What causes acne on the face?

Your skin has tiny holes called pores which can become blocked by oil, bacteria, dead skin cells, and dirt. When this occurs, you may develop a pimple or “zit.” If your skin is repeatedly affected by this condition, you may have acne.

In simple terms, Acne occurs when the pores on your skin become blocked with oil, dead skin, or bacteria. Each pore on your skin is the opening to a follicle. The follicle is made up of a hair and a sebaceous (oil) gland. 

Acne can be caused by one or more problems in this lubrication process. It can occur when:

• too much oil is produced by your follicles
• dead skin cells accumulate in your pores
• bacteria build up in your pores

Synonyms	Acne vulgaris

All of these problems contribute to the development of pimples. A zit appears when bacteria grows in a clogged pore and the oil is unable to escape.

What are the risk factors for developing acne?

• hormonal changes caused by puberty or pregnancy
• certain medications, such as certain birth control pills or corticosteroids
• a diet high in refined sugars or carbohydrates, such as bread and chips
• having parents who had acne

How is acne diagnosed?

Young people are most at risk for developing acne during puberty. During this time, your body undergoes drastic hormonal changes. These changes can trigger oil production, leading to an increased risk of acne. Hormonal acne related to puberty usually subsides or at least improves when you reach adulthood.

How is Acne Treated?

At-home care

You can use a number of self-care activities at home to prevent pimples and to clear up your acne. Home remedies for acne include:

• cleaning your skin daily with a mild soap to remove excess oil and dirt
• shampooing your hair regularly and keeping it out of your face
• using makeup that’s water-based or labeled as “noncomedogenic” (not pore-clogging)
• not squeezing or picking pimples, which spreads bacteria and excess oil
• not wearing hats or tight headbands
• not touching your face

Medication

If self-care activities don’t help with your acne, a number of over-the-counter acne medications are available. Most of these medications contain ingredients that can help kill bacteria, open pores, or reduce oil on your skin:

• Benzoyl peroxide is present in many acne creams and gels. It’s used for drying out existing pimples and preventing new ones. Benzoyl peroxide also kills acne-causing bacteria.
• Sulfur is a natural ingredient with a distinctive smell that’s found in some lotions, cleansers, and masks.
• Resorcinol is a less common ingredient that’s used to remove dead skin cells.
• Salicylic acid is often contained in soaps and acne washes. It helps prevent pores from getting plugged.

Sometimes, you may continue to experience symptoms. If this happens, you may want to seek medical advice. Your doctor can prescribe medications that may help reduce your symptoms and prevent scarring:

• Oral or topical antibiotics kill the bacteria that cause pimples and reduce inflammation. Typically, antibiotics are only used for a short amount of time so that your body doesn’t build up a resistance and leave you prone to infections.
• Prescription topical creams such as retinoic acid or prescription-strength benzoyl peroxide are often stronger formulas of over-the-counter treatments. These work to reduce oil production and open pores.
• Women with hormonal acne may be treated with birth control pills or spironolactone. These medications regulate hormones that can cause acne through a decrease in oil production.
• Isotretinoin (Accutane) is a vitamin-A-based medication that’s used to treat certain cases of severe nodular acne. It can cause serious side effects, and it’s only used when other treatments have failed.

Your doctor may recommend additional procedures to treat severe acne and prevent scarring. These work by removing damaged skin, reducing oil production, or opening pores:

• Photodynamic therapy uses a medication and a special light or laser to reduce oil production and reduce bacteria. Other lasers may be used alone to help improve acne or scarring.
• Dermabrasion removes the top layers of your skin with a rotating brush and would be best used to treat acne scarring as opposed to a treatment for acne. Microdermabrasion is a milder treatment that helps open pores and remove dead skin cells.
• A chemical peel essentially removes the top layers of your skin. That skin peels off to reveal less damaged skin underneath. Chemical peels also help open pores and can improve mild acne scarring.

Your doctor may suggest using cortisone injections if your acne consists of large cysts. Cortisone is a steroid naturally produced by your body. It can reduce inflammation and speed healing. Cortisone is usually used along with other acne treatments.

What is the outlook for someone with acne?

How can acne be prevented?