acnes

Acne, or acne vulgaris, is a chronic inflammatory skin condition of the pilosebaceous units. It commonly affects adolescents but can persist into adulthood and also occur in adults. Lesions range from noninflammatory comedones (open and closed) to inflammatory papules, pustules, and, in severe forms, nodules or cysts. The condition usually appears on the face, chest, and back and may cause scarring or pigmentary changes.

Pathogenesis involves several factors: increased sebum production under hormonal influences; hyperkeratinization leading to follicular plugging; colonization by Cutibacterium acnes (formerly Propionibacterium acnes); and inflammation. Genetic predisposition and environmental factors such as diet, stress, and certain medications can modulate risk and severity.

Diagnosis is clinical, based on lesion type and distribution. In persistent or severe cases, or when considering hormonal or systemic causes, clinicians may evaluate for underlying conditions (e.g., polycystic ovary syndrome) or perform laboratory tests.

Treatment is tiered by severity. Mild acne responds to topical retinoids (e.g., adapalene or tretinoin) timed with benzoyl peroxide and possibly topical antibiotics. Moderate disease may require oral antibiotics for short periods, while hormonal therapy may benefit females (combined oral contraceptives, spironolactone). Severe nodulocystic acne often requires systemic isotretinoin. Skincare measures include gentle cleansing, non-comedogenic products, sun protection, and avoidance of picking.

Prognosis varies; many improve with age, but persistent cases can cause scarring. Public health impact is significant due to its high prevalence among adolescents.