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Acne, or acne vulgaris, is a skin problem that starts when oil and dead skin cells clog up your pores. Some people call it blackheads, blemishes, whiteheads, pimples, or zits. When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or it can be bigger, solid, red lumps that are painful (cysts).
Acne is very common among teens. It usually gets better after the teen years. Some women who never had acne growing up will have it as an adult, often right before their menstrual periods.
Acne starts when oil and dead skin cells clog the skin's pores. This traps bacteria inside the pores, causing swelling, redness, and pus. For most people, acne starts during the teen years. This is because hormone changes make the skin oilier after puberty starts.
Symptoms of acne include whiteheads, blackheads, and pimples and cystic lesions. These can occur on the face, neck, shoulders, back, or chest. Mild acne usually causes only whiteheads and blackheads. Severe acne can produce hundreds of pimples that cover large areas of skin.
When you see a doctor about acne, you'll have a physical exam. Your doctor will ask you questions about your past and current health. Women may be asked questions about their menstrual cycles. Most often, you won't have any special tests to diagnose acne.
To help control acne, keep your skin clean. Avoid skin products that clog your pores. Look for products that say "non-comedogenic" on the label. Wash your skin once or twice a day with a gentle soap or acne wash. Try not to scrub or pick at your pimples. This can make them worse and can cause scars.
If you have mild acne, you can get an acne cream without a prescription. Look for one that has benzoyl peroxide or salicylic acid. These work best when they're used just the way the label says.
It can take time to get acne under control. But if non-prescription products haven't helped after 3 months, see your doctor. You may need different medicines or prescription medicines. The medicines may be creams or pills, and may include antibiotics or medicines derived from vitamins. If you are a woman, taking certain birth control pills may help control acne.
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Acne starts when skin glands start making more oil. The oil and dead skin cells can clog the pores of the skin. This traps bacteria inside the pores causing swelling, redness, and pus.
For most people, acne starts during the teen years. This is because hormone changes make the skin oilier after puberty starts.
Acne can run in families. If one of your parents had severe acne, you are more likely to have it. Certain medicines, such as corticosteroids or lithium, can also cause acne to form.
Sometimes newborns have acne because their mothers pass hormones to them just before they are born. Acne can also appear when the stress of birth causes the baby's body to release hormones on its own. Young children and older adults also may get acne.
A few conditions, such as polycystic ovary syndrome and Cushing's syndrome, can lead to outbreaks of acne.
The tendency to develop acne runs in families.
The risk of getting acne is highest during the teen and young adult years. These are the years when hormones such as testosterone are increasing. Many women have acne flare-ups in the days just before their menstrual periods.
Acne can be made worse if you:
Symptoms of acne include whiteheads, blackheads, and pimples. These can occur on the face, neck, shoulders, back, or chest.
Mild acne usually causes only whiteheads and blackheads. At times, these may develop into an infection in the skin pore (pimple).
Severe acne can produce hundreds of pimples that cover large areas of skin. Cystic lesions are pimples that are large and deep. These lesions are often painful and can leave scars on your skin.
Acne can last for a few months or many years. Or it may come and go your entire life.
Acne develops most often in the teen and young adult years. During this time, both males and females usually produce more testosterone than at any other time in life. This hormone causes oil glands to produce more oil (sebum). The extra oil and dead skin cells can clog pores. This traps bacteria inside the pores, causing swelling, redness, and pus (pimples).
Acne usually gets better in the adult years when your body produces less testosterone. Still, some women have premenstrual acne flare-ups well into adulthood.
Call a doctor if:
You may want to see a doctor sooner if you have a strong family history of acne, are emotionally affected by acne, or got acne at an early age.
Watchful waiting is a wait-and-see approach. If you get better on your own, you won't need treatment. If you get worse, you and your doctor will decide what to do next.
Mild acne, with a few pimples that clear up on their own, may not need any treatment. But if you are worried about how much you're breaking out, see your doctor. Getting medical treatment early may prevent acne from getting worse or from causing scars.
When you see a doctor about acne, you'll have a physical exam. Your doctor will ask you questions about your past and current health. Women may be asked questions about their menstrual cycles. This information can help a doctor find out if hormones are playing a role in a woman's acne.
Most often, you won't have any special tests to diagnose acne.
You may need other tests if your doctor suspects that acne is a symptom of another medical problem. These problems include higher-than-normal amounts of testosterone in a woman.
Acne treatment depends on whether you have a mild, moderate, or severe type of acne. Sometimes a doctor will combine treatments to get the best results and to avoid developing drug-resistant bacteria. Treatment could include lotions or gels you put on blemishes or sometimes on entire areas of skin, such as the chest or back (topical medicines). You might also take medicines by mouth (oral medicines).
Most treatments for acne take time. It often takes 6 to 8 weeks for acne to improve after you start treatment. Some treatments may cause acne to get worse before it gets better.
Certain medicines, such as low-dose birth control pills or spironolactone, may help control acne for some women.
If you have just a few pimples to treat, you can get an acne cream without a prescription. Look for one that has benzoyl peroxide or salicylic acid. These work best when they're used just the way the label says.
Treatment for mild acne (whiteheads, blackheads, or pimples) may include:
If these treatments don't work, you may want to see your doctor. You may be given a prescription for stronger lotions or creams. You may try an antibiotic lotion. Or you may try a lotion with medicine that helps to unplug your pores.
Sometimes acne needs treatment with stronger medicines or a combination of therapies. Deeper blemishes, such as nodules and cysts, are more likely to leave scars. So your doctor may give you oral antibiotics sooner to start the healing process. This kind of acne may need a combination of several therapies. Treatment for moderate-to-severe acne may include:
Photodynamic therapy (PDT) and other light and laser-based therapies are being used to treat acne. These include the use of blue light, red light, intense pulsed light (IPL), and infrared or pulsed dye lasers. Sometimes these treatments are used along with medicines. But they may also help people who can't be treated with medicines.
There are many procedures to remove acne scars, such as laser resurfacing, chemical peels, and dermal fillers. Some scars shrink and fade with time. But if your scars bother you, talk to your doctor. You may be referred to a dermatologist or a plastic surgeon.
Medicated creams, soaps, lotions, and gels can help treat your acne. Always read the label carefully to make sure you are using the product the right way.
Use over-the-counter acne medicines. Examples include:
Some skin care products, such as those with alpha hydroxy acid, will make your skin very sensitive to ultraviolet (UV) light. Protect your skin from the sun and other sources of UV light.
Medicines can help manage how severe acne outbreaks are and how often they occur.
Treatment depends on whether inflammation or bacteria are present. The best treatment often is a combination of creams or lotions (topical medicines) and pills (oral medicines).
Creams and lotions usually have fewer and less serious side effects than pills. But they may not work as well for severe acne.
Medicines used to treat acne include:
Isotretinoin and the retinoid tazarotene can have serious side effects. Women who take one of these medicines need to use birth control to avoid having a baby with serious birth defects.
Current as of: March 22, 2023
Author: Healthwise StaffClinical Review Board: Kathleen Romito MD - Family MedicineAdam Husney MD - Family MedicineE. Gregory Thompson MD - Internal MedicineMartin J. Gabica MD - Family MedicineElizabeth T. Russo MD - Internal MedicineEllen K. Roh MD - Dermatology
Current as of: March 22, 2023
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Martin J. Gabica MD - Family Medicine & Elizabeth T. Russo MD - Internal Medicine & Ellen K. Roh MD - Dermatology
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