We’ve all got these tiny openings in our skin for releasing sweat and oil,
but for some people, they can be more temperamental than others.
Acne is a very common skin condition that causes pimples. You’ll usually get pimples on your face. Clogged pores cause acne. Teenagers and young adults most often get acne, but it can also occur during adulthood for many people. Treatment is available to clear acne from your skin and prevent scarring.
Overview
What is acne?
Acne is a common skin condition where the pores of your skin clog. Pore blockages produce blackheads, whiteheads and other types of pimples. Pimples are pus-filled, sometimes painful, bumps on your skin.
The medical term for acne is acne vulgaris.
What are the types of acne?
There are several types of acne, including:
Cystic acne: Cystic acne causes deep, pus-filled pimples and nodules. These can cause scars.
Fungal acne (pityrosporum folliculitis): Fungal acne occurs when yeast builds up in your hair follicles. These can be itchy and inflamed.
Hormonal acne: Hormonal acne affects adults who have an overproduction of sebum that clogs their pores.
Nodular acne: Nodular acne is a severe form of acne that causes pimples on the surface of your skin, and tender, nodular lumps under your skin.
All of these forms of acne can affect your self-esteem, and both cystic and nodular acne can lead to permanent skin damage in the form of scarring. It’s best to seek help from a healthcare provider early so they can determine the best treatment option(s) for you.
Who does acne affect?
Acne usually affects everyone at some point in their lifetime. It’s most common among teenagers and young adults undergoing hormonal changes, but acne can also occur during adulthood. Adult acne is more common among women. You may be more at risk of developing acne if you have a family history of acne (genetics).
How common is acne?
If you have acne, know that you’re not alone. Acne is the most common skin condition that people experience. An estimated 80% of people ages 11 to 30 will have at least a mild form of acne.
Where on my body will I have acne?
The most common places where you might have acne are on your:
Face.
Forehead.
Chest.
Shoulders.
Upper back.
Oil glands exist all over your body. The common locations of acne are where oil glands exist the most.
Symptoms and Causes
What are the symptoms of acne?
Symptoms of acne on your skin include:
Pimples (pustules): Pus-filled bumps (papules).
Papules: Small, discolored bumps, often red to purple or darker than your natural skin tone.
Blackheads: Plugged pores with a black top.
Whiteheads: Plugged pores with a white top.
Nodules: Large lumps under your skin that are painful.
Cysts: Painful fluid-filled (pus) lumps under your skin.
Acne can be mild and cause a few occasional pimples, or it can be moderate and cause inflammatory papules. Severe acne causes nodules and cysts.
What causes acne?
Clogged hair follicles or pores cause acne. Your hair follicles are small tubes that hold a strand of your hair. There are several glands that empty into your hair follicles. When too much material is inside your hair follicle, a clog occurs. Your pores can clog with:
Sebum: An oily substance that provides a protective barrier for your skin.
Bacteria: Small amounts of bacteria naturally live on your skin. If you have too much bacteria, it can clog your pores.
Dead skin cells: Your skin cells shed often to make room for more cells to grow. When your skin releases dead skin cells, they can get stuck in your hair follicles.
When your pores clog, substances plug up your hair follicle, creating a pimple. This triggers inflammation, which you feel as pain and swelling. You can also see inflammation through skin discoloration, like redness around a pimple.
Triggers of acne
Certain things in your environment contribute to acne, or they can make an acne breakout worse, including:
Wearing tight-fitting clothing and headgear, like hats and sports helmets.
Toxins in the air and certain weather conditions, especially high humidity.
Using oily or greasy personal care products, like heavy lotions and creams, or working in an area where you routinely come in contact with grease, such as working at a restaurant with frying oil.
Stress, which increases the hormone cortisol.
Side effects of medications.
Picking at your acne.
Foods that cause acne
Some studies link particular foods and diets to acne, like:
Skim milk.
Whey protein.
Diets high in sugar.
While high-sugar diets may lead to acne outbreaks, chocolate isn’t directly linked to acne.
To reduce your risk of acne, choose to eat a balanced, nutritious diet with plenty of fresh fruits and vegetables, especially those rich in vitamin C and beta-carotene, which helps reduce inflammation.
Hormones and acne
Acne is largely a hormonal condition that’s driven by androgen hormones, especially testosterone. This typically becomes active during teenage and young adult years. You might also notice acne forming around the time of your period as a result of hormone activity. Sensitivity to these hormones — combined with surface bacteria on your skin and substances released from your body’s glands — can result in acne.
Diagnosis and Tests
How is acne diagnosed?
A healthcare provider can diagnose acne during a skin exam. During this exam, a provider will closely look at your skin to learn more about your symptoms. In addition, they may also ask about risk factors for acne, like:
Are you feeling stressed?
Do you have a family history of acne?
Do you notice breakouts during your menstrual cycle?
What medications do you currently take?
Your healthcare provider won’t need to run any diagnostic tests for acne, but they may offer tests to diagnose any underlying conditions if you have sudden, severe acne outbreaks, especially if you’re an adult.
Who treats acne?
A general healthcare provider or a dermatologist can diagnose and treat acne. If you have stubborn acne that doesn’t improve with treatment, a dermatologist can help.
How severe can acne get?
Dermatologists rank acne by severity:
Grade 1 (mild): Mostly whiteheads and blackheads, with a few papules and pustules.
Grade 2 (moderate or pustular acne): Multiple papules and pustules, mostly on your face.
Grade 3 (moderately severe or nodulocystic acne): Numerous papules and pustules, along with occasionally inflamed nodules. Your back and chest may also be affected.
Grade 4 (severe nodulocystic acne): Numerous large, painful and inflamed pustules and nodules.
Management and Treatment
How is acne treated?
There are several ways to treat acne. Each type of treatment varies based on your age, the type of acne you have and the severity. A healthcare provider might recommend taking oral medications, using topical medications or using medicated therapies to treat your skin. The goal of acne treatment is to stop new pimples from forming and to heal the existing blemishes on your skin.
Topical acne medications
Your healthcare provider may recommend using a topical acne medication to treat your skin. You can rub these medications directly onto your skin as you would a lotion or a moisturizer. These could include products that contain one of the following ingredients:
Benzoyl peroxide: This is available as an over-the-counter product (such as Clearasil®, Stridex® and PanOxyl®) as a leave-on gel or wash. It targets surface bacteria, which often aggravates acne. Lower concentrations and wash formulations are less irritating to your skin.
Salicylic acid: This is available over the counter for acne as a cleanser or lotion. It helps remove the top layer of damaged skin. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging.
Azelaic acid: This is a natural acid found in various grains such as barley, wheat and rye. It kills microorganisms on the skin and reduces swelling.
Retinoids (vitamin A derivatives): Retinol, such as Retin-A®, Tazorac® and Differin®, which is available without a prescription, breaks up blackheads and whiteheads and helps prevent clogged pores, the first signs of acne. Most people are candidates for retinoid therapy. These medications aren’t spot treatments and must be used on the entire area of skin affected by acne to prevent the formation of new pimples. You often need to use these for several months before noticing positive results.
Antibiotics: Topical antibiotics like clindamycin and erythromycin control surface bacteria that aggravate and cause acne. Antibiotics are more effective when combined with benzoyl peroxide.
Dapsone: Dapsone (Aczone®) is a topical gel, which also has antibacterial properties. It treats inflamed acne.
Oral acne medications
Oral acne medications are pills that you take by mouth to clear your acne. Types of oral acne medications could include:
Antibiotics: Antibiotics treat acne caused by bacteria. Common antibiotics for acne include tetracycline, minocycline and doxycycline. These are best for moderate to severe acne.
Isotretinoin (Amnesteem®, Claravis® and Sotret®): Isotretinoin is an oral retinoid. Isotretinoin shrinks the size of oil glands, which contributes to acne formation.
Contraceptives: The use of certain contraceptives can sometimes help women who have acne. The U.S. Food and Drug Administration (FDA) approved several types of birth control pills for treating acne. Some brand names include Estrostep®, Beyaz®, Ortho Tri-Cyclen® and Yaz®. These pills contain a combination of estrogen and progesterone.
Hormone therapy: Hormone therapy is helpful for some people with acne, especially those who experience acne flare-ups during menstruation or who have irregular periods caused by excess androgen. Hormone therapy may be in the form of low-dose estrogen and progesterone pills (birth control pills), or a medication called spironolactone that blocks the effect of certain hormones at the level of your hair follicles and oil glands.