Acne vulgaris

By Dr. Pascal Bafteh · last updated 09/2026

Definition and Pathogenesis

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, arising from seborrhea + hyperkeratosis + C. acnes. Increasingly, metabolic signaling pathways such as IGF-1, leptin are discussed as pathogenetically relevant.

Forms of Acne

Classic Forms

• The non-inflammatory early form with microcomedones is called Acne comedonica
• The Acne papulopustulosa presents with papules and pustules.
• The Acne conglobata presents with abscessing nodules and fistulating courses.
• The Acne fulminans has an acute systemic and necrotizing course.
• The Acne tarda begins persistently or late in adulthood.
• Artificially maintained by manipulation is Acne excoriée.
• Exogenously induced by comedogenic substances is called Acne venenata.

Rare Forms

• Acne neonatorum arises from transient maternal/fetal androgens.
• A possible indicator of hyperandrogenism is Acne infantum.
• After exposure to halogenated hydrocarbons (dioxins), Chloracne develops.

Drug-induced Acne

Triggers: Typical triggers are EGFR inhibitors + GCS, androgens, as well as psychotropic drugs and isoniazid.

Differential diagnoses

• Acne comedonica
• Acneiform eruption
• Rosacea
• Malassezia (Pityrosporum) folliculitis
• Epidermoid cyst
• Demodicosis
• Acne fulminans
• Seborrhoeic dermatitis

Sources (selection)

1. Zaenglein et al. 2016
2. AWMF S2k Akne 2023

More diseases of the skin appendages

• Acne fulminans
• Hidradenitis suppurativa (acne inversa)
• Alopecia areata
• Androgenetic alopecia
• Folliculitis (infectious)
• Lichen planopilaris
• Milia (milium)
• Perioral dermatitis

Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.