[JohnBovenmyer]

However, It seems to me that acne is declining.

I don't think that is the case. Rather kids with significant acne are getting more and better treatment than in the past. And a big part of that, for the really severe cases, is Accutane. Before Accutane came out (in either '82 or '84, I forget which) much of the really severe acne failed all treatment and left people scarred for life. After Accutane those kids usually do well. The downside of generally successful treatment is that kid's expectations have risen to unrealistic levels. The only perfect treatment for acne is more birthdays.

[jocon307]

"Rather kids with significant acne are getting more and better treatment than in the past."

Well, yes, this is probably a big part of it. And there is no doubt that Accutane is a wonder drug for acne. Something that when it is bad is far worse than just 'a few pimples'.