Acne is a common inflammatory disease that peaks in adolescence, but may affect any age group.
Lesions consist of noninflammatory comedones (whiteheads and blackheads) and inflammatory papules, pustules, nodules, and cysts.
Systemic effects may also be present with acne fulminans, a rare variant of nodulocystic acne.
Treatments include topical retinoids, keratolytics, hormonal therapy, and antibiotics; moderate to severe nodulocystic acne may require oral isotretinoin.
Acne vulgaris is a skin disease affecting the pilosebaceous unit. It is clinically characterized by comedones, papules, pustules, nodules, cysts, and/or scarring, primarily on the face and trunk. The severity of disease ranges from mild comedonal acne to severe nodulocystic acne, which can be permanently disfiguring. In addition to the physical lesions, acne can have profound psychological and social impact on patients.
History and exam
Key diagnostic factors
- skin lesions
Other diagnostic factors
- skin tenderness
- systemic complaints
- age 12 to 24 years
- genetic predisposition
- oily skin/increased sebum production
- masculinizing hormone therapy
- endocrine disorders
- dietary factors
- male sex (acne during adolescence)
- female sex (acne during adulthood)
- obesity/insulin resistance
- halogenated aromatic hydrocarbons exposure
1st investigations to order
- clinical diagnosis
Investigations to consider
- hormonal evaluation
- bacterial culture
not hormone-related (not pregnant)
hormone-related (women, not pregnant)
- Acne keloidalis nuchae
- Acneiform eruptions
- Acne vulgaris: management
- European evidence-based (S3) guideline for the treatment of acne
AcneMore Patient leaflets
- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer