Definition

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

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

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 chance of acne include:

• Family history
• 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
• Irritation from chin straps and headbands

Symptoms

Acne symptoms vary from person to person and can range from mild to severe (based on how many and where they are present). 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

Diagnosis

The areas of your skin with the most sebaceous glands will be examined. These areas include the face, neck, back, chest, and shoulders. You have acne if any of the findings are present.

If your acne is severe, you may be referred to a dermatologist (skin specialist).

Treatment

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

It is also common to have to change treatments after current treatments stop working.

Prevention

It can be difficult to prevent acne from occurring. It can be difficult to control the factors that cause acne. But, there are some things you can do to keep your acne from getting worse:

• Gently wash your face with mild soap and warm water no more than twice a day to remove excess oil. Scrubbing or washing too often can make acne worse.
• Allow your face to dry before applying any lotion.
• Do not pick at or squeeze blemishes.
• Use lotions, soaps, and cosmetics labeled noncomedogenic. This means it won’t clog your pores.
• Use topical acne treatments only as directed. Using them more often could make your condition worse.
• Recognize and limit emotional stress whenever possible if it triggers your acne.
• Wear sunscreen year-round. This is especially important if you are using medication that can make your skin more sensitive to the sun.

The American Academy of Dermatology https://www.aad.org/for-the-public

Dermatologists.ca http://www.dermatologists.ca

Acne. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
September 8, 2014. Accessed November 7, 2014.

Questions and answers about acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at:
http://www.niams.nih.gov/Health_Info/Acne/default.asp
Updated May 2013. Accessed November 7, 2014.

9/2/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed
: Arowojolu A, Gallo M, et al. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev. 2009;(3):CD004425.