The clinical severity of acne vulgaris ranges, ranging from mild comedonal illness to severe hemorrhagic and ulcerative lesions that leave scars. Although having a family history increases the likelihood of getting acne, it’s unclear if heredity and clinical severity were related. For a study, researchers sought to investigate the heredity and natural course of severe acne with scarring in isotretinoin-treated individuals.

A total of 101 patients with severe acne with scarring, including acne conglobata and acne fulminans, were included in the study. The severity of their acne was assessed during interviews with all participants and adult family members, and a corresponding “historical” Investigator’s Global Assessment (hIGA) score (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate, 4 = severe, 5 = very severe) was given. Based on each subject’s clinical assessment, study assessors conducted a “examination” known as an Investigator’s Global Assessment (eIGA) (0 = clear, 1 = practically clear, 2 = mild, 3 = moderate, 4 = severe, and 5 = extremely severe). A thorough pedigree and family history were recorded.

The majority of the individuals (44.5%) were Caucasian men (79.2%), who had taken doxycycline and/or minocycline (86.1%) in the past. The mean eIGA and hIGA scores were, respectively, 2.7 and 4.4. In addition, of the patients with hemorrhagic illness, 30% had at least one parent with moderate to severe acne. Of the individuals, 37.2% had one first-degree family with a history of moderate to severe acne with scarring.

The heritability of acne and the predictive relevance of a family history of moderate to severe illness was highlighted by the fact that severe types of acne frequently “cluster” in families.