From a medical psychological point of view, acne vulgaris can be schematically divided into two clinical pictures: (1) the common adolescent eruption, more mind-influencing and thus somatopsychic; (2) the less frequent acne of adults (young adults for the most part), both as a continuation of adolescent acne and, more rarely, as a never before experienced cutaneous affection, and thus psychosomatic in a strict sense. We believe that the dermatologist can treat both of these clinical manifestations, even from a psychological aspect, from the very first visit with the patient using the first step in psychotherapy: counseling. The principal points of this approach are presented, with special attention to the differences to be considered in the two clinical pictures specified as well as to the opportuneness and timing of an eventual liaison consultation with psychologists/psychiatrists in realizing other therapeutic strategies.

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