Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It often causes whiteheads, blackheads or pimples, and usually appears on the face, forehead, chest, upper back and shoulders. Acne is most common among teenagers, though it affects people of all ages.
Effective treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up. Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems.
Signs and symptoms vary depending on the severity of your condition:
- Whiteheads (closed plugged pores).
- Blackheads (open plugged pores).
- Small red, tender bumps (papsusle).
- Pimples (pustules), which are papules with pus at their tips.
- Large, solid, painful lumps beneath the surface of the skin (nodules).
- Painful, pus-filled lumps beneath the surface of the skin (cystic lesions).
The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.
Typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands. Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne.
- Excess oil production.
- Hair follicles clogged by oil and dead skin cells.
- Excess activity of a type of hormone (androgens).
- Age : People of all ages can get acne, but it’s most common in teenagers.
- Hormonal changes : Such changes are common in teenagers, women and girls, and people using certain medications, including those containing corticosteroids, androgens or lithium.
- Family history : Genetics plays a role. If both parents had acne, you’re likely to develop it, too.
- Greasy or oily substances : You may develop acne where your skin comes into contact with oily lotions and creams or with grease in a work area, such as a kitchen with fry vats.
- Friction or pressure on your skin : This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks.
- Stress : Stress is not a know cause, but if you have acne already, it may make it worse.
Factors that may worsen it
These factors can trigger or aggravate the condition:
- Hormones : Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. And low amounts of androgens circulate in the blood of women and can worsen acne.
- Certain medications : Examples include drugs containing corticosteroids, testosterone or lithium.
- Diet : Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods such as bread, bagels and chips may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
- Stress : Stress can make acne worse.
These factors have little effect;
- Greasy foods : Eating greasy food has little to no effect on acne. Though working in a greasy area, such as a kitchen with fry vats, does because the oil can stick to the skin and block the hair follicles. This further irritates the skin or promotes acne.
- Hygiene : Acne isn’t caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make it worse.
- Cosmetics : Cosmetics don’t necessarily worsens the condition, especially if you use oil-free makeup that doesn’t clog pores (noncomedogenics) and remove makeup regularly. Non-oily cosmetics don’t interfere with the effectiveness of acne drugs.
How To Treat Acne
If you’ve tried over-the-counter (nonprescription) acne products for several weeks and they haven’t helped, your doctor can prescribe stronger medications. A dermatologist can help you:
- Control your acne,
- Avoid scarring or other damage to your skin,
- Make scars less noticeable.
Medications work by reducing oil production, speeding up skin cell turnover, fighting bacterial infection or reducing inflammation — which helps prevent scarring. With most prescription drugs, you may not see results for four to eight weeks, and your skin may get worse before it gets better. It can take many months or years for your acne to clear up completely.
Lifestyle and home remedies
You can try to avoid or control mild acne with nonprescription products, good basic skin care and other self-care techniques:
- Wash problem areas with a gentle cleanser. Twice a day, use your hands to wash your face with a mild soap and warm water. If you tend to develop acne around your hairline, shampoo your hair every day. And be gentle if you’re shaving affected skin. Avoid certain products, such as facial scrubs, astringents and masks. They tend to irritate the skin, which can worsen acne. Excessive washing and scrubbing also can irritate the skin.
- Try over-the-counter acne products to dry excess oil and promote peeling. Look for products containing benzoyl peroxide as the active ingredient. You might also try products containing salicylic acid, glycolic acid or alpha hydroxy acids, which may help with mild and moderate acne. It may take a few weeks before you see any improvement. Nonprescription medications may cause initial side effects — such as redness, dryness and scaling — that often improve after the first month of using them.
- Avoid irritants, oily or greasy cosmetics, sunscreens, hairstyling products or concealers. Use products labeled water-based or noncomedogenic, which means they are less likely to cause acne.
- Protect your skin from the sun. For some people, the sun worsens acne. And some medications make you more susceptible to the sun’s rays. Check with your doctor to see if your medication is one of these. If it is, stay out of the sun as much as possible. Regularly use a nonoily (noncomedogenic) moisturizer that includes a sunscreen.
- Avoid friction or pressure on your skin. Protect your acne-prone skin from contact with items such as phones, helmets, tight collars or straps, and backpacks.
- Avoid touching or picking at the problem areas.Doing so can trigger more acne or lead to infection or scarring.
- Shower after strenuous activities. Oil and sweat on your skin can lead to breakouts.