Acne: Causes, Types, and Modern Dermatological Treatment

Acne (Acne Vulgaris) is one of the most common inflammatory skin conditions. Although it occurs mainly during adolescence—affecting up to 85% of teenagers—it very often continues to affect a large percentage of people well into adulthood. Acne is not merely a cosmetic issue, but a serious dermatological condition that can significantly affect a person’s mental health and self-confidence; without proper treatment, it may leave permanent scars.

What is acne vulgaris, and what age groups does it affect?

Common acne occurs when the skin's pores become clogged with excess sebum and dead skin cells. Although almost all teenagers will occasionally develop a few pimples, about 15% experience a more severe form (mild, moderate, or severe) that requires specialized medical treatment.

The typical onset occurs between the ages of 11 and 14, with the peak incidence observed between the ages of 14 and 19. However, adult acne is extremely common: it manifests strongly between the ages of 19 and 35, and in some cases persists until the age of 40.

What Causes Acne? (Causes & Pathogenesis)

The development of acne is multifactorial. The first lesion to appear on the skin is a comedone (commonly known as a “blackhead” or “whitehead”). The main factors contributing to its formation include:

• Excess sebum production: Due to hyperplasia and hyperfunction of the sebaceous glands, often influenced by hormonal fluctuations (such as androgens/testosterone).
• Keratinization disorder: Dead cells accumulate in the pore, blocking the normal drainage of sebum.
• Bacterial proliferation: The bacterium Cutibacterium acnes (formerly Propionibacterium acnes) proliferates in trapped sebum.
• Inflammation: The immune system's response to bacteria causes redness, swelling, and pus.

What are the main types of acne?

Depending on the type of lesions present on the skin, acne is classified into various forms, each of which requires a different treatment approach:

• Phagocytic acne: Characterized by open (blackheads) and closed comedones.
• Papular / Pustular Acne: Red bumps (papules) or pus-filled bumps (pustules) appear.
• Papulopustular acne: A combination of the above forms with mild to moderate inflammation.
• Cystic/nodular acne: A severe form of acne characterized by deep, painful cysts and nodules, which carries the highest risk of causing permanent scarring.

What is the goal of dermatological treatment?

The personalized treatment provided at our clinic aims to address all the underlying causes of the disease:

• • To reduce sebum production.
  • To normalize desquamation and keratinization in the pilosebaceous follicle.
  • To eliminate the acne-causing bacteria and the associated inflammation.
  • For the prevention of scars and post-inflammatory hyperpigmentation (marks).

Topical and Systemic Acne Treatments

The treatment strategy is determined by the severity of the acne and the specific circumstances of each patient:

• Topical Treatment: Used for mild to moderate cases. It involves medicinal creams or gels containing active ingredients such as retinoids, benzoyl peroxide, azelaic acid, and topical antibiotics.
• Systemic (oral) Treatment: Used for moderate to severe forms of the condition or when topical treatment is ineffective. It involves the administration of specific antibiotics, hormonal therapies (when indicated), and isotretinoin.
• Isotretinoin (Retinoid): It is the most effective treatment, as it acts on all the pathogenic mechanisms of acne. It is administered under strict medical supervision and with regular laboratory monitoring (blood tests).

What should you know during treatment?

Patience and adherence to the dermatologist’s instructions are crucial. Improvement is not immediate; the first visible results usually appear after 4–6 weeks, while the treatment may take 5 to 8 months to complete.

During the first few weeks, mild dry skin, irritation, or a temporary flare-up of lesions may occur; these symptoms can be easily managed with appropriate moisturizing care and medical guidance.

Schedule an Appointment for Personalized Acne Treatment

Acne can be completely cured when treated promptly and scientifically. At the Dermtherapy clinic in Galatsi, dermatologist and venereologist Alexandros Soumalevris designs a personalized treatment plan tailored to the specific needs of your skin.