Acne (Vulgaris, Cystic, Hormonal)
Symptoms
Acne presents as whiteheads, blackheads, open or closed comedones, papules, pustules, cysts, or nodules on the face, chest, back, or shoulders. Lesions may be tender, inflamed, or filled with pus. Oiliness and enlarged pores often accompany breakouts. Flare‑ups can worsen around menstruation, stress, or high‑humidity climates. Post‑inflammatory hyperpigmentation and scarring may develop after lesions heal.
Cause
Acne results from clogged hair follicles due to excess sebum, dead skin cells, and bacteria (mainly Cutibacterium acnes). Hormonal changes—especially androgens—stimulate sebaceous glands to produce more oil. Genetics influence individual susceptibility and lesion severity. External factors like occlusive cosmetics, friction, or certain medications can trigger breakouts. Diets high in dairy or high‑glycemic foods may contribute in some individuals.
Treatment
Topical retinoids normalize skin-cell turnover and unclog pores. Benzoyl peroxide and topical antibiotics reduce bacterial load and inflammation. Oral antibiotics, combined oral contraceptives, or anti‑androgen agents (e.g., spironolactone) address moderate to severe or hormonal acne. Isotretinoin is reserved for severe cystic or treatment‑resistant cases. Adjunctive procedures such as chemical peels, Hydrafacial, light‑based therapies, or cortisone injections can speed resolution and minimize scarring.
Dr. Beth Schulz-Butulis
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