The nurse is providing education to a client about potential complications of untreated severe acne. Which statement by the client indicates a need for further teaching?

Explanation: Hormonal fluctuations, particularly an increase in androgen hormones during adolescence, play a significant role in the development of acne vulgaris. Androgens stimulate the sebaceous glands to produce more sebum, which can clog hair follicles and lead to the formation of acne lesions.

Incorrect choices: a. Bacterial infection - While bacteria, specifically Propionibacterium acnes, may contribute to the inflammation and worsening of acne lesions, it is not the primary cause of acne vulgaris.

b. Excessive sun exposure - Excessive sun exposure can exacerbate acne lesions, but it is not the primary cause of acne vulgaris.

d. Allergic reaction to cosmetics - Allergic reactions to cosmetics can cause skin irritation and rashes but are not the primary cause of acne vulgaris.

Explanation: The primary diagnostic criterion for acne vulgaris is the presence of comedones, which are non-inflammatory lesions that occur when hair follicles become clogged with sebum and dead skin cells. Comedones can be either open (blackheads) or closed (whiteheads) and are a hallmark of acne vulgaris.

Incorrect choices: b. Appearance of pustules - Pustules are inflammatory lesions seen in acne vulgaris, but they are not the primary diagnostic criterion.

c. Erythematous, raised plaques with silver scales - This description is characteristic of psoriasis, not acne vulgaris. Psoriasis is a chronic autoimmune skin condition.

d. Nodules and cysts on the skin - Nodules and cysts are severe forms of acne vulgaris, but they are not the primary diagnostic criterion. They may develop in later stages of the condition.