Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (156)

Acne vulgaris in Adult
Other Resources UpToDate PubMed

Acne vulgaris in Adult

Contributors: Rajini Murthy MD, Youssef Salem MD, Lorena A. Mija, John Barbieri MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

This summary discusses acne in adults. Acne in neonates and acne in infants are addressed separately.

Acne, or acne vulgaris (typical teenage acne), is an extremely common, usually self-limited, chronic inflammatory condition of the pilosebaceous unit. The pathogenesis involves multiple factors, including (1) increased sebum production, (2) follicular hyperkeratinization and corneocyte hypercohesiveness, (3) proliferation of the bacterium Cutibacterium acnes (formerly known as Propionibacterium acnes), and (4) inflammation that is neutrophil-driven in early lesions and Th1/Th17 driven in established lesions. Acne vulgaris typically begins at puberty as a result of androgen stimulation of the pilosebaceous unit and changes in the keratinization at the follicular orifice.

There is a wide spectrum of clinical disease, ranging from a few comedones to many inflamed papules, pustules, and nodules. While there is no single severity grading system that has been adopted by all clinicians, the Investigator Global Assessment (IGA) is most commonly utilized in the United States.

Acne vulgaris is most commonly found on areas of skin with the greatest density of sebaceous follicles, such as the face, back, and upper chest. Acne can affect people of every race and ethnicity. Acne can last through the teenage years into adulthood. Women are more likely than men to have acne in adulthood, which in many cases is thought to be hormonally driven. While a benign condition, acne can lead to permanent scarring and significant psychosocial distress. Therefore, initiation of treatment in the earliest stages is preferable.

Patients with hyperandrogenic states (ie, HAIR-AN syndrome, polycystic ovary syndrome [PCOS]) and hypercorticism (ie, Cushing syndrome, ectopic ACTH syndrome, congenital adrenal hyperplasia) have an increased risk of developing acne.

A number of medications have been reported to cause acne vulgaris or an acneiform eruption. Most commonly, this is seen in patients who have received systemic corticosteroids or are using topical corticosteroids, or individuals using anabolic steroids (see steroid acne). Acneiform eruptions also have been reported in patients treated with cetuximab, gefitinib, and erlotinib (see EGFR inhibitor-induced papulopustular eruption), danazol, stanozolol, testosterone, lithium, quetiapine, iodides, bromides, isoniazid, phenytoin, cyclosporine, granulocyte-colony stimulating factor (G-CSF), medroxyprogesterone, low-estrogen oral contraceptives, progesterone-only birth control, phenobarbital, propylthiouracil, and vitamins B2, B6, and B12. JAK inhibitors (JAKi) have also been shown to induce acne and acneiform eruptions, as well as exacerbate underlying acne. While the onset of the eruption varies among the different agents, it typically occurs within 1-2 weeks of initiating systemic corticosteroid therapy.

Occupational acne can occur from chemicals in the workplace including petroleum and its derivatives, certain coal-tar products, and halogenated aromatic compounds (chloracne).

Related topics: acne conglobata, acne excoriée, acne fulminans, acne mechanica, acne necrotica, cosmetic-induced acne

Codes

ICD10CM:
L70.0 – Acne vulgaris

SNOMEDCT:
88616000 – Acne vulgaris

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Subscription Required

References

Subscription Required

Last Reviewed:04/21/2024
Last Updated:05/23/2024
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Acne vulgaris in Adult
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Acne vulgaris in Adult
A medical illustration showing key findings of Acne vulgaris : Erythema, Face, Superior chest, Upper back, Smooth papules
Clinical image of Acne vulgaris - imageId=2106161. Click to open in gallery.  caption: 'Multiple open and closed comedones and a few excoriated papules on the forehead.'
Multiple open and closed comedones and a few excoriated papules on the forehead.
Copyright © 2024 VisualDx®. All rights reserved.