Acne

Many people develop acne during their life, usually in their teens. It’s common to get the skin condition during teenage years as part of puberty, but acne affects people of all ages. Learn about the different types of acne, their causes and how to treat them effectively.

Last Modified: October 4, 2022
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What Is Acne?

Acne is an inflammatory skin condition that can develop when hair follicles are clogged with dead skin cells and oil. It can take the form of blackheads, pimples or whiteheads that appear on the chest, face and forehead. While acne in teens is most common, it can also affect people of any age.

There are a variety of treatments available that can resolve acne. However, it can be a persistent condition and some treatments may take longer than others to show noticeable results. A study by the American Academy of Dermatology Association shows that acne can also lead to scarring. Early treatment can help prevent the risk of serious acne scars.

Types of Acne

Acne is a generic term that describes various forms of skin inflammation. Skin specialists categorize it into six types. Some are more serious, while others are easier to treat.

The major concern about acne is that it can lead to long-term scarring. Lasting facial scarring is what many people fear when they discover that their blemishes and pimples are serious.

The six common types of acne are:
  • Blackheads: Blackheads are black on the skin surface, and doctors often call them open comedones — tiny bumps that can be white, dark or flesh-colored.
  • Whiteheads: Whiteheads, alternatively known as closed comedones, occur when skin pores get clogged by oil.
  • Pustules: Pustules are small bumps with red, inflamed skin surrounding a white center. They develop in bunches on the face, back or chest. Pustules usually form when clogged pores get infected.
  • Cysts: Cysts are the most severe form of acne, and result from an infection within the skin. They’re often softer than other acne types because they’re filled with pus.
  • Papules: Papules form when excess skin cells or oil clog pores and mix with bacteria. The content of the clogged pore spills out, allowing the bacteria to escape into the surrounding tissues. The spillage creates inflamed lesions called papules.
  • Nodules: Nodular acne results from bacteria that cause painful infections within a pore.

Whiteheads and blackheads are the mildest forms of acne. Cysts and nodules are severe forms of acne. Left untreated — or treated improperly — both can lead to long-term scarring.

What Causes Acne?

Clogged follicles are the primary cause of acne. The sebaceous glands are tiny glands on the skin’s surface where individual hairs grow. The glands produce sebum that lubricates the skin and hair to prevent them from drying out. Excess sebum can clog the follicle, leading to acne.

Acne can also develop because of certain medications or increased levels of testosterone hormones in teenagers. Additionally, smoking contributes to acne, particularly in seniors. Research has also linked acne to steroid medicines prescribed for treating bipolar disorder and depression.

Who Is Most at Risk of Developing Acne?

Almost anyone can develop acne, and it affects one in 10 people. But the skin condition is most common — and most severe — among teens and those undergoing hormonal changes. Babies can also experience baby acne because of hormonal fluctuations following birth.

Acne in teens occurs because of hormonal changes when the body goes through puberty. Teens normally get acne vulgaris, which usually shows up on the shoulders, face, chest, neck and upper back.

People with a family history of acne, smokers, people who take certain medications, particularly those for epilepsy or depression, are at increased risk for acne. Those with various endocrine disorders, including Cushing syndrome, are also at higher risk of developing acne.

Acne in Women

Men and women both experience hormonal acne during puberty. At this stage, girls tend to have high androgen hormones, which causes the glands to enlarge and produce more sebum.

Menopause and pregnancy are also high-risk times for acne in women. Women with polycystic ovary disease experienced increased rates of acne as well.

How to Treat Acne

With several prescription acne treatment options, you might not see results for up to eight weeks. It can take months to clear acne entirely in severe cases. Your doctors will consider factors such as the severity of the condition, your age and overall health.

Basic treatment regimens for specific acne types:
  • Blackheads: They can be squeezed out, but this can cause scarring. Effective over-the-counter treatments include benzoyl peroxide and salicylic acid.
  • Whiteheads: Topical retinoids or tretinoin are some of the typical treatments for whiteheads.
  • Pustules: Dermatologists may safely drain pustules and recommend either over-the-counter treatment or prescription medication.
  • Cysts: Cystic acne is hard to treat, and you may need multiple medications.
  • Papules: Dermatologists may prescribe topical retinoids or other prescription medications.
  • Nodules: Typically, these are treated with OTC medication and sometimes a dermatologist will drain the nodules.

Acne treatments focus on improving the appearance and preventing a breakout. Your doctor may write a prescription for topical medications. Some doctors also prescribe birth control medication and other oral medications as part of an acne treatment plan. Discuss any side effects with your prescribing doctor or pharmacist. Seek medical help urgently for severe complications.

When to See a Doctor for Acne

When home acne remedies or OTC treatments don’t work, you may want to see a doctor, who in severe cases may refer you to a dermatologist. If you’re under the care of a dermatologist and your condition worsens, schedule an appointment to discuss adjusting any prescription doses or trying new medications.

Your doctor will examine your skin, discuss your overall health as well as medical and family history. You and your health practitioner will find an ideal solution for you.

How to Prevent Acne

Acne is not a preventable condition. Many factors from genetics to hormones play a role. There are some skin care practices, however, that may help reduce the severity, duration and incidences of breakouts.

The idea that insufficient face washing causes acne is a myth. Excessive scrubbing and harsh chemicals can irritate skin and worsen acne and trigger further breakouts. Gentle cleansing, avoiding scrubbing and skin friendly cleansers twice a day can help care for skin.

Discussing overall health information with your doctor to ensure you are maintaining your overall health can help as well. Rest, balanced nutrition, sunscreen, avoiding smoking and reducing alcohol consumption and managing other health conditions can help.

Avoid picking acne when you do experience a breakout. Over the counter treatments can help reduce acne when it occurs and prevent it from worsening. Ensuring skin care products are noncomedogenic can also help.

Please seek the advice of a medical professional before making health care decisions.