Acne Vulgaris
Also known as: Acne, Pimples, Breakouts
The most common skin condition worldwide - affects 85% of teenagers. Caused by clogged pores, bacteria, hormones, and inflammation.
What to look for
Side-by-side comparison
Clear skin
No breakouts
Acne
Blackheads, pimples, cysts
Acne vulgaris is the most common skin condition, affecting approximately 85% of people between ages 12 and 24. It occurs when hair follicles become clogged with dead skin cells and sebum (oil), creating an environment where the bacterium Cutibacterium acnes thrives, triggering inflammation.
Acne presents as various lesion types: comedones (blackheads and whiteheads), papules (small red bumps), pustules (bumps with pus), nodules (large, painful, deep bumps), and cysts (deep, pus-filled lesions that can cause scarring).
Four key factors drive acne: excess sebum production (often hormonally driven), abnormal follicular keratinization (dead skin cells sticking together and blocking pores), C. acnes bacterial colonization, and inflammation.
Treatment is tailored to severity. Mild acne: topical retinoids and benzoyl peroxide. Moderate: add topical or oral antibiotics. Severe or scarring: isotretinoin (Accutane), the most effective acne treatment available, achieving long-term remission in approximately 85% of patients after one course. Hormonal therapy (spironolactone, combined oral contraceptives) is effective for hormonally driven acne in women.
Early effective treatment is important to prevent scarring. Post-inflammatory hyperpigmentation and acne scars are often more distressing than the acne itself and are harder to treat.
Quick self-check
Does this look like acne vulgaris? Answer 2 questions.
Do you have a mix of blackheads, whiteheads, and red bumps?
Is it mainly on the face, chest, or back (areas with many oil glands)?
Risk factors
- Puberty and hormonal changes
- Family history of acne
- Hormonal fluctuations (menstrual cycle, PCOS)
- Certain medications (steroids, lithium)
- Occlusive cosmetics and skincare products
- Stress (worsens via cortisol)
When to see a dermatologist
- ⚠Acne not improving with over-the-counter benzoyl peroxide and retinoids after 2-3 months
- ⚠Painful, deep nodules or cysts
- ⚠Acne leaving scars
- ⚠Acne significantly affecting self-esteem or mental health
Often confused with
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Full ABCDE check →Frequently asked questions
Does diet cause acne?
The relationship is nuanced. High-glycemic foods and dairy (especially skim milk) show some association with acne in studies, but diet is rarely the primary cause. Hormones, genetics, and skincare habits play larger roles.
Is isotretinoin (Accutane) safe?
Isotretinoin is the most effective acne treatment, achieving long-term remission in about 85% of patients. It requires monitoring for side effects (dry skin, mood changes, liver function) and strict pregnancy prevention. For severe acne, the benefits typically far outweigh risks.
Related conditions
Rosacea
Chronic facial redness, visible blood vessels, and sometimes bumps. Common triggers: heat, alcohol, spicy food, stress.
Folliculitis
Infected or inflamed hair follicles causing red, tender bumps. Common from shaving, tight clothing, or hot tubs.
Perioral Dermatitis
Red, bumpy rash around the mouth and nose - often triggered by topical steroids. Common in women aged 20-45.