In adolescent acne, which statement is most consistent with its pathophysiology?

• A. Poor hygiene is the primary cause of acne
• B. Increased androgenic hormonal activity contributes to acne
• C. Females can have a cycle component to their acne
• D. Only males experience severe acne

Answer: (B)

The key idea is that androgens drive the main process behind adolescent acne. During puberty, elevated androgens stimulate the sebaceous glands to produce more sebum. This excess sebum, together with abnormal keratinization of the hair follicle, leads to blocked pores (comedones) and creates an environment where Propionibacterium acnes can thrive, triggering inflammation and the typical pimples. So increased androgenic hormonal activity best fits the pathophysiology.

Hygiene is not the primary cause of acne. While hormonal fluctuations in females can influence acne severity, the underlying mechanism is still androgen-driven sebaceous activity. And severe acne can occur in both males and females, not just one sex.