provide your credit card information on our website to finalize your purchase. Your credit card details will be protected using Global Sign Encryption. The legal basis is that the processing is necessary in order for us to be able to fulfill our contractual obligations to you under the purchase agreement. We will retain your data for as long as necessary for this purpose.
Social Security number: If you chose to apply for credit, allowing you to make your payment by invoice, you may be required to provide your social security number on our website. Your social security number will be directly transferred and available only to our payment service provider, which will process your social security number to be able to obtain a credit report and to facilitate your payment. The legal basis is that the processing is necessary for us to ensure accurate identification of our customers for invoice purposes and to fulfill our contractual obligations to you under the purchase agreement. It is our policy to retain your social security number only as long as reasonably necessary for this purpose.
Previous purchases and returns: If you have signed up for an account we will store information regarding (i) your online purchases and returns, and (ii) your purchases and returns in physical stores, if you have provided your e-mail address to our personnel. Such information encompasses product, size, price and date of purchase. We will also store information regarding your recently viewed items. This will allow you to keep track of your purchases and returns, and recently viewed items, by logging into your personal account. The legal basis is our legitimate interest to provide you with the service of a personal account as requested by you when you signed up for the account. You may choose to deregister your account at any time. We will also save information on your contact details and previous purchases and returns during 36 months after the purchase to be able to administer returns and/or complaints. The legal basis is our legitimate interest to provide our customers with speedy and efficient service after the purchase.
It is widely suspected that the anaerobic bacterial species Cutibacterium acnes (formerly Propionibacterium. acnes) contributes to the development of acne, but its exact role is not well understood.[2] There are specific sub-strains of C. acnes associated with normal skin, and moderate or severe inflammatory acne.[50] It is unclear whether these undesirable strains evolve on-site or are acquired, or possibly both depending on the person. These strains have the capability of changing, perpetuating, or adapting to the abnormal cycle of inflammation, oil production, and inadequate sloughing of dead skin cells from acne pores. Infection with the parasitic mite Demodex is associated with the development of acne.[30][51] It is unclear whether eradication of the mite improves acne.[51]
How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. (If you're feeling bloated, now's the time to do it.) The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash, like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($7), with a benzoyl peroxide spot treatment, such as Murad Acne Spot Fast Fix ($22). If you're still seeing zits, "visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.

Diet. Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
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