Background: Acne vulgaris is a common chronic inflammatory disorder of the pilosebaceous unit, characterized by comedones, papules, pustules, nodules, and scarring. It affects nearly every individual at some point in life and frequently presents during adolescence and early adulthood. Several factors, including follicular hyperproliferation, increased sebum production, Cutibacterium acnes activity, and inflammation, contribute to its pathogenesis. Acne also has a notable psychosocial impact due to its sequelae such as post-inflammatory hyperpigmentation and scarring.

Aim: To evaluate the clinical pattern of acne vulgaris among patients attending a tertiary care hospital in Northeast India.

Materials and Methods: A cross-sectional study was conducted among 158 consecutive patients with acne vulgaris in the Dermatology Department of Silchar Medical College and Hospital. Detailed histories were recorded, including age of onset, gender, duration, lesion characteristics, aggravating factors, menstrual history, post-acne hyperpigmentation, and scarring. Acne severity was graded using a simple four-grade system, and scarring was assessed using the Comprehensive Acne Severity System (CASS). Ethical clearance and informed consent were obtained.

Results: Of the 158 patients, 63.4% were females and 36.6% males. The most affected age group was 21–25 years (40.1%), followed by 16–20 years (30.5%). Duration of acne was <1 year in 44.9% of cases. The face was the most commonly involved site (80.3%), followed by the trunk and neck. Grade 2 acne was the predominant severity type (53.7%), while Grade 4 constituted only 5.06%. Post-inflammatory hyperpigmentation was present in 48.3%, and scarring in 22.1%. Premenstrual flare occurred in 16.7% of females. Seborrheic dermatitis (13.8%) was the most common associated condition.

Conclusion: Acne vulgaris in this population most commonly affects young adults, with a predominance of females and Grade 2 severity. Facial involvement and pigmentation were frequent findings. Understanding these clinical patterns can guide improved management strategies in similar demographic settings.