Acne vulgaris
Abstract
Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting th…
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Acne vulgaris is characterized by excessive keratin deposition and an increase in SG size, which is dependent upon sebocyte hyperproliferation and sebum production.
“Acne vulgaris is characterized by excessive keratin deposition and an increase in SG size, which is dependent upon sebocyte hyperproliferation and sebum production.”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
Androgen stimulation plays a critical role in regulating sebocyte proliferation and driving the emergence of acne.
“Androgen stimulation has been found to play a critical role in regulating sebocyte proliferation and driving the emergence of acne2, while PPARs have been shown to alter sebaceous lipid production and modulate acne formation34, 35.”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
The lipid-rich environment of acne vulgaris allows C. acnes to flourish, which in turn triggers inflammation via induction of pro-inflammatory cytokines.
“This serves as an ideal lipid-rich environment for C. acnes to flourish which in turn triggers inflammation via the induction of pro-inflammatory cytokines2.”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
PPAR activators and the potent androgen DHT are known to lead to hyperseborrhoea and increased sebocyte proliferation.
“We administered the organoids with PPAR activators and the potent androgen, DHT, which are known to lead to hyperseborrohoea and increased sebcote proliferation2.”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
Retinoids are derivatives of vitamin A and serve as the first-line treatment for acne.
“Retinoids are derivatives of vitamin A, which serve as the first-line treatment for acne2.”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
All-trans-retinoic acid (ATRA; Tretinoin), formulated ATRA (Ret-Avit), and 13-cis RA (Isotretinoin) are used worldwide for acne.
“Specifically, all-trans-retinoic acid (ATRA; Tretinoin), formulated ATRA (Ret-Avit), and 13-cis RA (Isotrtinoin) are used worldwide2.”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
C. acnes upregulates the expression of pro-inflammatory cytokines in cultured sebocytes.
“it has been shown that C. acnes upregulates the expression of pro-inflammatory cytokines in cultured sebocytes2”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
Key features of acne development include disturbed SG activity resulting in excessive sebum, altered sebocyte proliferation and differentiation, dysregulation of the hormonal environment, hyperkeratinization, colonization of C. acnes, and inflammation.
“Some of the key features of acne development include disturbed SG activity resulting in excessive sebum, altered sebocyte proliferation and differentiation, dysregulation of the hormonal environment, hyperkeratinization, colonization of C. acnes and inflammation2, 40.”
From Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro (2019) · cites this paper as [2]
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Self-citationInflammatory Events Are Involved in Acne Lesion Initiation
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Self-citation
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Balić, A., Vlašić, D., Žužul, K., Marinović, B., & Bukvić Mokos, Z. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21030741 · Cited by 400 · see citing works
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Acne, Microbiome, and Probiotics: The Gut–Skin Axis
Sánchez-Pellicer, P., Navarro-Moratalla, L., Núñez-Delegido, E., Ruzafa-Costas, B., Agüera-Santos, J., & Navarro-López, V. (2022) · Microorganisms · doi:10.3390/microorganisms10071303 · Cited by 137 · see citing works
Altered Skin and Gut Microbiome in Hidradenitis Suppurativa
McCarthy, S., Barrett, M., Kirthi, S., Pellanda, P., Vlckova, K., Tobin, A.-M., Murphy, M., Shanahan, F., & O’Toole, P. W. (2022) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2021.05.036 · Cited by 98 · see citing works
50 Years of Topical Retinoids for Acne: Evolution of Treatment
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Interventions to increase adherence to acne treatment
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Self-citationMicrobiome and Probiotics in Acne Vulgaris—A Narrative Review
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A Time-Series Study of the Effect of Air Pollution on Outpatient Visits for Acne Vulgaris in Beijing
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Blimp1+ cells generate functional mouse sebaceous gland organoids in vitro
Feldman, A., Mukha, D., Maor, I. I., Sedov, E., Koren, E., Yosefzon, Y., Shlomi, T., & Fuchs, Y. (2019) · Nature Communications · doi:10.1038/s41467-019-10261-6 · Cited by 52 · see citing works
Dermocosmetics: beneficial adjuncts in the treatment of acne vulgaris
Araviiskaia, E., Lopez Estebaranz, J. L., & Pincelli, C. (2021) · Journal of Dermatological Treatment · doi:10.1080/09546634.2019.1628173 · Cited by 47 · see citing works
- Authors
- Tuchayi, S. M., Makrantonaki, E., Ganceviciene, R., Dessinioti, C., Feldman, S. R., & Zouboulis, C. C.
- Affiliations
- Wake Forest University Health Sciences (US)
- Universität Ulm (DE)
- National and Kapodistrian University of Athens (GR)
- Städtisches Klinikum Dessau (DE)
- Corresponding author
- Feldman, Steven R.
- ORCID
- Venue
- Nature Reviews Disease Primers
- Published
- 2015-09-17
- Volume
- 1
- Issue
- 1
- Pages
- 15029-15029
- ISSN
- 2056-676X (ISSN-L)
- OpenAlex
- W4210957916
- Cited by
- 432
- References
- 8
- Citations by year
- 2026: 50 · 2025: 73 · 2024: 57 · 2023: 44 · 2022: 56 · 2021: 53 · 2020: 43 · 2019: 27 · 2018: 15 · 2017: 10 · 2016: 4
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature Reviews Disease Primers (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Keywords
- acne, pilosebaceous unit, hormonal dysregulation, neuropeptides, follicular hyperkeratinization, inflammation, innate and adaptive immunity, acne prevention, acne scars, quality of life, acne pathophysiology
- MeSH terms
- Acne Vulgaris, Cicatrix, Humans, Quality of Life, Risk Factors, Sebaceous Glands, Sebum, Hair Follicle
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