Skin surfaces in the acne prone areas are colonized with Staphylococcus epidermidis and Propionibacterium acnes. In adolscence, the number of bacteria on the skin surface increases. However, P. acnes appear to be the main organism in acne and its elimination should be addressed during the course of acne. Studies suggest that bacteria have nothing to do with the initiation of comedogenesis. However, Propionibacterium acnes, in particular, may in some situations be important in the initiation of inflammation especially in cystic acne. It is also quite likely that they are involved in a perpetuation of inflammation once established. Severity of acne however does not relates to the number of bacteria on the skin surface or in the sebaceous ducts. Many topical treatments for acne target bacterial control in order to subsidize acne, among them Benzoyl peroxide.

Folliculitis, however clinically different from acne, has somewhat similar manifestations. Folliculitis is a somewhat nonspecific term that refers to inflammation of the hair follicle. The most common etiology of folliculitis is bacterial infection, often due to Staphylococcus aureus. The usual clinical presentation is that of superficial pustules and/or papules in the distribution of the hair follicles; the face, chest, back, thighs, and buttocks are often involved. Folliculitis is frequently initiated by mild physical injury to the follicles, such as friction caused by tight-fitting garments, or by ingrown hairs in the beard area in men.

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Propionibacterium acnes