What is the primary cause of acne vulgaris?

Acne vulgaris is a multifactorial skin condition leading to the formation of acne lesions. The primary cause can be attributed to several interconnected factors, each playing a crucial role in the development of the condition.

Hyperkeratinization of hair follicles is significant because it leads to the clogging of pores, which can create an environment where acne can develop. When the keratinocytes in the hair follicle become excessively thickened, this can obstruct the natural flow of sebum, promoting the formation of comedones.

Bacterial infection, particularly with Propionibacterium acnes (now known as Cutibacterium acnes), is another vital factor in acne pathogenesis. This bacterium thrives in the anaerobic environment of clogged follicles and can contribute to inflammation and the formation of pustules and nodules.

Hormonal fluctuations, particularly during puberty, menstrual cycles, and pregnancy, also play an essential role in acne, as they can stimulate sebaceous gland activity leading to increased sebum production. This variation in hormone levels can exacerbate the condition, making it more prevalent in certain populations.

Recognizing that all these factors interact to promote acne vulgaris highlights the complexity of the condition and underscores why understanding each aspect is critical in diagnosis and