Overview

Acne vulgaris is the most common skin condition worldwide, affecting up to 85% of people at some point. It occurs when hair follicles become clogged with oil and dead skin cells. Adult-onset acne is increasingly common, especially in women. Kuwait's heat, humidity, and heavy sunscreen and cosmetic use can worsen acne-prone skin.

Symptoms

• Whiteheads, blackheads, papules, and pus-filled pustules
• Painful nodules or cystic acne deep under the skin
• Post-acne scarring and dark spots — very common and pronounced in darker GCC skin tones
• Most common on face, forehead, chest, upper back, and shoulders

Causes & Risk Factors

• Excess sebum, clogged follicles, Cutibacterium acnes bacteria, and inflammation
• Hormonal changes: puberty, menstrual cycle, PCOS, pregnancy
• Occlusive cosmetics/sunscreens, high-glycemic diet, stress, heat, and humidity

Complications

• Permanent pitted or rolling acne scars
• Post-inflammatory hyperpigmentation (PIH) — more pronounced in darker skin
• Anxiety, depression, and reduced self-esteem; keloid scars in predisposed individuals

Diagnosis

Clinical diagnosis by lesion type and severity. Blood tests if hormonal acne is suspected (testosterone, DHEAS, LH/FSH, prolactin).

Treatment

• Mild: topical benzoyl peroxide, retinoids (adapalene/tretinoin), clindamycin, azelaic acid
• Moderate: oral antibiotics (doxycycline — time-limited), combined oral contraceptives for hormonal acne
• Severe/cystic: oral isotretinoin (Roaccutane) — most effective, requires monitoring
• Scars: chemical peels, microneedling, laser resurfacing

Prevention

• Wash face twice daily with a gentle non-comedogenic cleanser
• Use oil-free non-comedogenic moisturisers and SPF — essential in Kuwait
• Avoid picking; change pillowcases regularly; remove makeup before sleeping

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