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Acne Vulgaris and it's Management

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Acne Vulgaris and it's Management

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Acne vulgaris is commonly known as acne, which is a common skin condition affecting young adults. Though it is associated with significant psychological morbidity, it can be managed effectively with a daily skincare routine and medicines. Read the article to know more.

Medically reviewed by

iCliniq medical review team

Published At May 6, 2014
Reviewed AtSeptember 16, 2023

What Is Acne Vulgaris?

Acne vulgaris is a common skin concern in adolescents and may sometimes persist in adulthood too. It is a skin disorder involving pilosebaceous follicles or oil glands and is therefore seen to involve areas where oil glands are dense. Hence face, chest, back, upper arms are common sites of involvement.

Though acne is commonly seen in oily skin, it can involve dry skin too due to blockage of oil glands when excessive creams or thick greasy creams are used to moisturize the skin.

Acne can present as whiteheads, blackheads, papules, pustules, nodules, and abscesses. If not treated properly, it will leave extensive scarring and pigmentation in the skin.

What Is the Pathophysiology of Acne Vulgaris?

Acne occurs due to four major factors. They are,

  • Excessive sebum production.
  • Follicular plugging of sebum and keratinocytes.
  • Colonization of follicles by Cutibacterium acnes, a normal human anaerobe.
  • Release of multiple inflammatory mediators.

How Are Acne Vulgaris Classified?

They can be classified as,

  • Non-inflammatory Acne - Characterized by comedones.
  • Inflammatory Acne - Characterized by pustules, papules, nodules, and cysts.

Non-Inflammatory Acne:

Comedones are sebaceous plugs that are impacted within the follicles. Depending on the follicle being dilated or closed at the skin surface, they are named opened and closed comedones. The plugs are easily removed from open comedones but are difficult to remove from closed comedones. Closed comedones can lead to inflammatory acne.

Inflammatory Acne:

Papules and pustules occur when Cutibacterium acnes in the closed comedones break down sebum into free fatty acids. It irritates the follicular epithelium by the inflammatory response of neutrophils and lymphocytes. The inflamed follicle ruptures into the dermis, where the comedone contents cause a further local inflammatory reaction, producing papules. When the inflammation is severe, grossly purulent pustules occur.

What Are the Common Causes of Acne?

Excessive use of cosmetics, oily creams, facials, medicines like steroids, menses, humid weather, a hormonal disorder like polycystic ovarian disease can precipitate acne. Diet has a role in acne too. It has been documented that dairy products and foods with a high glycemic index like refined carbohydrates may cause acne.

What Are the Symptoms and Signs of Acne Vulgaris?

Skin lesions and scarring can cause significant emotional distress, while nodules and cysts are more painful.

1. Comedones - There are different types of skin lesions where comedones appear as whiteheads or blackheads. Whiteheads are closed comedones that are whitish palpable lesions (flesh-colored) of 1 to 3 mm in diameter. Blackheads are open comedones that are similar in appearance with a dark center.

2. Pustule - Pustules are elevated, yellow-topped lesions that contain pus, and they appear scattered on the face of the person with acne. They are 2 to 5 mm in diameter and are more superficial.

3. Papules - Papules are red lesions of 2 to 5 mm in diameter, which are relatively deep.

4. Nodules - Nodules are more prominent, more profound, and more solid than papules. These lesions resemble inflamed epidermoid cysts, although they lack actual cystic structure.

5. Cysts - Cysts are suppurative nodules that rarely form deep abscesses. In the case of long-term cystic acne, scarring manifests as tiny and deep pits (icepick scars), shallow depressions, larger pits, or hypertrophic scarring or keloids.

How Is Acne Managed?

In order to understand the management of acne, it is essential to understand its pathogenesis. Acne is basically seen in excessively oily skin (seborrhoea) due to the blockade of oil glands by the shedding of ductal cells. This blockade leads to the growth of a bacteria known as propionibacterium acnes.

Also, androgen (hormone) has a role to play in acne. The medicines used in acne are basically meant to target these underlying causes.

  • Antibiotics like Clindamycin, Nadifloxacin, Benzoyl peroxide are used to control the bacteria Propionibacterium acnes.
  • Seborrhoea is controlled by using Glycolic or Salicylic acid-based face washes or Tretinoin/ Adapalene gels.
  • Retinoids are a group of drugs (Isotretinoin) that are said to work on all stages of acne. In cases of hormonal derangement, medicines like Cyproterone acetate, oral contraceptives, etc., are added to control acne flare-ups.

How Is Acne Treated?

Treatment is suggested according to the type of acne.

  • If lesions are mainly comedonal - Salicylic or Glycolic acid-based face wash along with night application of Adapalene gel helps. Sometimes for faster response, Salicylic acid peels are added too. Also, the patient should be advised to get blackheads or whiteheads extracted daily.

  • If lesions are red bumps or pustules - Benzoyl peroxide-based face wash along with the application of Clindamycin and/or Benzoyl peroxide cream and Tretinoin or Adapalene gel in the night helps. If required, antibiotics like Azithromycin, Doxycycline, Minocycline, or lymecycline can be added.

  • If lesions are severe, like nodules and cysts - Oral Isotretinoin is the drug of choice and gives magnificent results.

Home Remedies:

You can try to control mild or moderate acne with good basic skin care and other self-care techniques. They are,

  1. Wash your face with a gentle skin cleanser.
  2. Avoid facial scrubs, astringents and masks frequently as they can irritate the skin.
  3. Products like Benzoyl peroxide, Salicylic acid, Glycolic acid can be used to dry the excess oil and peel the skin.
  4. Avoid oily, greasy cosmetics, hair styling products, sunscreens. Instead, use non-comedogenic or water-based products.
  5. After excessive sweating, heat and oil can lead to breakouts so having a bath will help.
  6. Do not prick or touch the acne as it may cause infection and scarring.
  7. Avoid contact with phones, tight collars or straps, helmets, and backpacks.

What Skin Care Is Needed in Acne-Prone Skin?

  • Use Salicylic acid or Glycolic acid-based face wash.
  • Get your comedones extracted regularly.
  • Use a mud mask weekly.
  • Use a water-based moisturizer, and even oily skin needs hydration.
  • Scrub your face two times a week.
  • Take Glycolic acid or Salicylic acid peels twice a week or monthly once to improve skin texture, for acne control, and reduce scars and marks.
  • Take a well-balanced nutritious diet and exercise daily.
  • Avoid face massages or the application of greasy cosmetics and oils.

Acne-prone skin needs proper skincare. If the right medicines and products are used, it is easy to manage acne.


It is advisable that one should consult a dermatologist for a proper personalized prescription and skincare regime rather than using home remedies, as acne can have long-term sequelae in the form of scars and marks if not treated adequately. Patients can easily get acne prescription online through dedicated platforms. These services enable individuals to connect with healthcare professionals remotely, discuss the concerns, and receive personalized treatment recommendations. Acne and acne scars cause anxiety and affect social relationships and self-image. Stress can even worsen acne. So, try to manage stress by practicing relaxation techniques and getting enough sleep.

Frequently Asked Questions


How Can You Differentiate Acne and Acne Vulgaris?

Acne can refer to the simple pimple or spots. Acne is commonly seen in teenage girls. Acne vulgaris is a condition where there is blockage of the hair follicles. This blockage can occur along with the oil and the dead cells of the skin. In simple terms, acne vulgaris is a pus-filled pimple.


What Bacteria Causes Acne Vulgaris?

The bacteria that cause acne vulgaris are:
- Staphylococcus aureus.
- Propionibacterium acnes.
- Propionibacterium acnes is the main causative agent for acne vulgaris. The severity of the acne depends on the number of bacteria involved.


How Does Acne Vulgaris Look Like?

Acne vulgaris can happen both as a non-inflammatory or inflammatory condition. It can present as pustules, papules, or nodules. It is known to affect several areas of the skin. The area which has the highest number of sebaceous follicles can invite acne vulgaris. The other sites where acne vulgaris can occur are the chest and the back portion.


What Are the Possible Triggers of Acne?

The possible triggers for the occurrence of acne are:
- Hormonal changes.
- Stress.
- Diet.
- Certain medications.


It Is Possible to Cure Acne Vulgaris?

In most cases, acne vulgaris cannot be cured fully. It is only possible to treat the symptoms. The symptoms can be alleviated with the help of topical application of medications and other prescribed drugs. You can get help from icliniq.com.


Can Acne Be Caused by Masturbation?

Acne is not associated with masturbation. The formation of acne due to masturbation is a complete myth. When there are a lot of physiological changes going on during adolescence, acne can occur.


Which Foods Can Cause Acne?

It is necessary to avoid the following foods as it can cause acne.
- Refined grains.
- Sugars.
- Whey protein powder.
- Fast food.
- Dairy products.
- Foods that are rich in omega-6 Fats.
- Chocolate.


What Are the Ways to Clear Acne Faster?

The following tips will be helpful in clearing the acne faster.
- Application of apple cider vinegar.
- Spot treatment with tea tree oil.
- Apply green tea to your skin.
- Apply witch hazel.
- Moisturize with aloe vera.
- Take a fish oil supplement.


How Can I Clear up Acne Fast?

Medications with Isotretinoin is very helpful in healing the acne faster. This medication is suggested when several other drugs are unsuccessful. It is advisable for faster healing of several other skin conditions also.


Is It Possible to Cure Acne Vulgaris Permanently?

It is hard to achieve a permanent cure for acne vulgaris. The severe cysts and nodules can be treated with oral Isotretinoin. A permanent clearing in the acne is seen after intake of this drug. It has several side effects associated with it. So it is necessary to get a prescription from the doctor.


How Long Can Acne Vulgaris Last?

Acne vulgaris can occur in age groups between 10 and 30. It is known to affect young women. Skin is the common site of occurrence in individuals. In young adults, acne can increase during the time of the menstrual period. The duration of occurrence can vary from one person to another.


Can Acne Indicate Poor Health?

Acne does not necessarily mean the occurrence of poor health. It can be due to a hormonal imbalance. The medical condition of the patient should be considered. If an imbalance in the diet pattern can cause acne, such foods should be avoided.


What Happens if Acne Is Left Untreated?

In most cases, the acne can clear itself after many years. It is not a threatening condition. Acne can develop at multiple sites if it is left untreated. If it appears as a multiple lesion, then it can produce severe scarring and pigmentation.


What Are the Home Remedies for Acne Vulgaris?

The home remedies for acne vulgaris are:
- Aloe vera.
- Cinnamon and honey mask.
- Green tea.


What Is the Actual Cause of Acne Vulgaris?

Acne vulgaris develops due to the obstruction of an oily substance that is plugging the hair follicles. The infections with the bacteria can also trigger the occurrence of acne vulgaris. Anxiety and certain medications can also cause acne vulgaris.


What Are the Precautionary Measures for Acne Vulgaris?

The precautionary measures to be followed for the prevention of acne vulgaris are:
- It is necessary to wash your face twice daily.
- It is mandatory to keep the hair clean.
- Picking at pimples should be avoided.
-Topical retinoids.
- Harsh scrubbing should be stopped.


How Do You Get Rid of Acne Vulgaris Naturally?

The following ways are helpful in getting rid of acne vulgaris naturally.
- You can try making a mask with honey and cinnamon mask.
- Take appropriate Zinc supplements.
- You can moisturize with aloe vera.
- You can try applying green tea to the skin.


What Is the Treatment for Acne Vulgaris?

The initial treatment process should begin with benzoyl peroxide. Topical application of retinoids and antibiotics can also be used. Oral pills of Tetracycline are known to be beneficial. Doxycycline and Minocycline are highly effective drugs. It is necessary to get recommendations from your doctor before going for it.
Dr. Kalpana Pathak
Dr. Kalpana Pathak



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