Summary:
Acne vulgaris is conventionally viewed as the result of physiological factors like increased sebum production and proliferation of Cutibacterium acnes. However, there is emerging evidence suggesting that internal and external stressors may induce or exacerbate the pathophysiology of acne vulgaris.
This review introduces six patient-centric systems that may be implicated in the development of acne vulgaris. The systems are:
- Psycho-emotional stress
- Diet and metabolism
- Dysbiosis of the gut and skin microbiome
- Hormonal fluctuations
- Oxidative stress
- Immune response
It is proposed that each of these systems contributes to an overall dysregulation which may contribute to the development and/or exacerbation of acne vulgaris and may allow for a more expanded therapeutic approach.
