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Abstract Acne vulgaris can be defined as a chronic inflammatory disorder affecting the pilosebaceous units. Acne is one of the most common skin diseases worldwide and results in major health care costs and significant morbidity to severely affected individuals. Acne affects up to 85% of adolescents and young adults worldwide. Severe manifestations of acne are painful and cause disfigurment and scarring, and in some patients, profoundly reduce self-esteem and affect mental health Acne development is not only individual specific but also site-specific, with only some follicles developing inflammation even during severe manifestations of disease. Four main factors are believed to contribute to acne development: increased sebum production, follicular hyperkeratinization, colonization of skin bacteria, and inflammation. |