Acne Vulgaris: Causes, Symptoms and Treatments

Written by Medicover Team and Medically Reviewed by Dr Girishma J , Dermatologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Acne vulgaris is an inflammatory skin disorder that primarily affects the pilosebaceous units (hair follicles and sebaceous glands). It most commonly occurs during adolescence but can persist into adulthood.

The condition is marked by the presence of comedones (blackheads and whiteheads), papules, pustules, nodules, and in severe cases, cysts.

What Are the Types of Acne Vulgaris?

There are various types of Acne vulgaris manifests in various forms, each requiring different approaches to treatment.

Comedonal Acne

This type is characterized by the presence of comedones, including blackheads and whiteheads. Comedonal acne is usually non-inflammatory and is often treated with topical retinoids.

Inflammatory Acne

Inflammatory acne includes papules, pustules, and nodules. It is more severe than comedonal acne and can cause significant inflammation and discomfort. Treatment often involves a combination of topical and oral medications.

Cystic Acne

Cystic acne is the most severe form of acne vulgaris, characterized by large, painful cysts. This type often requires aggressive treatment, including oral isotretinoin and corticosteroid injections.

What Are the Causes of Acne Vulgaris?

Acne vulgaris is a common skin condition caused by a combination of factors that lead to blocked hair follicles, excess oil production, inflammation, and bacterial growth. Both internal and external factors can contribute to its development.

Excess sebum production: Overactive sebaceous glands increase oil buildup, leading to clogged pores.
Blocked hair follicles: Dead skin cells accumulate and obstruct pores, promoting acne formation.
Bacterial growth: Overgrowth of Cutibacterium acnes triggers inflammation within blocked follicles.
Hormonal changes: Androgen fluctuations during puberty, menstruation, or stress increase oil production.
Genetic factors: Family history of acne increases the likelihood of developing the condition.
Dietary influences: High glycemic foods and dairy products may worsen acne in some individuals.
Stress: Increases hormone levels that can aggravate acne breakouts.
Cosmetic products: Heavy or comedogenic skincare and makeup products can clog pores.
Medications: Certain drugs such as steroids or lithium may trigger acne flare-ups.

What Are the Symptoms of Acne Vulgaris?

The acne vulgaris symptoms can vary in severity and type, including:

Comedones: Blackheads and whiteheads
Papules: Small, red, raised bumps
Pustules: Red bumps with white or yellow pus-filled centers
Nodules: Large, painful lumps beneath the skin
Cysts: Deep, painful, pus-filled lesions

When to See a Dermatologist?

If acne is causing significant pain, scarring, or affecting your self-esteem and daily life, it may require professional treatment beyond over-the-counter remedies or hospital-level care.

You should see a doctor if you have:

Persistent or worsening acne that does not respond to over-the-counter treatments after several weeks.
Deep, painful cysts or nodules that are leaving permanent scars on your skin.

Get medical help immediately if:

Your acne is accompanied by a high fever, severe swelling, or spreading redness suggesting infection.
You experience sudden widespread breakouts along with joint pain or other systemic symptoms.

These could be signs of a serious complication like Acne Fulminans, which needs urgent care.

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How is Acne Vulgaris Dianosis Performed?

Diagnosis of acne vulgaris is primarily based on clinical evaluation of the skin. A dermatologist assesses the type, severity, and distribution of lesions along with the patient's medical history.

Clinical examination: Visual inspection of comedones, papules, pustules, nodules, and cysts on the face, chest, and back.
Medical history: Assessment of onset, duration, triggers, diet, medications, and family history of acne.
Severity grading: Classification of acne as mild, moderate, or severe based on lesion type and extent.
Hormonal evaluation (if needed): Recommended in cases of suspected hormonal imbalance, especially in females with irregular cycles.
Skin assessment: Evaluation of oiliness, inflammation, and presence of scarring or pigmentation.
Exclusion of other conditions: Differentiation from acne-like eruptions such as rosacea or folliculitis.

What Are the Treatment Options for Acne Vulgaris?

The effective acne vulgaris treatment requires a multifaceted approach, often involving a combination of topical and systemic therapies.

Retinoids: Topical retinoids, such as tretinoin and adapalene, are derived from vitamin A and are effective in treating comedonal acne. They work by promoting cell turnover and preventing the formation of comedones.
Benzoyl Peroxide: Benzoyl peroxide is a powerful antibacterial agent that targets P. acnes. It is often used in combination with other treatments to enhance efficacy.
Antibiotics: Topical antibiotics, such as clindamycin and erythromycin, help reduce inflammation and bacterial proliferation. These are typically used in combination with benzoyl peroxide to prevent antibiotic resistance.
Oral Antibiotics: Oral antibiotics, such as doxycycline and minocycline, are prescribed for moderate to severe inflammatory acne. They work by reducing P. acnes and inflammation.
Hormonal Therapies: For female patients, hormonal therapies, including oral contraceptives and anti-androgens like spironolactone, can be effective in reducing acne lesions by regulating hormonal fluctuations.
Isotretinoin: Isotretinoin, a potent oral retinoid, is reserved for severe, treatment-resistant acne. It reduces sebum production, keratinization, and P. acnes proliferation. Due to its potential side effects, isotretinoin requires close monitoring by a healthcare professional.
Homeopathic Treatments: Some people seek homeopathic remedies such as sulfur, pulsatilla, and hepar sulphuris, though their efficacy lacks strong scientific backing.

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How can I reduce the Risk of Acne?

While you can't fully prevent acne, especially during hormonal changes, there are you can take to lower your risk:

Wash your face daily with warm water and a gentle facial cleanser.
Use an oil-free moisturizer.
Choose non comedogenic makeup products and always remove makeup before bed.
Avoid touching your face with your hands.

Lifestyle and Home Remedies

In addition to medical treatments, lifestyle modifications can play a crucial role in managing acne vulgaris.

Skincare Routine

A consistent skincare routine tailored to acne-prone skin is essential. This includes gentle cleansing, exfoliation, and the use of non-comedogenic moisturizers and sunscreens.

Diet

Adopting a diet low in refined sugars and dairy products may help reduce acne breakouts. Incorporating foods rich in antioxidants and omega-3 fatty acids can also promote healthier skin.

Stress Management

Stress reduction techniques, such as yoga, meditation, and regular exercise, can help mitigate the impact of stress on acne severity.

Frequently Asked Questions

1. What causes acne vulgaris?

Acne vulgaris is caused by clogged hair follicles, often due to excess oil production, dead skin cells, and bacterial infections.

2. What are the symptoms of acne vulgaris?

Symptoms include pimples, blackheads, whiteheads, and, in severe cases, cysts on the face, chest, back, and shoulders.

3. How is acne vulgaris treated?

Treatment includes topical treatments like benzoyl peroxide, salicylic acid, and retinoids, as well as oral medications like antibiotics or hormonal therapy.

4. What are the types of acne vulgaris?

Types include comedonal acne, inflammatory acne, cystic acne, and hormonal acne, each varying in severity and treatment.

5. What creams are recommended for acne vulgaris?

Creams containing benzoyl peroxide, retinoids, or salicylic acid are commonly used to treat acne vulgaris and reduce inflammation.

6. Is acne vulgaris fungal or bacterial?

Acne vulgaris is primarily a bacterial condition, caused by the overgrowth of Propionibacterium acnes bacteria in clogged pores.

7. How to control hormonal acne?

To control hormonal acne, consider using topical treatments like benzoyl peroxide or retinoids, oral contraceptives for hormone regulation, and maintaining a consistent skincare routine.

8. Who does Acne Affect?

Acne affects almost everyone at some point in their life. It's most common in teenagers and young adults due to hormonal changes, but adults can get acne too. Adult acne is more frequent in women and people assigned female at birth (AFAB). You may be more likely to develop acne if it runs in your family.