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Acne is a skin problem that causes pimples and other skin changes.

What are the causes?

Acne is caused when oil glands get blocked with sebum, dead skin cells, and dirt. The bacteria that are normally found in the oil glands then multiply and cause inflammation.

Acne is commonly triggered by changes in your hormones. These hormonal changes can cause the oil glands to get bigger and to make more sebum. Factors that can make acne worse include:

• Hormone changes during:
  • Adolescence
  • Women's menstrual cycles.
  • Pregnancy
• Oil-based cosmetics and hair products.
• Stress.
• Hormone problems that are caused by certain diseases.
• Certain medicines.
• Pressure from headbands, backpacks, or shoulder pads.
• Exposure to certain oils and chemicals.
• Eating a diet high in carbohydrates that quickly turn to sugar. These include dairy products, desserts, and chocolates.

What increases the risk?

This condition is more likely to develop in:

• Teenagers
• People who have a family history of acne.

What are the signs or symptoms?

Symptoms include:

• Small, red bumps (pimples or papule).
• Whiteheads
• Blackheads
• Small, pus-filled pimples (pustules).
• Big, red pimples or pustules that feel tender.

More severe acne can cause:

• An abscess. This is an infected area that contains a collection of pus.
• Cysts. These are hard, painful, fluid-filled sacs.
• These can happen after large pimples heal.

How is this diagnosed?

This condition is diagnosed with a medical history and physical exam. Blood tests may also be done.

How is this treated?

Treatment for this condition can vary depending on the severity of your acne. Treatment may include:

• Creams and lotions that prevent oil glands from clogging.
• Creams and lotions that treat or prevent infections and inflammation.
• Antibiotic medicines that are applied to the skin or taken as a pill.
• Pills that decrease sebum production.
• Birth control pills.
• Light or laser treatments.
• Injections of medicine into the affected areas.
• Chemicals that cause peeling of the skin.
• Surgery

Your healthcare provider will also recommend the best way to take care of your skin. Good skin care is the most important part of treatment.

 
Follow these instructions at home:

Skin care

Take care of your skin as told by your healthcare provider. You may be told to do these things:

• Wash your skin gently at least two times each day, as well as:
  • After you exercise.
  • Before you go to bed.
• Use mild soap.
• Apply a water-based skin moisturiser after you wash your skin.
• Use a sunscreen or sunblock with SPF 30 or greater. This is especially important if you are using acne medicines.
• Choose cosmetics that will not block your oil glands (are noncomedogenic).

Medicines

• Take over-the-counter and prescription medicines only as told by your healthcare provider.
• If you were prescribed an antibiotic medicine, apply it or take it as told by your health are provider. Do not stop using the antibiotic even if your condition improves.

General instructions

• Keep your hair clean and off your face. If you have oily hair, shampoo your hair regularly or daily.
• Avoid wearing tight headbands or hats.
• Avoid picking or squeezing your pimples. That can make your acne worse and cause scarring.
• Shave gently and only when necessary.
• Keep a food journal to figure out if any foods are linked to your acne. Avoid dairy products, desserts, and chocolates.
• Take steps to manage and reduce stress.
• Keep all follow-up visits as told by your healthcare provider. This is important.

Contact a healthcare provider if:

• Your acne is not better after eight weeks.
• Your acne gets worse.
• You have a large area of skin that is red or tender.
• You think that you are having side effects from any acne medicine.
  
  

Summary

• Acne is a skin problem that causes pimples and other skin changes. Acne is a common skin problem, especially for teenagers. Acne usually goes away over time.
• Acne is commonly triggered by changes in your hormones. There are many other causes, such as stress, diet, and certain medicines.
• Follow your health care provider's instructions for how to take care of your skin. Good skin care is the most important part of treatment.
• Take over-the-counter and prescription medicines only as told by your healthcare provider.
• Contact your healthcare provider if you think that you are having side effects from any acne medicine.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

References:

Gannon M., Underhill M., Wellik K.E.: Which oral antibiotics are best for acne?. J Fam Pract 2011; 60: pp. 290-292.

Knutsen-Larson S., Dawson A.L., Dunnick C.A., et. al.: Acne vulgaris: Pathogenesis, treatment, and needs assessment. Dermatol Clin 2012; 30: pp. 99-106.

Titus S., Hodge J.: Diagnosis and treatment of acne. Am Fam Physician 2012; 86: pp. 734-740.

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