Diagnosis: Acne vulgaris
Image of an 18 year old male with moderate acne vulgaris (white heads). His face appears to be very oily as well.. Clinical photograph sourced from Wikimedia Commons (CC BY-SA 4.0). Attribution: Roshu Bangal.
Presents with open and closed comedones, inflammatory papules, pustules, and in severe cases, nodules and cysts. Lesions predominantly affect the face, chest, and upper back. Post-inflammatory hyperpigmentation and scarring may develop.
Onset typically in adolescence with hormonal changes. May be exacerbated by stress, certain medications (corticosteroids, lithium, androgens), occlusive cosmetics, and dietary factors. Family history of severe acne is a risk factor.
Mild: topical retinoids + benzoyl peroxide. Moderate: add topical/oral antibiotics. Severe/nodulocystic: oral isotretinoin. Hormonal: spironolactone or combined OCPs in females. Adjuncts: chemical peels, phototherapy.
Rosacea, Folliculitis, Perioral dermatitis, Keratosis pilaris, Drug-induced acneiform eruption
Grade severity using the Global Acne Grading System. Isotretinoin requires iPLEDGE registration. Antibiotic stewardship is critical — limit oral antibiotic courses to 3 months. Always combine antibiotics with benzoyl peroxide to reduce resistance.
Tags: acne, inflammatory, comedonal, pilosebaceous