Acne Vulgaris
What Is It?
The most common skin disease. Caused by follicular plugging, Cutibacterium acnes overgrowth, and sebaceous gland hyperactivity. Ranges from comedones and papules to nodulocystic lesions that cause scarring.
How Is It Diagnosed?
Clinical diagnosis. Assess severity (mild, moderate, severe). Evaluate for hormonal acne (PCOS, adrenal disorders) if indicated.
How Is It Treated?
Mild: topical retinoids (tretinoin, adapalene) + benzoyl peroxide. Moderate: topical + oral antibiotics (doxycycline). Hormonal acne: OCP or spironolactone. Severe nodular: isotretinoin (requires iPLEDGE). Avoid long-term antibiotics alone.
Tests and Imaging Typically Needed
Clinical diagnosis primarily. For hormonal acne: total testosterone, DHEAS, LH, FSH, prolactin, TSH.
Approximate Self-Pay Costs
Office visit: $95-$150. Topical retinoids: $20-$80/month. Doxycycline: $10-$30/month. Isotretinoin: $200-$400/month (iPLEDGE program required).