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Definition  

Acne occurs when the pores of the skin become clogged, inflamed, and sometimes infected. These clogged pores can result in blackheads, whiteheads, or pimples. Acne is common in teenagers, but can also occur in adults.

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Pimple  
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Causes  

Acne starts in the skin's sebaceous glands. These glands secrete an oily substance called sebum. The sebum normally travels through a tiny hair follicle from the gland to the skin's surface. Sometimes the sebum becomes trapped and mixes with dead skin cells and bacteria. This causes clogged pores called comedones.

Blackheads are comedones that reach the skin's surface. Whiteheads are comedones that stay beneath the surface of the skin. Small red bumps, pimples, and cysts may also develop.

The main causes of acne include:

  • Changes in levels of male hormones called androgens
  • Increased sebum production
  • Changes inside the hair follicle
  • Bacteria
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Risk Factors  

Acne is more common in people who are Caucasian. It is also common in people who are 12-24 years old.

Factors that increase your risk of acne include:

  • Changes in hormone levels, such as during:
    • Puberty
    • Pregnancy
    • The time before a menstrual period
  • Stress
  • Certain medication such as androgens, lithium, and barbiturates
  • Certain cosmetic products
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Symptoms  

Acne symptoms vary from person to person and can range from mild to severe. They include:

  • Excess oil in the skin
  • Blackheads
  • Whiteheads
  • Papules—small, pink bumps that may be tender to the touch
  • Pimples—inflamed, pus-filled bumps that may be red at the base
  • Nodules—large, painful, solid lumps that are lodged deep within the skin
  • Cysts—deep, inflamed, pus-filled lumps that can cause pain and scarring
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Diagnosis  

The areas of your skin with the most sebaceous glands will be examined. These areas include the face, neck, back, chest, and shoulders. If your acne is severe, you may be referred to a dermatologist (skin specialist).

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Treatment  

Acne may require a combination of treatments. Most acne does not require surgery. Some treatments may take several weeks to work. Your skin may actually appear to get worse before it gets better.

Medications  

  • Over-the-counter topical medications such as cleansers, creams, lotions, and gels—to reduce the amount of oil and/or bacteria in the pores. These medications may contain one of the following ingredients:
    • Benzoyl peroxide
    • Salicylic acid
  • Prescription topical medications—includes cleansers, creams, lotions, and gels to reduce the amount of oil and/or bacteria in the pores. Examples include:
    • Antibiotics, such as clindamycin, erythromycin
    • Retinoids, such as tretinoin adapalene
  • Oral antibiotics—to control the amount of bacteria in pores, including:
    • Tetracycline
    • Clindamycin
  • Oral medications—to control androgen levels, including:
    • Birth control pills
    • Spironolactone
  • Oral retinoids—to reduce the size and secretions of sebaceous glands. This medication is only used for severe cases of cystic acne.
    • Isotretinoin—must not be taken by women who are pregnant or who may become pregnant due to the risk of serious birth defects.

Procedures  

There are a number of procedures that can be used by your doc