Acne vulgaris is a common condition, which affects most people at some point
in their lives (1).
Acne vulgaris is a common, chronic, inflammatory disease of the pilosebaceous
This is a polymorphic eruption primarily of the face, which usually occurs
in adolescents during puberty. It also occurs on the upper trunk and neck. It
is characterised by the obstruction of the pilosabaceous follicle with keratin
plugs. This results in comedones (the primary non inflammatory lesions), inflammation
- nearly 90% of teenagers suffer from acne, and half of them will continue
to experience symptoms as adults (2)
- peak incidence is 13-16 years, although it may continue into the 20's,
30's and later
- females with polycystic ovary syndrome or those with excess cortisol
(e.g. steroid use) are prone
- by age 40 years, 1% of men and 5% of women still have lesions (3)
- acne has clear detrimental effects on a psychosocial level and can lead
to permanent scarring
- a common presenting complaint in primary care, accounting for more than
3.5 million annual visits to General Practitioners in the UK (4)
The condition may be triggered by an over-responsiveness of the sebaceous
glands to the effects of androgenic hormones which results in an increase in
sebum production (1). The anaerobic bacterium, Propionobacterium acnes has an
uncertain role. It may colonize the comedones, resulting in inflammation (1).
Occurrence before the onset of puberty requires further investigation to exclude
underlying adrenal pathology.
Acne vulgaris can be broadly categorized into:
here for an example image of this condition
Differential diagnoses include rosacea, folliculitis, angiofibromas, perioral
dermatitis, and keratosis pilaris.
Contributor: Dr Maryanne Hammon (GP; 24/3/14)
Clinical Knowledge Summaries.2006.Acne Vulgaris
- Yentzer BA, Hick J, Reese EL, Unhas A, Feldman SR, Balkrishnan R. Acne Vulgaris
in the Unites States: a descriptive epidemiology. Cutis 2010;86:94-99.
- Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults.
J Am Acad Dermatol 1999;41:577-80.
- Purdy S, e Berker D. Acne. BMJ 2006;333:949-53.