GUIDELINES IN DERMATOLOGY

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ACNE VULGARIS

Selda Pelin Kartal1
Tuğcan Yüksek2

1University of Health Sciences, Ankara Etlik City Hospital, Department of Dermatology, Ankara, Türkiye
2Girne Dr. Akçiçek Hospital, Department of Dermatology, Girne, KKTC

Kartal SP, Yüksek T. Acne Vulgaris. In: Kutlubay Z, editor. Guidelines in Dermatology. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.1-14.

ABSTRACT

Acne vulgaris is a chronic inflammatory disorder affecting the pilosebaceous units, and it remains one of the most prevalent dermatologic conditions globally. Beyond its dermatological manifestations, acne significantly impacts patients’ psychological well-being and social functioning, necessitating a comprehensive, evidence-based approach to management. This guideline provides a detailed overview of the pathogenesis, clinical classification, differential diagnosis, and therapeutic strategies for acne vulgaris, offering dermatologists a robust framework for optimizing patient outcomes.

The pathogenesis of acne involves a complex interplay of factors, including excessive sebum production, abnormal follicular keratinization, inflammatory responses, and colonization by Cutibacterium acnes. Androgen-mediated sebogenesis plays a pivotal role, while dietary factors, such as high-glycemic diets and dairy consumption, have been implicated in disease exacerbation. Clinically, acne encompasses a spectrum of non-inflammatory (open and closed comedones) and inflammatory (papules, pustules, nodules) lesions, necessitating accurate grading in order to guide appropriate treatment. Treatment paradigms are stratified by severity and patient-specific factors. Topical therapies, including retinoids, benzoyl peroxide, and antibiotics, form the foundation for mild to moderate acne. Systemic agents such as oral antibiotics, hormonal therapies, and isotretinoin are reserved for moderate to severe cases or cases refractory to topical treatment. Isotretinoin, in particular, addresses all key pathogenic pathways and remains the gold standard for severe, nodulocystic acne. Emerging modalities, including laser and light-based therapies, provide promising adjuncts for resistant acne and scarring, although further validation is required. Patient education plays a crucial role in managing acne vulgaris. Emphasis on lifestyle modifications, including dietary adjustments and proper skincare routines, is essential for complementing pharmacologic interventions. Additionally, addressing the psychosocial impact of acne is vital, as the condition significantly affects the self-esteem and quality of life of affected individuals.

This guideline aims to equip dermatologists with the latest scientific insights and practical recommendations, ensuring a holistic and individualized approach to the management of acne vulgaris. By bridging current evidence with clinical application, it seeks to enhance therapeutic outcomes and improve the overall care of patients affected by this condition.

Keywords: Acne; Acne vulgaris; Acne management; Guideline; Classification of acne

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