What are the other Names for this Condition? (Also known as/Synonyms)

• Common Acne

What is Acne Vulgaris? (Definition/Background Information)

• Acne refers to a family of multiple subtypes. Acne is a very common skin condition, with many variations in physical findings and course. As the name implies in Latin (vulgaris translates as “common”), Acne Vulgaris is the most common form of acne
• Acne Vulgaris is a very commonly occurring chronic skin condition that occurs when hair follicles become clogged with oil (sebum) and dead skin cells. It typically manifests as pimples (papules and pustules), blackheads (open comedones), whiteheads (closed comedones), cysts, or nodules on the face, chest, back, and shoulders
• Acne is characterized by inflammation, and it may result in scarring or pigmentation changes if left untreated. There is a wide range of treatment possibilities available, and they are customized to suit the specific characteristics observed in each patient
• The approach to addressing Acne Vulgaris varies based on the seriousness of the condition and encompasses the application of cleansers, topical creams and gels, oral medications, light-based therapies, and various other alternatives

Who gets Acne Vulgaris? (Age and Sex Distribution)

• Acne Vulgaris most commonly affects teenagers and young adults, especially during puberty when hormonal changes occur. However, it can occur at any age
• Both males and females can develop acne, but males tend to experience more severe cases
• Acne Vulgaris is a worldwide condition affecting all racial and ethnic groups

What are the Risk Factors of Acne Vulgaris? (Predisposing Factors)

The following risk factors are noted for Acne Vulgaris:

• Hormonal changes during puberty or pregnancy
• Family history of acne
• Certain medications (e.g., corticosteroids, androgens, etc.)
• Hormonal disorders such as polycystic ovary syndrome
• Exposure to certain chemicals or oils
• Excessive sweating or humidity
• High levels of stress
• Poor skin hygiene
• Dietary factors (e.g., high glycemic index foods, dairy products)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others. 

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acne Vulgaris? (Etiology)

The exact cause of Acne Vulgaris is not fully understood, but several factors contribute to its development:

• Excess sebum production by the sebaceous glands
• Buildup of dead skin cells that block hair follicles
• Bacterial colonization by Propionibacterium acnes
• Inflammation triggered by the immune response
• Hormonal abnormalities  (increased androgen activity as seen in Polycystic Ovarian Syndrome-PCOS)
• Genetic predisposition

What are the Signs and Symptoms of Acne Vulgaris?

The signs and symptoms of Acne Vulgaris may include:

• Whiteheads (closed comedones): Small, flesh-colored, yellow  or white bumps under the skin
• Blackheads (open comedones): Dark or black bumps on the skin's surface
• Papules: Small, red, raised bumps
• Pustules: Red bumps with a white or yellow center (pus-filled)
• Nodules: Large, painful, solid lesions deep within the skin
• Cysts: Painful, pus-filled lumps under the skin
• Inflammation, redness, and tenderness in affected areas

How is Acne Vulgaris Diagnosed?

• Diagnosis is usually made by a healthcare professional based on a physical examination of the skin. No specific tests are required for diagnosis of Acne Vulgaris in most cases
• In severe or persistent cases, a dermatologist may perform additional tests, such as skin swabs or biopsies, as well as blood tests for hormone levels, to rule out other conditions

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acne Vulgaris?

The complications of Acne Vulgaris may include:

• Scarring: Severe acne lesions can leave permanent scars or pitted skin
• Hyperpigmentation: Dark spots or patches may occur after acne lesions heal
• Psychological effects: Acne can have a significant impact on self-esteem, body image, and emotional well-being

How is Acne Vulgaris Treated?

The treatment options for Acne Vulgaris include:

• Topical medications (e.g., benzoyl peroxide, retinoids, antibiotics, azelaic acid, and clascoterone anti-androgen)
• Oral medications (e.g., antibiotics, spironolactone hormonal therapy, and isotretinoin)
• Procedures such as chemical peels, laser therapy, and extraction of comedones
• Skincare routine adjustments (e.g., gentle cleansing, non-comedogenic products, etc.)
• Lifestyle modifications, including stress reduction and dietary changes

Note: Isotretinoin should NOT be used on pregnant women or on women who are planning to become pregnant. This is very important because isotretinoin can cause fetal abnormalities and malformations during the growth of the fetus in the mother’s womb, termed teratogenic defects of isotretinoin. Hence, a pregnancy test is usually performed in women of childbearing age before starting treatment with isotretinoin.

Taking care of oneself, being clean and hygienic (especially face and hands), avoiding the urge to touch/break the blisters, avoiding oily make-ups and creams, drinking lots of water, etc., are all simple practices that can ensure a faster recovery from acne.

How can Acne Vulgaris be Prevented?

While it may not be possible to prevent all cases of Acne Vulgaris, the following measures can help reduce the risk:

• Maintain good skin hygiene by washing gently and avoiding excessive scrubbing
• Use non-comedogenic or oil-free skincare products
• Avoid picking or squeezing acne lesions to prevent further inflammation or scarring
• Manage stress levels through healthy coping mechanisms
• Follow a balanced diet that includes fruits, vegetables, and whole grains

What is the Prognosis of Acne Vulgaris? (Outcomes/Resolutions)

Acne Vulgaris is a treatable condition and, in most cases, can be effectively managed.

• With appropriate treatment, the majority of acne lesions improve, and scarring can be minimized. However, the duration of treatment and outcomes vary depending on the severity of the condition, adherence to treatment, and individual factors
• Early intervention and consistent management increase the chances of successful resolution and prevention of complications

Additional and Relevant Useful Information for Acne Vulgaris:

• There is no evidence to prove that oily foods and chocolate-based products have an influence on Acne
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition
• The presence of dirt on the body is not a causative factor for acne, but it helps to be clean and hygienic