A microcomedone is the first subclinical acne wound or scar distinguished by follicular epithelial hyperproliferation. On the periphery of these scars inflammatory cells have been discovered. The purpose of this study was to determine whether inflammatory events occur before or after hyperproliferative changes. Immunohistochemical techniques were used to look for cellular, vascular, and proliferative markers in biopsies of clinically normal follicles from uninvolved skin and early inflamed acne lesions. Control follicles were provided by non-acne subjects. Uninvolved skin follicles lacked microcomedonal characteristics.

Acne is a common cause of post-inflammatory hyperpigmentation (PIH), especially in patients of colour, and PIH is frequently more distressing to patients than the acne itself. Topical retinoids are approved for the treatment of acne as well as pigmentation disorders such as melasma or mottled hyperpigmentation caused by photo damage; they have also been shown to reduce hyperpigmentation in SOC patients. As a result, unless contraindicated, treatment with topical retinoids should begin as soon as possible. Irritation may be reduced by using novel formulations or applying commonly recommended moisturisers. Retinoids can be combined with other topical agents and procedures, such as superficial chemical peels, to help improve hyperpigmentation. Primary acne lesions will likely improve weeks before PIH resolves, so assisting patients in managing their expectations may reduce frustration. More education for clinicians and researchers about the presentation and management of dermatologic conditions in SOC patients is also recommended.