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Lay perceptions that diet, hygiene and sunlight exposure are strongly associated with acne causation and exacerbation are common but at variance with the consensus of current dermatological opinion. Given the prevalence of lay perceptions, and the confidence of dermatological opinion in rebutting these perceptions as myths and misconceptions, surprisingly little evidence exists for the efficacy or lack of efficacy of dietary factors, face-washing and sunlight exposure in the management of acne. Much of the available evidence has methodological limitations. Based on the present state of evidence, clinicians cannot be didactic in their recommendations regarding diet, hygiene and face-washing, and sunlight to patients with acne. Advice should be individualized, and both clinician and patient cognizant of its limitations. These perceived myths and misconceptions about acne causation, exacerbating factors and treatment efficacies are common, and not just among patients. The corollary of these beliefs about aetiology were some of the treatment recommendations of the final year students—cleaners and washes, antiseptics and medicated soaps, and improved facial hygiene and diet. There has been a lay and traditional dermatological opinion that sunlight exposure was beneficial in acne and that this caused acne to improve in summer and worsen in winter, 3, 4, 19, 23 —28 though this is now generally thought to be more likely not to be the case. The search was confined to English language articles. Reference lists of identified articles were examined for further relevant studies.
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