What is acne?
Acne, or acne vulgaris, is a skin problem that starts when oil and dead skin cells clog up your pores. Some people call it blackheads, blemishes, whiteheads, pimples, or zits. When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or it can be bigger, solid, red lumps that are painful (cysts).
Most young people get at least mild acne. It usually gets better after the teen years. But many adult women do have acne in the days before their menstrual periods.
How you feel about your acne may not be related to how bad it is. Some people with severe acne are not bothered by it. Others are embarrassed or upset even though they have only a few pimples.
The good news is that there are many good treatments that can help you get acne under control.
What causes acne?
Acne starts when oil and dead skin cells clog the skin's pores. If germs get into the pores, the result can be swelling, redness, and pus.
For most people, acne starts during the teen years. This is because hormone changes make the skin more oily after puberty starts.
You do not get acne from eating chocolate or greasy foods. But you can make it worse by using oily skin products that clog your pores.
Acne can run in families. If one of your parents had severe acne, you are more likely to have it.
What are the symptoms?
Symptoms of acne include whiteheads, blackheads, and pimples. These can occur on the face, neck, shoulders, back, or chest. Pimples that are large and deep are called cystic lesions. These can be painful if they get infected. They also can scar the skin.
How is acne treated?
To help control acne, keep your skin clean. Avoid skin products that clog your pores. Look for products that say "noncomedogenic" on the label. Wash your skin once or twice a day with a gentle soap or acne wash. Try not to scrub or pick at your pimples. This can make them worse and can cause scars.
If you have just a few pimples to treat, you can get an acne cream without a prescription. Look for one that has benzoyl peroxide or salicylic acid. These work best when used just the way the label says.
It can take time to get acne under control. Keep using the same treatment for 6 to 8 weeks. You may even notice that it gets worse before it gets better. If your skin is not better after 8 weeks, try another product.
Acne - Treatment Overview
Acne treatment depends on whether you have a mild, moderate, or severe form. Sometimes your doctor will combine treatments to get the best results and to avoid developing drug-resistant bacteria. Treatment could include lotions or gels you put on blemishes or sometimes entire areas of skin, such as the chest or back (topical medicines). You might also take medicines by mouth (oral medicines).
Treatment for mild acne (whiteheads, blackheads, or pimples) may include:
- Gentle cleansing with a mild soap (such as Dove or Neutrogena).
- Applying benzoyl peroxide (such as Brevoxyl or Benzac).
- Applying salicylic acid (such as Propa pH or Stridex).
If these treatments do not work, you may want to see your doctor. Your doctor can give you a prescription for stronger lotions or creams. You may try an antibiotic lotion. Or you may try a lotion with medicine that helps to unplug your pores.
Moderate to severe acne
Sometimes acne needs treatment with stronger medicines or a combination of therapies. Deeper blemishes, such as nodules and cysts, are more likely to leave scars. As a result, your doctor may give you oral antibiotics sooner to start the healing process. Inflammatory acne may need a combination of several therapies. Treatment for moderate to severe acne may include:
- Applying benzoyl peroxide.
- Draining of large pimples and cysts by a doctor.
- Applying prescription antibiotic gels, creams, or lotions.
- Applying prescription retinoids.
- Applying azelaic acid.
- Taking prescription oral antibiotics.
- Taking prescription oral retinoids (such as Accutane).
Treatment for acne scars
Treatment may improve and even remove acne scars. Sometimes a combination of treatments works best. These treatments include:
- Collagen injections, which smooth the skin by plumping the skin under the scar.
- Dermabrasion, which uses a whirling wire brush to skim off scar tissue.
- Laser resurfacing, which uses a carefully controlled laser to burn away scar tissue.
- Chemabrasion, which uses chemicals to peel away top layers of skin.
What To Think About
- Most treatments for acne take time. It often takes 6 to 8 weeks for acne to improve after you start treatment. Some treatments may cause acne to get worse before it gets better.
- If your acne still hasn't improved after several tries with other treatment, your doctor may recommend that you take an oral retinoid, such as isotretinoin (Accutane). Doctors prescribe this medicine as a last resort, because it has some rare but serious side effects and is expensive.
- Certain low-dose birth control pills may help control acne in women who tend to have flare-ups before menstruation.
Acne - Prevention
Although you cannot prevent acne, there are steps you can take at home to keep acne from getting worse.
- Gently wash and care for your skin every day. Avoid scrubbing too hard or washing too often.
- Avoid heavy sweating if you think it causes your acne to get worse. Wash soon after activities that cause you to sweat.
- Wash your hair often if your hair is oily. Try to keep your hair off of your face.
- Avoid hair care products such as gels, mousses, cream rinses, and pomades that contain a lot of oil.
- Avoid touching your face.
- Wear soft, cotton clothing or moleskin under sports equipment. Parts of equipment, such as chin straps, can rub your skin and make your acne worse.
- Avoid exposure to oils and harsh chemicals, such as petroleum.
- Avoid long periods of time in sunlight, as this doesn't help acne and can increase your risk of skin cancer. Use sunscreens when you are out in the sun.
Acne - Home Treatment
Treatment at home can help reduce acne flare-ups.
- Wash your face (or other affected skin) gently one or two times a day.
- Do not squeeze pimples, because that often leads to infections, worse acne, and scars.
- Use water-based skin care products that gently clean your skin. Avoid products such as milky cleansers, cold creams, lipsticks, and lip glosses that contain oils.
- Use over-the-counter medicated creams, soaps, lotions, and gels to treat your acne. Always read the label carefully to make sure you are using the product correctly.
Examples of some over-the-counter products used to treat acne include:
- Benzoyl peroxide (such as Brevoxyl or Benzac), which unplugs pores.
- Alpha-hydroxy acid, which dries up blemishes and causes the top skin layer to peel. You'll find alpha-hydroxy acid in some moisturizers, cleansers, eye creams, and sunscreens.
- Salicylic acid (Propa pH or Stridex), which dries up blemishes and causes the top skin layer to peel.
- Tea tree oil, which kills bacteria. You'll find tea tree oil in some gels, creams, and oils.
Other products that may help your overall skin condition include skin pore-cleaning strips. When you peel these sticky strips off your skin, dirt and/or makeup is removed by the strip.
You'll have better results if you follow the directions for using topical medicines. If you use a product too often, acne can get worse.
Skin Care Tips for Teens
Many teenagers struggle with acne due to their changing hormones. Here are some skin care tips to help teenagers achieve the best possible results for their skin.
- Take care when choosing cosmetics: Cosmetics like foundation, blush, and moisturizer should be oil-free. Chose products that do not promote the formation of blemishes or cause blocked pores. Ask a qualified sales person or a dermatologist which skin products would be best for your skin type.
- Don't pick your face: If you pick, squeeze, or pinch blemishes, you risk developing acne scars. Don't rub or touch blemishes.
- Be gentle with cleaning: Hard scrubbing will only make your skin condition worse. Gently wash your skin with a mild cleanser in the morning, at bedtime, and after heavy exercise. Avoid rough scrubs or pads. After you wash your skin, rinse it thoroughly.
- Use sunscreen (SPF 30 or more) regularly: The sun can damage the skin and promote premature aging; therefore, daily use of sunscreen is recommended. Although a tan or sunburn can make the skin feel less oily, the benefits are short-lived. Remember that some acne medications, as well as some other medications, can make you more prone to sunburns. For this reason, use sunscreens all of the time. Re-apply sunscreen when you are in the sun for prolonged periods of time.
- Be careful when shaving: Avoid the accidental nicks of blemishes by shaving lightly and only when you have to. You can experiment with different razors to find the one that is more comfortable for your skin.