What is Acne?

Acne is a common skin disorder that is characterized by clogged pores and pimples. Nearly everyone suffers from outbreaks of pimples at some point in thier life. More than four out of five people between the ages of 12 and 24 have acne at least once. Teenage boys seem to have the most severe cases.

While acne is generally associated with teenagers, it can affect people of any age. 20% of all cases occur in adults. Women are more likely to have mild to moderate forms of acne into their 30’s and beyond. It starts when greasy secretions from the skin’s sebaceous glands plug the tiny openings for hair follicles. If the openings are large, the clogs take the form of blackheads. If the openings stay small, the clogs take the form of whiteheads. Both types of clogged pores can develop into swollen tender pimples or deeper lumps.   Cycts associated with severe acne cases (Cystic Acne) are firm swellings below the skins surface that become inflamed and sometimes infected. Acne lesions are most common on the face, but they can also occur on the neck, chest, back, shoulders, scalp, and upper arms. Acne isn’t caused by diet, poor hygiene, or an uncontrolled sex drive. The truth is that heredity and hormones cause most forms of acne. Acne is rarely a serious medical condition, but often it can cause emotional distress and can lead to scarring. With the right treatment, you can often keep your acne under control.

Acne symptoms

Acne usually occurs on the face, neck, chest, back, shoulders, and scalp and can take the following forms:

Whiteheads – These are created when small openings of the hair follicles become clogged and blocked with oil secretions and dead skin.

Blackheads – These are similar to whiteheads, but occur in larger openings of hair follicles, are open to the skin surface and become dark in color when exposed to air.

Pimples – These are raised, red spots that signal inflammation or infection in the hair follicles.

Cysts – These are thick lumps beneath the surface of the skin formed by the buildup of secretions deep within hair follicles.


Although the cause of acne is not fully understood, it is believed that acne occurs when hair follicles become plugged with oil and dead skin cells.  Each follicles is connected to a sebaceous gland.  These glands secrete an oily substance called sebum to lubricate your hair and skin.  Sebum normally travels up the hair shaft and out through openings in the skin, however, when your body produces an excess amount of sebum, it can accumulate with dead skin cells to plug up the hair follicle.  This plug can cause the follicle wall to bulge and produce a whitehead.  The plug may darken and become a blackhead.  Pimples are raised red spots with a white center that develops due to inflammation or infection in the follicle.   Other pores in your skin (such as openings for sweat glands) aren’t normally involved in acne.

It’s not known what causes sebum production to increase, however, it has been discovered that diet and hygiene factors do not play a role in acne outbreaks.  A number of factors may be involved in causing acne.  These factors include hormones, bacteria, certain medications, heredity and stress. Depending on the type of pill, oral contraceptives may trigger acne in some women but suppress it in others. Steroids taken by some bodybuilders and other athletes can also lead to severe outbreaks.

What are the Risk Factors of Acne?

Hormonal changes in the body can provoke or make acne worse.  These changes are common in:

Teenage boys and girls, women two to seven days before their periods, pregnant women, people under stress, and people using certain medications

Other risk factors include:

exposing your skin directly to greasy or oily substances (or certain cosmetics), having a family history of acne, friction or pressure on your skin caused by items like telephones, helmets, tight collars, and backpacks.

How is Acne treated?

Nonprescription Treatment for Acne

Soap and Water – Cleansing the face with soap and water no more than 3 times a day removes excess oils on the skin.  This does not clear up acne that is already there.  Be gentle when cleansing an acne outbreak – agressive scrubbing can injure the skin and make the problem worse.

Benzoyl peroxide – For mild acne, try treatment with a nonprescription medication that contains Benzoyl peroxide.  This compound works by destroying the bacteria associated with acne.  It usually takes at least four weeks to work and must be used continuously to keep acne away until you outgrow your acne stage.  Benzoyl peroxide does not affect sebum production or the way the skin follicles are shed.  When you stop using it, the acne may come back.

Salicylic Acid – On the skin, salicylic acid helps to correct the abnormal shedding of cells.  For mild acne, salicylic acid helps unclog pores to correct and prevent lesions.  Salicylic acid does not effect the sebum production and does not kill bacteria.

Prescription Acne Treatments

Medicated acne treatments work by reducing the oil production, speeding up skin cell turnover, fighting bacterial infection, or doing all three.  With most prescribed treatments, you may not see results for up to eight weeks and you skin will likely get worse before the treatment starts to work.  Oral prescription medication for acne should not be used during pregnancy.

Your doctor may recommend one or more of the following acne treatments:

Antibiotics – For moderate to severe acne, prescription oral antibiotics may be needed to reduce the bacteria and fight inflammation in the skin.  These may need to be taken for months, and you may need to use them in combination with topical products.

Isotretinoin – For deep cysts, antibiotics might not be enough.  Isotretinoin (Accutane) is a strong medication available for scarring cystic acne, or acne that doesn’t respond to other treatments.  This medicine is reserved for the most severe forms of acne.  It is very effective, but people who take it need close monitoring by a dermatologist because of the possibility of severe side effects.

Oral Contraceptives – Birth control pills, including a combination of norgestimate and ethinyl estradiol (Ortho-Cyclen, Ortho Tri-Cyclen) have been shown to improve acne in women.  Oral contraceptives may cause other side effects that you’ll want to discuss with your doctor about.

Cosmetic Surgery – Doctors may be able to use cosmetic surgery to diminish scars left by acne.  Procedures include peeling away damaged skin with chemicals or by freezing it, dermabrasion, and laser resurfacing.  Peeling procedures eliminate superficial scars.  Dermabrasion, which is usually reserved for more severe acne scars, involves removing the top layers of skin with a rapidly rotating wire brush.  Laser resurfacing involves using short pulses of intense light to remove the outer layer of your skin.  If your skin tends to form scar tissue, these procedures can make your complexion worse.

How can you avoid Acne?

You can avoid or control acne (most) with good basic skin care and the following self-care techniques:

Gently Cleanse – Using mild soap and warm water, gently cleanse your face twice daily.  Products such as facial scrubs, astringents and masks generally aren’t recommended because they tend to irritate skin, which can aggravate acne. Excessive washing and scrubbing also can irritate skin. If you tend to develop acne around your hairline, shampoo your hair frequently.

Dry excess oil with topical products – Look for products containing benzoyl peroxide, resorcinol or salicylic acid as the active ingredient.

Avoid Irritants – You may want to avoid oily or greasy cosmetics, sunscreens, hair-styling products or acne concealers. Use products labeled “water-based” or “noncomedogenic.” If the sun worsens your acne, protect yourself from sunlight — which is a good idea in general. If stress causes outbreaks, work on reducing your stress level.

Try not to touch your face – Keep your hair clean and off your face. Also avoid resting your hands or objects such as telephone receivers on your face. Tight clothing or hats also can pose a problem, especially if you’ll be sweating. Sweat, dirt and oils can contribute to acne.

Don’t pick, squeeze, or pop blemishes – Picking or squeezing can cause infection or scarring. Most acne will clear up without this kind of intervention. If you need aggressive treatment, see your doctor or dermatologist.