What causes acne?
Acne commonly starts in the early teen years, when the oil glands in the body start making more sebum (oil). In people who have acne, dead skin cells mix with the extra oil and plug up hair follicles in the skin. Bacteria that grow in the hair follicles cause more skin irritation.
A “whitehead” occurs when the hair follicle is plugged with oil and skin cells. If the follicle is plugged near the surface of the skin and the air touches it, it turns black and is called a “blackhead.” A blackhead isn’t caused by dirt.
If the wall of a plugged follicle breaks, the area swells and turns into a red bump. If the follicle wall breaks near the skin surface, the bump usually becomes a pimple. If the wall breaks deep into the skin, acne nodules or cysts can form. This is called “cystic acne.”
Things that often make acne worse
Oil-based makeup, suntan oil, and hair products
Hormonal changes, especially during menstruation
Squeezing or picking at blemishes
Hard scrubbing of the skin
Things that don’t cause acne
Chocolate or french fries
Who gets acne?
Both boys and girls get acne. But it may be worse in boys because they have more skin oils.
Heredity also plays a role. If your mother and father had bad acne, you may too.
Your immune system plays a role too. Some people are extra sensitive to the bacteria that get trapped in their hair follicles.
For many people, acne fades by the age of 25, but it can continue well into the adult years.
How can acne be treated?
Many treatments are available for acne, including over-the-counter creams and prescription medications. Talk with your doctor about which options are right for you.
Can an over-the-counter acne product help?
Yes. Benzoyl peroxide, resorcinol, salicylic acid, and sulfur are the most common over-the-counter medications used to treat acne. These medications are available in many forms, such as gels, lotions, creams, soaps or pads.
In some people, over-the-counter acne medications may cause side effects such as skin irritation, burning or redness. Tell your doctor if you have side effects that are severe or that don’t go away over time.
Keep in mind that it can take up to eight 8 weeks before you notice an improvement in your skin. If an over-the-counter acne product doesn’t seem to help after 2 months, get advice from your doctor.
What can my doctor prescribe?
Your doctor may recommend antibiotics, which can be very effective for treating acne. They can be taken by mouth or used on the skin in a lotion, cream, or gel.
Retinoids, such as tretinoin (brand names: Retin-A, Avita, Altinac cream) and adapalene (brand name: Differin), are usually rubbed onto the skin once a day. Be sure not to get them near your eyes, mouth, and the area under your nose.
If you use a retinoid, you must avoid the sun or use a strong sunscreen because this medicine increases your risk of getting a very bad sunburn. Women who are pregnant or may become pregnant should not use a retinoid called tazarotene (brand name: Tazorac) because it can cause birth defects.
How is severe cystic acne treated?
Isotretinoin (brand name: Accutane) may be used to treat severe cystic acne that doesn’t get better with other treatments. It’s a pill that is taken once a day by mouth for 15 to 20 weeks.
Isotretinoin should never be taken during pregnancy. It can cause serious side effects such as birth defects and miscarriages. Women on isotretinoin must use 2 types of birth control or not have sex starting 1 month before she begins taking the medication and lasting 1 month after she stops taking it.
There is a possibility that other serious side effects may occur, so people taking isotretinoin should be closely monitored by their doctor.
Does acne cause scars?
Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments are available.