Recent Advances in Acne Pathogenesis

Implications for Therapy

Shinjita Das; Rachel V. Reynolds


Am J Clin Dermatol. 2014;15(6):479-488. 

In This Article


Acne is an inflammatory disease that results from multiple factors within the pilosebaceous apparatus. New data about the physiopathology of acne show that acne is an inflammatory (rather than infectious) disease in which innate immunity and P. acnes play a crucial role.

While acne treatment is multimodal, the mainstay of therapy remains prevention of comedone formation. Topical agents are used for the treatment of mild to moderate acne, whereas oral agents are generally reserved for moderate to severe disease. Of the currently available treatments, isotretinoin offers the most sustained improvement and even cure. However, the side effect profile, government-mandated monitoring process, and teratogenicity, render it cumbersome to prescribe. This has prompted further research into both medical and device options. While radiofrequency, laser, and light treatments offer some improvement for inflammatory acne (with blue-light PDT being the only FDA-approved treatment), these options are not effective standalone modalities. Future studies will offer further insights into acne pathogenesis and, in turn, spark the development of novel targeted treatments.