News
Distinct Acne Incidence Patterns Seen in Transgender Individuals
Transmasculine individuals have the highest acne risk in the first year after initiation of testosterone
DE
Read full analysisDermsquared Editorial Team
Medical Condition Hub
Inflammatory
ICD-10: L63.9Acne
UpdatedFebruary 26, 2026
Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit driven by follicular hyperkeratinization, sebum production, Cutibacterium acnes proliferation, and complex innate immune activation. Clinical presentation ranges from comedonal disease to inflammatory papules, pustules, nodules, and scarring, with severity influenced by hormonal factors, genetic predisposition, and environmental triggers.
Why it matters: Acne is among the most prevalent dermatologic conditions worldwide and remains a leading cause of permanent scarring and psychosocial morbidity in adolescents and adults. Early, appropriately stratified therapy reduces long-term sequelae, limits antibiotic resistance, and may improve adherence by aligning treatment intensity with disease severity and patient risk factors.
This hub gathers the evidence, expert perspective, and practical insight shaping how acne is understood and treated today, connecting evolving therapeutic strategies with the nuanced decisions that influence outcomes across severity and age groups.
Diagnosis & Severity
Diagnosis
- Clinical diagnosis based on lesion morphology and distribution
- Noninflammatory lesions
- Inflammatory lesions: papules, pustules, nodules, cysts
- Common distribution: face, chest, back
- Evaluate for hormonal drivers in select patients (eg, adult females with signs of hyperandrogenism)
- Consider differential diagnosis: rosacea, folliculitis, perioral dermatitis, acneiform drug eruptions
Severity Assessment
- Mild: Predominantly comedonal or limited inflammatory lesions
- Moderate: Increased inflammatory papules/pustules; limited nodular disease
- Severe: Nodular or conglobate acne; significant inflammatory burden; scarring
- Assessment may incorporate lesion counts, distribution, scarring, and psychosocial impact
- Consider risk of permanent scarring and treatment refractoriness when determining escalation
Treatment Stratification
- Mild: Topical retinoids ± benzoyl peroxide ± topical antibiotics (avoid antibiotic monotherapy)
- Moderate: Combination topical therapy ± oral antibiotics (time-limited)
- Severe or nodulocystic: Oral isotretinoin; hormonal therapy in appropriate female candidates
Insights & Commentary
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Oct 23, 2025Acne
What is the "retinol sandwich" method for managing acne?
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Watch VideoJoshua Zeichner, MD
Aug 2, 2024Acne
Evaluating Benzene Concerns in Benzoyl Peroxide Products
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Watch VideoJohn Barbieri, MD, MBA, FAAD
Continuing Education
View all0.75 Credits
DermInsider - VGR Session 11
The Science of Botulinum Toxin Type A and Clinical Updates in Acne & Rosacea