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What’s New in Acne Management: What We Have Learned from Increased Understanding of Acne Pathophysiology

By October 28, 2020April 21st, 2021No Comments

Featured Article

What's New in Acne Management:

What We Have Learned From Increased Understanding of Acne Pathophysiology

Join Drs. Leon H. Kircik, Linda Stein Gold, and Jonathan S. Weiss as they discuss the medical interventions generally targeting one or more of the key factors contributing to the development of acne lesions: follicular hyperproliferation and abnormal desquamation (topical and oral retinoids, azelaic acid, salicylic acid, hormonal therapy), increase sebum production (oral isotretinoin, hormonal therapy), C. acnes proliferation (benzoyl peroxide, topical and oral antibiotics, azelaic acid) and inflammation (oral isotretinoin, oral tetracyclines, topical retinoids, azelaic acid).

Acne pathogenesis is multifactorial and not clearly understood; a key factor includes genetics and may result as in interplay of release of inflammatory mediators into the skin, follicular hyperkeratinization with subsequent plugging of the follicle, Cutibacterium acne (C. acnes), formerly Propionibacterium acnes or P. acnes, follicular colonization and excess sebum production.

C. acnes has been shown to mediate inflammatory processes at the site of the sebaceous follicle contributing to the formation of free radical species and generating pro-inflammatory cytokines. Excess sebum production and C. acnes colonization lead to the formation of microcomedones leading to the development of open or closed comedones, inflammatory papules, pustules and cysts characteristic of acne.
Acne severity and grade (comedonal, papulopustular, mixed, nodular), skin type, presence of acne scarring and postinflammatory hyperpigmentation, menstrual cycle history (in women), skin current skin care regimen are factors influencing treatment with classes of topical agents include: comedolytic (anticomedogenic), antimicrobial, antibiotic and antiinflammatory; each impact on the four main pathogenic features of acne.


Leon H. Kircik, MD

Clinical Professor of Dermatology
Indiana University School of Medicine
Mount Sinai Medical Center, New York, NY
Physicians Skin Care, PLLC
Louisville, KY

Linda Stein Gold, MD

Director, Dermatology Clinical Research
Henry Ford Health System
Detroit, Michigan

Jonathan S. Weiss, MD

Adjunct Assistant Clinical Professor of Dermatology
Emory University School of Medicine
Atlanta, GA
President & Co-Managing Partner
Georgia Dermatology Partners
(Formerly, Gwinnett Dermatology, PC)

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