Summary
Definition
History and exam
Key diagnostic factors
- skin lesions
Other diagnostic factors
- skin tenderness
- systemic complaints
Risk factors
- adolescence or young adult
- genetic predisposition
- oily skin/increased sebum production
- use of certain drugs
- use of masculinizing hormone therapy
- endocrine disorders
- dietary factors
- female sex
- obesity/insulin resistance
- halogenated aromatic hydrocarbons exposure
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- hormonal evaluation
- bacterial culture
Treatment algorithm
mild acne: nonpregnant
moderate to severe acne or acne resistant to standard treatment: nonpregnant
pregnant
Contributors
Authors
Robert P. Dellavalle, MD, PhD, MSPH
Professor of Dermatology and Public Health
University of Minnesota Dermatology Department
National Dermatology Program Director
US Department of Veterans Affairs
Minneapolis
MN
Disclosures
RPD has received editorial stipends (Journal of Medical Internet Research Dermatology (JMIR Dermatology)), royalties (UpToDate), and expenses reimbursement (Cochrane). RPD is an editor-in-chief of JMIR Dermatology, a joint coordinating editor for Cochrane Skin, a dermatology section editor for UpToDate, a social media editor for JAAD, and a coordinating editor representative on the Cochrane Council. He is a Cochrane Council Co-Chair, and serves as the National Dermatology Program Director for the US Department of Veteran Affairs.
Torunn E. Sivesind, MD
Dermatology Resident Physician
University of Colorado Anschutz School of Medicine
Aurora
CO
Disclosures
TES previously received fellowship funding from Pfizer and the National Institute of Health; TES previously served as an editorial board member-at-large for the Journal of Medical Internet Research Dermatology.
Acknowledgements
Professor Dellavalle and Dr Sivesind would like to gratefully acknowledge Dr Madeline Adelman, Dr Romerio Rodriguez, Dr Sarah Shangraw, Dr Mark Naftanel, Dr Yolanda Rosi Helfrich, and Dr Amanda Howland, previous contributors to this topic. The authors would like to thank Dr John Barbieri for his review of the topic. JB has received consulting fees from Dexcel Pharma.
Disclosures
SS, MN, YRH, and AH declare that they have no competing interests. MA has received fellowship funding from the Pfizer Global Medical Grant, RR receives fellowship funding from the National Institute of Health.
Peer reviewers
Gina Taylor, MD
Resident
Department of Dermatology
SUNY Downstate Medical Center
New York
NY
Disclosures
GT declares that she has no competing interests.
Gillian Murphy, MD, FRCPI, FRCP, Edin
Consultant Dermatologist
Dermatology
Beaumont Hospital
Dublin
Ireland
Disclosures
Not disclosed.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
National Institute for Health and Care Excellence. Acne vulgaris: management. Dec 2023 [internet publication].Full text
Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024 May;90(5):1006.e1-30.Full text Abstract
Thiboutot DM, Dréno B, Abanmi A, et al. Practical management of acne for clinicians: an international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018 Feb;78(2 suppl 1):S1-23;e1. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Acne keloidalis nuchae
- Acneiform eruptions
- Chloracne
More DifferentialsGuidelines
- Guidelines of care for the management of acne vulgaris
- Acne vulgaris: management
More GuidelinesPatient information
Acne
More Patient information
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