Etiology

  • Hormonal changes (androgens)

  • Follicular keratinization

  • Cutibacterium acnes proliferation

  • Excess sebum production

Pathogenesis

  • Follicle obstruction → comedones

  • Bacterial colonization → inflammation → papules/pustules

  • Deep inflammation → nodules/cysts

Clinical Features

  • Open/closed comedones

  • Papules, pustules, nodules

  • Common on face, chest, back

Treatment

  • Topical retinoids

  • Benzoyl peroxide

  • Topical/oral antibiotics

  • Oral isotretinoin (severe nodulocystic acne)

  • Hormonal therapy (OCPs, spironolactone)