What is acne?
Acne is a disorder of the hair
follicles and oil glands (sebaceous glands). The oil glands secrete oils (sebum) to keep
the skin moist. When the glands get clogged, it can lead to pimples and cysts.
Acne is very common. People of all
races and ages have acne. In fact, most people in the U.S. between 11 and 30 years old
will be affected by it. Even people in their 40s and 50s can have acne. However, acne
most often starts in puberty. During puberty, the male sex hormones (androgens) increase
in both boys and girls. This causes the glands to make more oil.
Normally, the oil produced travels
through the hair follicles to the skin. However, dead skin cells can plug the follicles.
This can block the oil. When follicles become plugged, skin bacteria start to grow
inside the follicles. Inflammation and pimples then develop. The most common types of
Whiteheads (closed comedones). These pimples are sealed over and have a small white pus filled top.
Blackheads (open comedones). These
pimples have a small, black opening at the top. Although these pimples are black, the
color is not from dirt. It's from the process of oxidation when the oil is exposed to
Papules. These are tender, small pink bumps.
Pustules. Pimples have pus on the top
and are red on the bottom of the lesion. These are characteristics of inflammatory
Nodules. These are hard, large, painful pimples that arise deep in the skin.
Cysts. These are pus-filled, deep,
painful pimples that often result in scars.
The basic acne lesion is called a comedo.
What causes acne?
Rising hormone levels during
puberty may cause acne. Also, acne is often found in families. . Other causes of acne
Hormone level changes during a woman’s menstrual cycle
Hormone changes during pregnancy
Starting or stopping birth control pills
Certain medicines (such as corticosteroids, lithium, and barbiturates)
Oil and grease from the scalp, mineral or cooking oil, and certain cosmetics
Diet may also play a role
Squeezing the pimples or scrubbing
the skin too hard can make acne worse. Skin may also become irritated with friction or
pressure from helmets, backpacks, or tight collars. Pollution or high humidity can also
irritate the skin.
What are the symptoms of acne?
Acne can appear as pimples without
abscesses or pus-filled cysts that rupture and result in larger abscesses. It can happen
anywhere on the body and be superficial or deep. However, acne most often appears in
areas where there is a high concentration of sebaceous glands, including:
Acne may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.
How is acne diagnosed?
Your healthcare provider can usually diagnose acne by examining your skin.
How is acne treated?
Your healthcare provider will
consider your age, overall health, the severity of the acne and other factors in
determining what treatment is best for you.
Treatment for acne focuses on
minimizing scarring and improving appearance. Treatment for acne may include medicines
you apply to your skin or medicine you take in pill form. Some of these medicines need
to be prescribed by your healthcare provider. In some cases, a combination of both types
of medicines may be advised.
Medicines you apply to the skin are
often prescribed to treat acne. These may be in the form of a cream, gel, lotion, or
solution. Examples include:
Kills the bacteria
and helps reduce the oil made by the sebaceous glands
Helps stop or slow
down the growth of the bacteria and reduces inflammation. Erythromycin
and clindamycin are commonly used.
development of new acne lesions and encourages cell turnover, unplugging
pimples. These include tretinoin, adapalene, and tazarotene.
Topical tazelaic acid, salicylic
acid, and dapsone are also commonly used. Acne medicines you take by mouth, or oral
antibiotics, are often prescribed to treat moderate to severe acne, and may include the
Spironolactone or birth control
pills can be used by women to affect hormones to control acne. Isotretinoin is a
prescription medicine taken by mouth for severe, cystic, or inflammatory acne. It is
used when other methods can’t prevent extensive scarring. Isotretinoin reduces the size
of the sebaceous glands that make the skin oil. It also increases skin cell shedding,
and affects the hair follicles. These effects reduce the development of acne.
Isotretinoin can clear acne in most people who use it. However, the medicine sometimes
has side effects, including potential psychiatric side effects. It 's very important to
discuss this medicine with your healthcare provider.
Women who are pregnant or who are
able to become pregnant must not take isotretinoin. It can cause birth defects.
Isotretinoin can also cause miscarriage or premature birth.
Your healthcare provider can
recommend specific steps to minimize acne scars.
Laser therapy or light therapy may be used to reduce the bacteria in
the clogged pores. Photodynamic therapy is a laser procedure used to control moderate to
Although acne often is a chronic
condition, even if it lasts only during adolescence, it can leave lifelong scars. Acne
scars typically look like "ice pick" pit scars or crater-like scars. Although proper
treatment may help reduce scarring, several dermatological procedures may help to
further reduce any acne scars, including the following:
Dermabrasion. This may be used to
minimize small scars, minor skin surface irregularities, surgical scars, and acne
scars. It involves removing the top layers of skin with an electrical machine that
"abrades" the skin. As the skin heals from the procedure, the surface appears
smoother and fresher.
Chemical peels. These are often used
to reduce sun-damaged skin, irregular pigment, and superficial scars. The top layer
of skin is removed with a chemical applied to the skin. By removing the top layer,
the skin regenerates, often improving the skin's appearance.
Dermal filler injections. These are
injected beneath the skin to replace the body's natural collagen that has been lost.
Injectable dermal fillers are generally used to treat wrinkles, scars, and facial
Laser resurfacing. This uses
high-energy light to burn away damaged skin. It may be used to reduce wrinkles and
Phototherapy or blue light therapy.
Phototherapy using a blue light source. It has been shown to decrease the number
of acne-causing bacteria with minimal side effects, such as dry skin. Blue light
therapy doesn't use ultraviolet (UV) light, so it doesn't damage the skin as earlier
types of light therapy did.
Pulsed light and heat energy (LHE)
therapy. This type of combined light and heat therapy is believed to work by
destroying acne-causing bacteria. It also shrinks the glands in the skin that make
oil. The FDA has approved an LHE system that uses green light and heat pulses for
treating mild to moderate acne.
Punch grafts. Punch grafts are small
skin grafts used to replace scarred skin. A hole is punched in the skin to remove the
scar. This is then replaced with unscarred skin (often from the back of the earlobe).
Punch grafts can help treat deep acne scars.
Autologous fat transfer. An
autologous fat transfer uses fat taken from another site on your own body that is
injected into your skin. The fat is placed beneath the surface of the skin to push up
the depressed scars. This method is used to correct deep contour defects caused by
scarring from severe acne. Because the fat may be reabsorbed into the skin over
months, you may need to have this procedure repeated.
What are possible complications of acne?
Acne can leave lifelong physical scars. It can also cause self-esteem problems.
Can acne be prevented?
Acne is caused by normal hormonal
changes that happen during puberty. This makes prevention of acne very hard, or even
However, avoiding substances that can cause acne may help. This includes certain medicines (such as corticosteroids, lithium, and barbiturates), mineral or cooking oil, or certain cosmetics. Also, daily shampooing helps prevent oil and grease on the scalp from getting on your face or back. Early treatment of acne may prevent it from getting worse and causing scars.
When should I call my healthcare provider?
Acne is a common condition. If you have acne that isn't helped with home care or is severe or leaving scars, see your healthcare provider.
Key points about acne
Acne is a disorder of the hair
follicles and oil (sebaceous) glands that become clogged. This leads to pimples and
Acne is a common condition that
usually starts during puberty because of hormonal changes.
Acne can be either superficial or deep.
If untreated, acne can cause scaring that can last a lifetime.
Avoiding substances that make acne worse, and early treatment of acne, can reduce or prevent acne scars.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider
if you have questions or if an emergency occurs.
Online Medical Reviewer:
Maryann Foley RN BSN
Online Medical Reviewer:
Michael Lehrer MD
Online Medical Reviewer:
Raymond Kent Turley BSN MSN RN
Date Last Reviewed:
© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.