Pathways to Inflammation: Acne Pathophysiology

The 2011 review article examines the complex pathophysiology of acne vulgaris, which affects a significant portion of adolescents and persists into adulthood for some. It identifies genetic factors, diet, hormones, and the bacterium Propionibacterium acnes as key contributors to the inflammation seen in acne. The skin's epidermis is primed for inflammatory responses, with P. acnes triggering immune reactions that lead to lesion formation. Androgens play a role in sebum production and hyperkeratinization, while dietary factors like high glycemic index foods can exacerbate acne by increasing insulin and androgen levels. The study by Cordain et al. is cited, showing no acne in non-westernized societies, contrasting with high incidences in Western populations. Genetic predisposition, particularly CAG repeats in the androgen receptor gene, may influence acne severity. The document underscores the importance of the hypothalamo-pituitary-adrenal axis in the timing of acne onset and suggests that current treatments are not curative, highlighting the need for future research for better management strategies.