Acne – What It Is and How to Manage It
Lena Bauer
2026-03-23
10 min. read
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Acne is commonly perceived as a hormonal disorder, which is an integral part of the maturing process. However, it can be caused by various factors. How to effectively treat acne-affected skin? How to care for acne-prone skin? What are the causes of acne?
Acne Vulgaris: Definition, Etiology, and Pathophysiology of Cutaneous Lesions
Acne vulgaris, commonly referred to as "acne," represents a chronic inflammatory dermatological condition characterized by a complex and multifactorial pathogenesis. At its core lies a dysfunction of the pilosebaceous units, wherein sebaceous glands exhibit hyperactivity—resulting in excessive sebum secretion—coupled with aberrant epidermal keratinization, leading to hyperkeratinization of follicular cells. These pathological alterations culminate in the obstruction of hair follicle ostia, thereby impeding the normal extrusion of sebum onto the skin’s surface. The accumulated sebum fosters an optimal environment for colonization by anaerobic bacteria, most notably *Cutibacterium acnes* (formerly *Propionibacterium acnes*), as well as opportunistic pathogens such as yeast-like fungi of the *Malassezia* genus. This microbial proliferation triggers a cascade of inflammatory responses, manifesting as distinctive cutaneous lesions: open comedones ("blackheads"), closed comedones ("whiteheads"), papules, pustules, and, in severe cases, nodulocystic or abscess-like purulent formations. Left untreated, these lesions may rupture, giving rise to persistent atrophic or hypertrophic scarring, as well as post-inflammatory hyperpigmentation. The condition predominantly affects sebum-rich anatomical regions, including the face (particularly the "T-zone" comprising the forehead, nose, and chin), neck, upper chest, and back, though less frequently, it may extend to the shoulders or upper thighs.
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