Acne is an inflammatory skin condition thought to be caused by the bacterium Propionibacterium acnes. The four main aetiological factors of acne are hypercornification of the pilosebaceous duct, increased sebum production, colonization with P. acnes, and subsequently the production of inflammation (Burkhart et al., 1999). The incidence of this skin condition seems to be highest in Western societies (Cordain et al., 2002). Common therapies used for acne include topical retinoids or antibiotics (Feldman et al., 2004). Oral isotretinoin (13-cis retinoic acid; Accutane) is reserved for severe cases and must be prescribed by a physician because of potential adverse effects and teratogenicity (Feldman et al., 2004). There have been intriguing reports of associations between isotretinoin therapy and the subsequent occurrence of inflammatory bowel disease (IBD), suggesting that isotretinoin may be a "trigger" for IBD in a sub-group of patients (Borobio et al., 2004; Passier et al., 2006; Reddy et al., 2006) [see isotretinoin or accutane for further details].

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