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Acne


What Is Acne?

Acne is a common skin condition that shows up as different types of bumps. These can be blackheads, whiteheads, pimples, or cysts.

Most people have acne at some point. Almost 8 in 10 teens get acne, as do many adults. In fact, acne is so common that it's considered a normal part of puberty. The good news is that, for most people, acne usually goes away or gets a lot better as they enter their twenties.

What Causes Acne?

Teens get acne because of the hormonal changes that come with puberty. If your parents had acne as teens, it's more likely that you will too.

Many teens get a type of acne called acne vulgaris. It usually shows up on the face, neck, shoulders, upper back, and chest. It happens when pores get clogged:

  • Skin's pores (or hair follicles) contain sebaceous glands (or oil glands). These glands make sebum (SEE-bum), an oil that lubricates hair and skin.
  • Most of the time, sebaceous (sih-BAY-shiss) glands make the right amount of sebum. During puberty, though, hormones stimulate the sebaceous glands to make more sebum.
  • Dead skin cells rise to surface of pore, then the body sheds the cells.
  • Pores get clogged when there's too much sebum and too many dead skin cells.
  • Bacteria (especially a type known as p. acnes) get trapped inside clogged pores and multiply. This causes swelling and redness — the start of acne.

Many girls get acne (or their acne gets worse) a few days before they get their period. This is called premenstrual acne. It's caused by changes in hormones during their menstrual cycle.

Views below the surface
            show skin with and without acne.

What Are the Types of Acne Blemishes?

Whiteheads and Blackheads

Both of these blemishes happen when pores get clogged by dead skin cells and bacteria. What's the difference?

  • Whiteheads: These happen when a clogged pore bulges out from the skin but stays closed. The clog stays below the skin's surface.
  • Blackheads: These are when a clogged pore stays open to the air and its surface darkens.

Pimples/Pustules/Papules

It's common to call all acne bumps pimples. But pimples are different from whiteheads and blackheads. Pimples happen when the wall of the pore breaks opens. This lets sebum, bacteria, and dead skin cells get under the skin. A papule is a closed red bump that's hard and might be painful to touch. A pustule is a pimple that has a pus-filled top (containing dead white blood cells) from the body's reaction to the bacterial infection.

Cysts and Nodules

When the inflammation of a clogged pore goes deep into the skin, it causes an acne cyst or nodule. These infected lumps are bigger than pimples and can hurt. Occasionally, large cysts that seem like acne may be boils caused by a staph infection.

How Is Acne Treated?

If you look in the mirror and see a pimple, don't touch it, squeeze it, or pick at it. This might be hard to do — it can be tempting to try to get rid of a pimple. But playing around with pimples can cause even more inflammation, lead to an infection, and make the acne take longer to heal. It also can leave tiny, permanent scars on your skin.

Instead, you can treat acne with many different topical (put on the skin) creams, lotions, and liquids that are available without a prescription. For more serious acne, or if home care doesn't help, call your doctor.

Acne Home Care

Many over-the-counter lotions and creams containing salicylic acid or benzoyl peroxide are available to help prevent acne and clear it up at the same time. You can try a variety of these to see which helps. Follow the instructions, and don't use more than you're supposed to at one time. Your skin may get too dried out and feel and look worse. Follow any label directions about allergy testing before using.

Getting a Doctor's Help for Acne

Some teens with acne might see a doctor or dermatologist (a doctor who specializes in skin problems). If needed, they can treat acne with prescription medicines. Depending on the person's acne, this might mean:

  • using prescription creams that prevent pimples
  • taking antibiotics to kill the bacteria that help create pimples
  • for some girls, taking birth control pills help to clear up their acne
  • for severe acne, taking stronger medicines such as isotretinoin

Other treatments can include:

  • laser treatments
  • chemical peels
  • minor surgery called "drainage and extraction" to remove cysts 

Can Acne Be Prevented?

It can be hard to completely prevent acne. Most people have it at some point, and for teens it can feel unavoidable. Still, these tips can help limit acne or make it clear up sooner:

Skin Cleaning

To help prevent the oil buildup that can lead to acne, wash your face once or twice a day with a mild soap and warm water. Don't scrub your face hard with a washcloth — acne can't be scrubbed away, and scrubbing may actually make it worse by irritating the skin and pores. Try cleansing your face as gently as you can.

If you have a job that puts you in contact with oil — like in a fast-food restaurant or gas station, for example — wash your face well when you get home. It also can help to wash your face after you've been exercising.

Makeup

If you wear makeup or sunscreen, make sure it's labeled "noncomedogenic" or "nonacnegenic." This means it won't clog pores and contribute to acne. When you wash your face, be sure to remove all makeup so it doesn't clog your pores.

Sun Exposure

It's not true that being in the sun helps acne. A tan can temporarily make acne look less severe, but it won't help it go away permanently. And some people find that the oils their skin makes after being in the sun make their pimples worse.

Hair Care and Products

If you use hair sprays or gels, try to keep them away from your face, as they also can clog pores. If you have long hair that touches your face, wash it often enough to keep oil away. 

Foods

Some people notice their breakouts get more severe when they eat too much of some foods. If you're one of them, try to cut back on that food to see what happens.

If you have acne, you're far from alone. Finding the right treatment can help you deal with it. If one OTC product doesn't help, try another. If you're tried a bunch without results, call your doctor. To find a dermatologist in your area, visit:

Reviewed by: Patrice Hyde, MD
Date reviewed: September 2019