Acne is a disorder of the hair follicles and oil glands (sebaceous glands). The sebaceous 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 begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls. This causes the sebaceous glands to make more oil.
Normally, the sebum produced travels through the hair follicles to the skin. However, skin cells can plug the follicles. This can block the sebum. When follicles become plugged, skin bacteria begin to grow inside the follicles. Inflammation and pimples then develop. The most common types of pimples are:
The basic acne lesion is called a comedo.
Rising hormone levels during puberty may cause acne. Also, acne is often inherited. Other causes of acne may include the following:
Squeezing the pimples or scrubbing the skin too hard can make acne worse. The skin may also become irritated with friction or pressure from helmets, backpacks, or tight collars. Pollution or humidity can also irritate the skin.
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. 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.
Your healthcare provider can usually diagnose acne by examining your skin.
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:
Topical tazarotene, azelaic 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 following:
Spironolactone or birth control can be used by women to affect hormones to control acne. Photodynamic therapy is a laser procedure used to control moderate to severe 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 the majority of people who use it. However, the medicine has major side effects, including potential psychiatric side effects. It is 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.
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:
Acne can leave lifelong physical scars. It can also cause self-esteem problems.
Acne is caused by normal hormonal changes that happen during puberty. This makes prevention of acne very difficult, or even impossible.
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.