The Lancet has featured a review of the pathophysiology and management of acne vulgaris.

Acne is a chronic inflammatory disease of the pilosebaceous unit resulting from androgen-induced increased sebum production, altered keratinisation, inflammation, and bacterial colonisation of hair follicles on the face, neck, chest, and back by Propionibacterium acnes.

The following topics are covered:

• Prevalence and natural history

• Cause

• Disease mechanism

• How does acne affect the patient?

• Management strategies, including treatment with topical benzoyl peroxide, antibiotics, retinoids or salicylic acid, or oral antibiotics, retinoids and combined contraceptives