Acne vulgaris is a common skin condition that is often effectively treated with a rational therapeutic approach based on its pathophysiology, lesion type, and skin type. It is a chronic inflammatory disease of the pilosebaceous unit characterized by the formation of comedones, papules, pustules, nodules, and cysts, which can progress to scarring. Acne typically begins during adolescence, related to puberty, and comedones often appear before inflammatory lesions. Adolescents are more frequently affected than adults, with a higher severity in males. The condition is often accompanied by seborrhea and may be associated with other skin conditions such as seborrheic dermatitis. Clinically, acne presents as a combination of non-inflammatory, inflammatory, and scarring lesions. Non-inflammatory lesions include open and closed comedones, while inflammatory lesions include papules and pustules, and deep lesions include nodules and cysts, which are more likely to leave scars. Scars can be atrophic or hypertrophic, with atrophic scars more common on the face and hypertrophic scars or keloids more common on the trunk and neck. Acne vulgaris affects the face in 99% of cases, with 60% of patients also affected on the back and shoulders, and 15% on the chest. It is often associated with seborrhea. Diagnosis is generally straightforward, but differential diagnosis includes conditions such as rosacea, folliculitis, syphilis, lupus miliaris disseminatus faciei, and others. The pathogenesis of acne involves impaired keratinization, altered sebum composition, increased sebum production, and bacterial proliferation. The lesion originates in the pilosebaceous unit, where excessive keratinization and increased cell turnover lead to the formation of a keratinized mass blocking the hair follicle. This mass leads to the accumulation of sebum and cellular debris, forming a microcomedone, which can progress to visible lesions. Androgens are the main regulators of sebum secretion, with testosterone and DHT being the most potent. However, most acne patients do not have significant hormonal abnormalities, and the condition is often localized to the pilosebaceous unit. The evaluation of a patient with acne is crucial and involves a detailed questionnaire about skincare methods, products used, previous treatments, and potential underlying conditions. A thorough assessment is necessary to determine the severity of acne and to rule out associated systemic conditions such as polycystic ovary syndrome, adrenal hyperplasia, and others. Treatment should be based on the type of lesions, skin type, and underlying causes. Topical treatments include benzoyl peroxide, which has antibacterial and anti-inflammatory properties, and retinoids, which have keratolytic effects. Antibiotics are used for inflammatory lesions, with common choices including erythromycin, clindamycin, and tetracycline. SystemicAcne vulgaris is a common skin condition that is often effectively treated with a rational therapeutic approach based on its pathophysiology, lesion type, and skin type. It is a chronic inflammatory disease of the pilosebaceous unit characterized by the formation of comedones, papules, pustules, nodules, and cysts, which can progress to scarring. Acne typically begins during adolescence, related to puberty, and comedones often appear before inflammatory lesions. Adolescents are more frequently affected than adults, with a higher severity in males. The condition is often accompanied by seborrhea and may be associated with other skin conditions such as seborrheic dermatitis. Clinically, acne presents as a combination of non-inflammatory, inflammatory, and scarring lesions. Non-inflammatory lesions include open and closed comedones, while inflammatory lesions include papules and pustules, and deep lesions include nodules and cysts, which are more likely to leave scars. Scars can be atrophic or hypertrophic, with atrophic scars more common on the face and hypertrophic scars or keloids more common on the trunk and neck. Acne vulgaris affects the face in 99% of cases, with 60% of patients also affected on the back and shoulders, and 15% on the chest. It is often associated with seborrhea. Diagnosis is generally straightforward, but differential diagnosis includes conditions such as rosacea, folliculitis, syphilis, lupus miliaris disseminatus faciei, and others. The pathogenesis of acne involves impaired keratinization, altered sebum composition, increased sebum production, and bacterial proliferation. The lesion originates in the pilosebaceous unit, where excessive keratinization and increased cell turnover lead to the formation of a keratinized mass blocking the hair follicle. This mass leads to the accumulation of sebum and cellular debris, forming a microcomedone, which can progress to visible lesions. Androgens are the main regulators of sebum secretion, with testosterone and DHT being the most potent. However, most acne patients do not have significant hormonal abnormalities, and the condition is often localized to the pilosebaceous unit. The evaluation of a patient with acne is crucial and involves a detailed questionnaire about skincare methods, products used, previous treatments, and potential underlying conditions. A thorough assessment is necessary to determine the severity of acne and to rule out associated systemic conditions such as polycystic ovary syndrome, adrenal hyperplasia, and others. Treatment should be based on the type of lesions, skin type, and underlying causes. Topical treatments include benzoyl peroxide, which has antibacterial and anti-inflammatory properties, and retinoids, which have keratolytic effects. Antibiotics are used for inflammatory lesions, with common choices including erythromycin, clindamycin, and tetracycline. Systemic