Acne vulgaris

Last updated: April 4, 2022

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Acne vulgaris is a common skin disease that affects most individuals at some point in their lives. It is classified into different forms which vary in severity, lesion type, and localization, with the face commonly involved. The hallmark of acne are comedones, which can develop further into inflammatory papules, pustules, or even abscesses and nodules. Symptoms typically begin in early puberty and cease spontaneously during the third decade of life. There are multiple etiological factors: genetic predisposition, seborrhea, and hyperkeratosis are known to promote the development of acne. Topical and systemic treatment options are available to counteract inflammation and hyperkeratosis, as well as to help purify the skin.

  • Prevalence: the most prevalent chronic skin condition in the US [1]
  • Age of onset: typically by 11–12 years, with symptoms usually disappearing around 20–30 years of age [2]
  • Sex: more common in males during adolescence; , but more common in women during adulthood

Epidemiological data refers to the US, unless otherwise specified.

References:[5]

Hidradenitis suppurativa [6]

Neonatal cephalic pustulosis [10]

Infantile acne [10]

Acne fulminans [11]

Acne treatment [13]

Overview of acne treatment
Severity Treatment
Mild (e.g., comedonal)
Moderate (e.g., papular/pustular)
Severe (e.g., conglobata)

Therapy is particularly important for patients with inflammatory acne to prevent complications such as scarring.

Retinoids [5][13]

Retinoid therapy should be discontinued at the latest one month before planned conception.

  1. Oge' LK, Broussard A, Marshall MD. Acne Vulgaris: Diagnosis and Treatment.. Am Fam Physician. 2019; 100 (8): p.475-484.
  2. Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. 2013; 168 (3): p.474-485. doi: 10.1111/bjd.12149 . | Open in Read by QxMD
  3. Tuchayi SM, Makrantonaki E, Ganceviciene R, Dessinioti C, Feldman SR, Zouboulis CC. Acne vulgaris. Nature Reviews Disease Primers. 2015; 1 (1). doi: 10.1038/nrdp.2015.29 . | Open in Read by QxMD
  4. Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, Ellervik C. Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults.. Nutrients. 2018; 10 (8). doi: 10.3390/nu10081049 . | Open in Read by QxMD
  5. James WD, Berger T, Elston D. Andrews' Diseases of the Skin: Clinical Dermatology. Elsevier Health Sciences ; 2015
  6. Napolitano M, Megna M, Timoshchuk E, et al. Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment. Clinical, Cosmetic and Investigational Dermatology. 2017; Volume 10 : p.105-115. doi: 10.2147/ccid.s111019 . | Open in Read by QxMD
  7. Yu CC, Cook MG. Hidradenitis suppurativa: a disease of follicular epithelium, rather than apocrine glands.. Br J Dermatol. 1990; 122 (6): p.763-9. doi: 10.1111/j.1365-2133.1990.tb06264.x . | Open in Read by QxMD
  8. Zouboulis CC, Nogueira da Costa A, Fimmel S, Zouboulis KC. Apocrine glands are bystanders in hidradenitis suppurativa and their involvement is gender specific.. J Eur Acad Dermatol Venereol. 2020; 34 (7): p.1555-1563. doi: 10.1111/jdv.16264 . | Open in Read by QxMD
  9. Gupta AK, Knowles SR, Gupta MA, Jaunkalns R, Shear NH. Lithium therapy associated with hidradenitis suppurativa: Case report and a review of the dermatologic side effects of lithium. J Am Acad Dermatol. 1995; 32 (2): p.382-386. doi: 10.1016/0190-9622(95)90410-7 . | Open in Read by QxMD
  10. Neonatal and infantile acne. https://www.dermcoll.edu.au/atoz/neonatal-infantile-acne/. Updated: August 10, 2015. Accessed: March 10, 2017.
  11. Bocquet‐Trémoureux S, Corvec S, Khammari A, Dagnelie M ‐A., Boisrobert A, Dreno B. Acne fulminans and Cutibacterium acnes phylotypes. Journal of the European Academy of Dermatology and Venereology. 2019; 34 (4): p.827-833. doi: 10.1111/jdv.16064 . | Open in Read by QxMD
  12. Karon A. Experts present first recommendations for treating acne fulminans. MDEdge Dermatology. 2016 .
  13. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016; 74 (5): p.945-973. doi: 10.1016/ j.jaad.2015.12.037 . | Open in Read by QxMD
  14. Browne H, Mason G, Tang T. Retinoids and pregnancy: an update. The Obstetrician & Gynaecologist . 2014; 16 : p.7–11. doi: 10.1111/tog.12075 . | Open in Read by QxMD
  15. Infantile acne. http://www.dermnetnz.org/topics/infantile-acne/. Updated: February 1, 2014. Accessed: February 17, 2017.
  16. ACCUTANE® (isotretinoin capsules).

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