Everything You Want to Know About Acne

What is acne?

Your skin has tiny holes called pores that can become blocked by oil, bacteria, dead skin cells, and dirt. When this occurs, you may develop a simple, sometimes also called a zit or blemish.

If you get pimples often, especially several at once repeatedly, you may have acne. In other words, acne is a skin condition that causes pimples.

Acne is very common. In fact, research estimates that 9.4 percent of trusted sources of people worldwide have acne. In the United States, acne is the most common skin condition, according to the American Academy of Dermatology (AAD).

While acne doesn’t pose a serious risk to your overall health, it can still be painful, particularly if you have severe acne. Over time, acne might also cause scarring.

There’s no denying that acne can contribute to emotional distress. Acne and acne scars on your face and other visible body locations can affect self-esteem and self-confidence, and they can even contribute to feelings of anxiety or depression Trusted Source.

If you live with acne, know that it’s a common condition.

Keep in mind, too, that acne is very treatable. A number of effective treatments exist, so you have options for reducing the number of pimples you get and minimizing your chances of scarring.

What are the different types of acne?

If you have acne, you might notice a mix of pimple types.

Whiteheads and blackheads, both also referred to as comedones, are the most common acne lesions.

  • Blackheads, or open comedones, open at the surface of your skin. Oxygen in the air (not dirt) gives the top of these pimples their darker appearance.
  • Whiteheads, or closed comedones, form as raised bumps under the surface of your skin. They remain flesh-colored.

Inflammatory lesions, which are more likely to cause scarring of your skin, include:

  • Papules. These small, red, raised bumps are caused by inflamed or infected hair follicles.
  • Pustules. These small red pimples have pus at their tips.
  • Nodules. These solid, often painful lumps develop beneath the surface of your skin.
  • Cysts. These large lumps beneath your skin contain pus and are usually painful.
What are the symptoms of acne?

Acne can be found almost anywhere on your body, but you’ll most commonly notice breakouts on your:

  • face and neck
  • back
  • shoulders
  • chest

Pimples can give your skin a rough, uneven texture.

With acne, you might also experience:

  • skin discoloration, including dark patches or spots (hyperpigmentation) and redness
  • swelling and inflammation
  • pain and tenderness when touched or not

Acne breakouts can also cause scarring or discoloration on your skin.

Popping pimples can raise your chances of scarring, so avoid squeezing — no matter how tempting it feels to get rid of the pimple immediately — and try these tips.

Once a pimple develops, it can take anywhere from a few days to several weeks to completely clear up.

An acne breakout can take a lot longer to heal and clear, especially without treatment.

What causes acne?

Acne occurs when the pores of your skin become blocked with oil, dead skin, or bacteria.

Each pore of your skin opens to a follicle. The follicle is made up of hair and a sebaceous (oil) gland.

The oil gland releases sebum (oil), which travels up the hair, out of the pore, and onto your skin. Sebum helps keeps your skin lubricated and soft.

One or more mishaps in this lubrication process can contribute to acne.

Acne might occur, for example, when:

  • your follicles produce too much oil
  • dead skin cells accumulate in your pores
  • bacteria build up in your pores

Any of these concerns can lead to pimples, which develop when bacteria grow in a clogged pore and the oil can’t escape.

What are the risk factors for developing acne?

Experts still don’t know exactly why some people experience acne and others don’t.

That said, they do recognize a number of risk factors that can contribute to or worsen acne, including:

  • hormonal changes due to pregnancy or puberty
  • polycystic ovarian syndrome (PCOS) and other endocrine conditions
  • cigarette smoking
  • poor sleep
  • stress
  • cleansers, creams, moisturizers, and other beauty products with high oil content
  • certain medications, including lithium, some types of hormonal birth control, anticonvulsants, and steroids
  • a family history of acne

You have the highest risk of developing acne during puberty. During this time, your body undergoes many hormonal changes. These changes can trigger oil production, leading to an increased risk of acne. Hormonal acne related to puberty usually improves when you reach adulthood, and your breakouts may even stop completely.

According to a 2021 review trusted Source, certain foods or diets may have an effect on acne:

  • Low glycemic index diet. Cutting out processed meats and refined carbs could help reduce acne lesions.
  • Milk products. Consuming certain milk products, like milk and ice cream, seems to worsen acne for some people. Nonmilk dairy products, like cheese, don’t seem to worsen acne.
  • Fat and fatty acids. Omega-3 and omega-6 fatty acids may help reduce acne breakouts.
  • Vegan and vegetarian diets. While vegan and vegetarian diets can offer plenty of health benefits, little evidence supports them specifically for the treatment of acne.
  • Probiotics. While probiotics — found in yogurt, other fermented foods, and supplements — could help improve acne, experts have yet to find conclusive support for probiotics as an acne treatment.
Getting a diagnosis

If you suspect you have acne, a good next step involves getting a diagnosis from a board-certified dermatologist.

Learn how dermatologists can help identify and treat skin conditions.

A dermatologist can make a diagnosis by examining your skin. They can help identify the types of lesions and their severity to develop a treatment plan that works for you.

Treatment for acne

Treatment for acne generally depends on its severity.

Mild

You can use over-the-counter (OTC) medicated creams, cleansers, and spot treatments to help address pimples as they pop up.

Common ingredients you’ll find in acne creams and gels include:

  • Benzoyl peroxide. This ingredient helps dry out existing pimples, prevents new ones from forming, and kills acne-causing bacteria.
  • Salicylic acid. This ingredient helps exfoliate your skin to prevent pores from getting clogged with acne-causing bacteria.

Moderate

If you continue to experience symptoms after using OTC acne treatments for several weeks, you may want to consider reaching out for professional treatment.

A dermatologist or other healthcare professional can prescribe medications that may help reduce your symptoms and prevent scarring.

If you have moderate acne, a dermatologist may recommend:

  • prescription-strength benzoyl peroxide
  • antibiotics, like erythromycin or clindamycin
  • retinoids, such as retinol

In some cases, they may suggest an oral antibiotic or hormonal birth control to help manage acne.

Typically, you’ll only use antibiotics for a short time, so your body doesn’t build up a resistance and leave you prone to infections.

Severe

For severe acne, a dermatologist may recommend treatment that combines one or more of the following:

  • oral antibiotics
  • benzoyl peroxide
  • topical antibiotics
  • topical retinoids

They may also suggest hormonal birth control or oral isotretinoin, also known by the brand name Accutane.

Accutane is a vitamin-A medication used to treat certain cases of severe nodular acne. It can cause serious side effects, and doctors usually only prescribe it when other treatments don’t work.

Can you keep taking acne medication during pregnancy?

Many acne treatments, including Accutane, can have severe consequences for a developing fetus.

If you plan to become pregnant or believe you could be pregnant, ask the doctor or clinician who prescribed your medication if you can continue taking it.

Your care team can also offer more guidance on other options to treat acne during pregnancy.

Your dermatologist may also recommend medical procedures to treat severe forms of acne and prevent scarring. These procedures work by removing damaged skin and reducing oil production. They include:

  • Photodynamic therapy (PDT). PDT uses medication and a special light or laser to reduce oil production and bacteria. Other laser treatments can also help improve acne and scarring.
  • Dermabrasion. This type of exfoliation removes the top layers of your skin with a rotating brush. The procedure works best for treating acne scarring, not acne itself. Microdermabrasion is a milder treatment that helps remove dead skin cells.
  • Chemical peel. This treatment removes the top layers of your skin to reveal less damaged skin underneath. Chemical peels can improve mild acne scarring.
  • Cortisone injections. These injections can help reduce inflammation and speed healing. Cortisone is usually used along with other acne treatments, particularly for acne that involves large cysts.

Acne home remedies

You’ve probably come across any number of acne home remedies. But, as you might have already realized, these remedies don’t always work — some might even make acne worse.

Instead of putting toothpaste on your face, try these at-home tips to help clear up acne and help prevent future breakouts:

  • Apply tea tree oil.
  • Apply aloe vera.
  • Use a honey mask.
  • Refresh your face with green tea.
  • Avoid touching your face.
  • Never squeeze or pick pimples. It makes scarring more likely, and it can also spread bacteria and excess oil.

Find more acne home remedies here.

What’s the outlook for someone with acne?

It goes without saying that no one should judge or stigmatize you for having acne, but having acne can feel distressing and isolating, all the same.

No matter how uncomfortable it is to have this skin condition, it could help to remember that you’re not alone. Pretty much everyone will get a pimple at some point in life, and many people deal with different forms of acne well into adulthood.

The good news: Plenty of effective treatment options exist. With treatment, your acne may begin clearing up within a matter of weeks.

Getting treatment for acne sooner rather than later can also help prevent scarring. If you’ve already noticed some acne scars, a dermatologist can offer more guidance on treatments to help minimize the appearance of scarring.

Even with treatment, flare-ups can still happen. Persistent acne may require additional or long-term treatment. It’s always best to work with a dermatologist to find the most effective treatment for regular or severe acne breakouts.

Preventing acne

It’s not always possible to completely prevent acne, but you can take certain steps at home to help lower your chances of getting pimples or acne breakouts.

Try these tips:

  • Wash your face daily with an oil-free cleanser.
  • Try an OTC acne cleanser to help remove excess oil.
  • Use water-based makeup or products labeled “noncomedogenic” — this means they’re less likely to clog your pores.
  • Avoid skin care and makeup products that contain oil.
  • Always remove makeup and cleanse your skin thoroughly before bed.
  • Shower or wash your face after exercising.
  • Tie back long hair to keep it out of your face.
  • Avoid tight-fitting hats, headbands, and clothing that covers breakout-prone areas.
  • Eat a balanced diet, and stay hydrated.
  • Take steps to reduce stress.

A dermatologist can offer more tips and guidance on managing and preventing acne.

The bottom line

Acne can be tough, but plenty of effective treatments can help ease breakouts and heal your skin.

If you continue to experience painful or persistent breakouts, a dermatologist can offer support with creating a treatment plan that works for your skin and reduces scarring.

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