AMB Volume 42, Issue 2, 2026 Pages 182-187 https://doi.org/10.59393/amb26420202
Recent aspects of the pathophysiology of acne vulgaris
Ratkova M., Raykova V.
Acne vulgaris is a common, chronic inflammatory disease affecting millions of people worldwide, significantly impacting the self-esteem and quality of life of patients. The disease is characterized by a multifactorial pathophysiological process, and recent years have seen a substantial increase in knowledge regarding the influence of each factor individually, as well as their interconnectedness in the genesis of the disease. The aim of this article is to provide a scientific review of newly discovered pathophysiological mechanisms in sebum production, hyperkeratinization, Cutibacterium acnes colonization, and inflammation in patients with acne vulgaris and in vitro. It has been proven that not only is excessive sebum production responsible for the genesis of acne, but also changes in the composition of sebum. Understandings of the role of C. acnes have also been revised. The importance of biological diversity in the skin microbiota and the loss of balance between different C. acnes phylogroups are dominant factors in the onset of the disease, in contrast to hyperproliferation of the bacterium as an isolated factor. New findings regarding the role of both innate and acquired immunity in the development and progression of the disease are reported. This article summarizes current pathophysiological aspects related to the onset and development of acne vulgaris. The necessity for further analysis in this direction is emphasized, as it would significantly contribute to the development of new therapeutic possibilities for treating this frequent dermatological condition.
Keywords: Acne vulgaris, Cutibacterium acnes, sebum, innate immunity, acquired immunity
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