Derangement of the digestive, or of the sexual organs, predisposes to outbreaks of acne. The disease is so chronic and intractable that it invariably tries the patience and skill of a physician. Nothing contributes more certainly to its relief than preventing abnormal fermentation in the gastrointestinal tract. This can be accomplished best by a diet of simply prepared foods, by their abstemious use, and by frequent, sometimes daily, gentle purgings. A dose of Carlsbad salts in a glass of water taken when the patient first arises will usually suffice as a purge. A glass of hot water twenty or thirty minutes before meals is a help. Overeating, which is especially apt to be indulged in at puberty when children grow rapidly, must be forbidden. The trouble is produced or aggravated in many cases by oatmeal, pancakes, particularly when made of buckwheat, pastries, candies, and sweets generally. To the list of foods that must be forbidden, or whose use must be regulated carefully, should be added foods cooked in fat, such as fried meats and vegetables, sausages, doughnuts, cheese, and any other food slow to digest or liable to ferment. Coffee and tea made very sweet are also often harmful.

When derangements of the sexual organs exist, they must be corrected. The period of puberty is often accompanied with persistent or recurrent acne, and while treatment may diminish the disfigurement, time alone seems able to bring complete relief.

The affected portions of the skin must be kept clean and functionally active. Fomentations and massage help to do this. Antiseptics may also usefully be applied.