What is Acne Vulgaris?

Acne vulgaris (cystic acne or simply acne) is a common human skin disease, characterized by areas of skin with seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), pustules (pimples), nodules (large papules) and possibly scarring. Acne affects mostly skin with the densest population of sebaceous follicles; these areas include the face, the upper part of the chest, and the back. Severe acne is inflammatory, but acne can also manifest in noninflammatory forms. The lesions are caused by changes in pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland, changes that require androgen stimulation.

Acne occurs most commonly during adolescence, and often continues into adulthood. In adolescence, acne is usually caused by an increase in testosterone, which accrues during puberty, regardless of sex.

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Presentation

Acne usually presents with a greasy skin with a mixture of comedones, papules and pustules, which present just after puberty and continue for a variable number of years, usually stopping in late teens or early 20s but uncommonly continuing well into adulthood.

The face is affected in 99% of cases, the back in 60% and the chest in 15%.

Acne runs a variable course with marked fluctuations.

Nodulocystic acne: severe acne with cysts. Cysts can be painful. They may occur in isolation or be widespread over the face, neck, scalp, back, chest and shoulders.

The severity of the condition varies enormously between individuals. It is unsightly but the degree of distress is sometimes disproportionate.