What Is Acne?

Whether it’s one pimple or a cluster of blemishes, acne is a common problem that affects people of all ages.

• Whiteheads A whitehead forms when a closed pore becomes impacted with oil and dead skin cells. It appears as a white bump on the skin’s surface.
• Blackheads In a blackhead, the pore is only partially clogged and remains open. Blackheads turn black when oil and dead skin cells react to oxygen in the air.
• Papules Papules are tiny, red, hard pimples. They form when bacteria get trapped in a pore.
• Pustules Pustules are similar to papules but contain pus that’s made of dead white cells.
• Nodules These large inflamed lesions occur when a pimple extends into the deeper layers of the skin.
• Cystic Acne This type of severe acne is similar to nodules and forms when the deeper layer of skin becomes inflamed. The difference is that cysts contain pus. These red lumps are soft, painful, and difficult to treat. Usually, they require a visit to a dermatologist.

In the same way that acne can take various forms, the severity of acne also varies depending on the type.

“People with mild acne can have some whiteheads and blackheads and a few — but not more than 10 — inflamed, red pimples called papules or pustules,” says San Francisco-based dermatologist Yoram Harth, MD, chief medical officer for MDacne.

Whiteheads and blackheads, while the less severe types, can still become a moderate problem. “People with moderate acne can have many blackheads and whiteheads, as well as 10 to 30 red, inflamed acne pimples,” says Dr. Harth.

“People with severe acne will usually have more than 30 red, inflamed pimples at any moment in time. They can also have a few deep cysts and nodules, which are more difficult to treat and usually heal with scars,” says Harth.

• Oily skin due to the skin’s overproduction of sebum
• Redness and swelling around inflamed acne lesions of any type
• Tenderness or pain, common with nodules and cystic acne
• Hyperpigmentation as a result of skin inflammation triggering the overproduction of melanin
• Scarring or dark spots, which can result from severe acne and cysts

A number of factors can exacerbate acne or increase your risk.

• Changes in Hormone Levels Changing hormones, such as during puberty or menstruation, can cause the sebaceous glands to secrete more sebum.

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• Cosmetics or Hair-Care Products Oily cosmetics can clog your pores, making you susceptible to breakouts.
• Family History There appears to be a connection between acne and genes, so if your parents struggled with acne, you may as well.

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• Some Medications You may have acne if you take other medications like corticosteroids or lithium (Lithobid).

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• Skin Friction Breakouts can also occur whenever there’s any type of pressure or friction on your skin, such as a hat, helmet, or face mask, says Kara Shah, MD, a board-certified dermatologist based in Cincinnati, Ohio. With the increased use of face masks to prevent COVID-19 and other viruses, maskne, or “mask acne,” has unsurprisingly become a problem, given what dermatologists know about the effects of friction on skin.
• Stress Stress increases your body’s level of cortisol, a hormone that causes your glands to produce more sebum.

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A doctor or dermatologist can usually diagnose acne by looking at your skin. They’ll examine your face, chest, back, and any other areas where acne appears.

The duration of acne varies from person to person. When acne develops in the teen years, it often becomes less of an issue by the time a person is in their mid-twenties.

A good skin care regimen is often the first line of defense for mild acne or the occasional pimple. But sometimes, treatment is needed to keep skin healthy.

Over-the-Counter Products

• Benzoyl peroxide
• Glycolic acid
• Salicylic acid
• Azelaic acid
• Niacinamide
• Topical retinoids

These ingredients work by preventing the plugging of hair follicles, fighting bacteria on the skin, reducing oil production, or exfoliating the top layer of skin.

Prescription-Strength Products

• Injections of a corticosteroid
• Isotretinoin (Accutane), a pill that is selectively prescribed to manage very severe acne and is under close supervision by a healthcare professional
• Oral antibiotics, such as minocycline (Minocin) and doxycycline (Vibramycin)
• Oral antihormonal medications for women, such as spironolactone (Aldactone)
• Oral contraceptives for women (Yaz)
• Retinoids, chemical compounds that are natural derivatives of vitamin A, such as adapalene topical (Differin) and tazarotene topical (Tazorac)
• Topical antibiotics (Acanya, BenzaClin, BenzaClin Pump, Duac, Neuac, and Onexton)
• Topical antihormonal medications for women, such as clascoterone (Winlevi)
• Topical azelaic acid (Azelex and Finacea), which has antibacterial, anti-inflammatory, and exfoliating properties

Dermatology Procedures

The Importance of Consistency in Treating Acne

Alternative and Complementary Therapies

Ingredients that may help fight acne include:

• Honey

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• Yogurt

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• Turmeric

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You can take steps to stop pimples before they pop up:

• Wash your face twice a day. Use warm water and a mild cleanser, and don’t scrub too hard, or else you could damage the protective layer of your skin and make acne worse, says Harth.
• Keep hair off your face. Greasy, oily hair can make your skin oily, which can clog your pores and cause acne. Wash your hair regularly, and keep hair off your face.

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• Use oil-free skin care products. Look for “noncomedogenic” skin care products, which don’t clog pores. Noncomedogenic products are less likely to result in acne breakouts.
• Don’t sleep in your makeup. Removing all traces of makeup before bedtime keeps your pores open and prevents acne. Sometimes, warm water isn’t enough to remove makeup. “You will usually need to use oil-free makeup remover wipes in addition to your cleanser,” says Harth. Some dermatologists also recommend micellar water as part of a double-cleanse routine to help remove makeup without leaving an oily residue behind.
• Don’t touch your face. The more you touch your face, the greater the risk of transferring oil and dirt from your hands to your face. Acne tends to occur on the face and forehead because this part of the body has more sebaceous glands.

Diet Tips for Acne

While the jury’s still out on whether diet choices definitely contribute to acne, Harth recommends erring on the side of caution. “The best diet for people with acne should include anti-inflammatory foods with a low glycemic load,” he says.

If scars don’t fade on their own, work with your dermatologist to reduce their appearance.

• Dermabrasion
• Microdermabrasion
• Chemical peels
• Microneedling
• Laser treatments
• Fillers
• Punch excisions

Black Americans and Acne

Hispanic Americans and Acne

Asian Americans and Acne

Even though acne develops when pores become clogged with dead skin cells or dirt, it can also occur alongside other conditions or as the result of hormonal changes.

• Menstruation
• Pregnancy
• Polycystic ovary syndrome (PCOS)
• Depression
• Stress
• Anxiety

• Acne is a common condition among people of all ages. It occurs when glands in the skin produce and secrete too much sebum, the skin’s natural oil.
• Acne is a broad term, encompassing a variety of breakout types that have different symptoms, ranging from redness and swelling to pain and scarring.
• While acne cannot be cured, it can be treated with over-the-counter products, prescription medications, and dermatology procedures.
• Certain lifestyle factors can help prevent the recurrence or worsening of acne, including regular face washing, using oil-free skin-care and cosmetic products, keeping your hands and hair away from your face, and limiting refined carbohydrates, sugary foods, and dairy in your daily diet.