Lecture on Acne
1. Introduction
Acne is one of the most common skin conditions worldwide, affecting nearly 85% of people at some point in their lives. Though often associated with adolescence, it can persist into adulthood. Acne is not simply a cosmetic problem — it can affect self-esteem, mental health, and even leave permanent scars.
2. What is Acne?
Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit — that’s the hair follicle plus its attached oil (sebaceous) gland.
The main clinical features include:
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Comedones (blackheads and whiteheads)
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Papules and pustules (red or pus-filled bumps)
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Nodules and cysts (deeper, more painful lesions)
3. Pathophysiology (Why it Happens)
Acne develops due to four main processes working together:
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Increased sebum production
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Triggered by androgens (male-type hormones present in both sexes).
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Oily skin provides the perfect environment for acne.
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Abnormal keratinization
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Skin cells lining the follicle don’t shed normally.
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They clump together, plugging the pore.
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Bacterial overgrowth
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The main bacteria is Cutibacterium acnes (formerly Propionibacterium acnes).
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It thrives in clogged, oily follicles.
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Inflammation
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The immune system reacts to bacteria and blocked pores, creating redness, swelling, and pain.
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4. Risk Factors
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Age: Most common in teens, but can appear at any age.
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Hormones: Puberty, menstrual cycles, pregnancy, or hormonal disorders (like PCOS).
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Genetics: Family history strongly influences acne severity.
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Diet: High-glycemic foods, dairy, and certain fats may worsen acne in some people.
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Stress: Doesn’t cause acne, but can flare it.
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Cosmetics or medications: Heavy oils, steroids, or certain drugs may trigger outbreaks.
5. Classification (Types of Acne)
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Mild: Mostly comedones, few papules/pustules.
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Moderate: More widespread papules and pustules.
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Severe: Nodules, cysts, risk of scarring.
6. Treatment Approaches
Treatment depends on severity and patient profile.
Topical therapies (first-line for mild acne):
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Benzoyl peroxide → kills bacteria, reduces inflammation.
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Retinoids (adapalene, tretinoin) → unclog pores, normalize shedding.
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Topical antibiotics → clindamycin, erythromycin (often combined with benzoyl peroxide).
Systemic therapies (for moderate-to-severe acne):
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Oral antibiotics (doxycycline, minocycline).
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Hormonal therapies (oral contraceptives, spironolactone in women).
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Isotretinoin (“Accutane”) → highly effective but with significant monitoring.
Other approaches:
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Chemical peels, laser/light therapy.
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Gentle skin care (non-comedogenic moisturizers, mild cleansers).
7. Psychosocial Impact
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Acne can affect self-esteem, social interactions, and mental health.
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Studies link it with higher rates of anxiety and depression.
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Addressing these aspects is as important as treating the skin.
8. Prevention & Myths
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Washing too much doesn’t “cure” acne — over-washing can irritate skin.
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Chocolate and greasy foods are not direct causes, though diet plays a role.
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Acne is not caused by poor hygiene.
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Early treatment reduces the risk of scarring.
9. Conclusion
Acne is a multifactorial condition involving hormones, oil production, bacteria, and inflammation. While common, it deserves serious attention because of both its physical and emotional impact. Modern medicine offers many effective therapies — but management often requires patience, consistency, and sometimes a combination of treatments.