Acne

Acne is a common inflammatory skin condition of the pilosebaceous units, most often affecting the face, chest, and back. It presents with open and closed comedones as well as inflammatory lesions such as papules, pustules, and, in more severe cases, nodules or cysts. Acne typically begins in adolescence but can persist into adulthood. Most cases are mild and non-life-threatening, but severe acne can lead to scarring and psychosocial distress.

The condition is multifactorial. Androgen-driven excess sebum production, abnormal follicular keratinization, and bacterial colonization by Cutibacterium acnes contribute to inflammation. Genetics, hormonal factors, certain medications, and external factors such as cosmetics can influence risk and severity.

Clinical features are classified as non-inflammatory (open and closed comedones) and inflammatory (papules, pustules). Deep nodules or cysts occur in severe disease. Lesions commonly occur on the face but may involve the chest and back.

Diagnosis is clinical. Laboratory tests are not routinely required unless there are signs suggesting an underlying endocrine disorder or nonstandard presentations. Treatment is tailored to severity and may include topical agents, oral antibiotics, hormonal therapy for females, or isotretinoin in severe cases. Early treatment reduces scarring risk.

Prevention focuses on gentle skin care, noncomedogenic products, and sun protection. Avoiding picking and excessive washing helps. Acne commonly improves with age, though some people experience persistent or recurrent symptoms into adulthood.