Acne

What is acne?

Acne is a skin condition that’s relatively common, appearing consistently in around 10% of the global population,^[1]though significantly more people experience acne-related symptoms each year. Acne is caused by hormonal changes which lead to an increase in sebum on the skin. Sebum is the natural oil that your skin produces.

This increase in sebum – usually on the face, back and chest – leads to blackheads and whiteheads on the skin as the pores on the skin become clogged. This can be painful, uncomfortable and cause emotional stress.

Acne is generally harmless physically, but it can vary in severity and appearance. Sometimes areas of acne can become infected or cause scarring. Acne can seriously affect self-esteem and body image at all ages.^[2]

Who gets acne?

Acne is common in teenagers due to the hormonal changes that take place during puberty. It’s more common in teenage boys as testosterone signals to the body to make more sebum. This is most common in the T-zone of the face, which includes your forehead, nose and chin.

However, acne can also continue into adulthood and can appear as an adult even if you didn’t experience acne as a teenager. Hormonal changes during a woman’s period or during pregnancy can also lead to acne. Inflammatory acne is thought to affect around 58% of women over the age of 25.^[3] Hormonal adult acne typically appears on the lower part of the face such as the bottom of your cheeks, chin and jawline.

Acne can also appear as women experience menopause. This usually happens in your 40s and 50s, though can be later or earlier. This is also hormone-related, due to estrogen levels dropping or an increase in testosterone levels. Acne can also run in families, so if your parents had acne you may be more likely to experience it too.

How common is acne?

Acne is very common, with around 90% of people experiencing it at some point in their life. ^[4] It’s more common in teenagers and is considered a relatively normal part of puberty. The level and severity of acne can vary from person to person and during different stages of life.

While adult acne is less common than teenage acne, it still affects a significant amount of the population and has increased over the past 20 years, especially in women^[5] — with one study finding that 85% of their adult acne patients were female. ^[6] It’s considered to be the eighth most common skin disease in the world.^[7]

Despite acne being so common, it can still affect daily life for some people. This is particularly true if their acne is more severe or painful.

What causes acne?

Acne is caused when excess oil on your skin (known as sebum) blocks your hair follicles. This mixes with dead skin cells and causes either blackheads or whiteheads. Bacteria that live on the skin can cause infection in these blocked follicles and can cause painful cysts, papules or pustules.^[1] These are all different types of spots caused by acne.

Bacteria on the skin is also thought to cause acne by causing too much waste, which blocks the follicles on the skin.^[1] Increased testosterone, having parents who have had acne and hormonal changes in women can also cause acne. In some cases, certain cosmetics, smoking or wearing items that regularly put pressure on your skin (such as headbands, a bra or a backpack) can all cause acne.

What are the symptoms of acne?

Acne appears as ‘spots’ on the skin that can look different from person to person, and even in different parts of your face. Acne can sometimes be painful, red and inflamed. The most common types of spots that you get with acne are:

• Blackheads – these are small black or yellow bumps that are filled with sebum and appear black because of the hair follicle within them. They usually empty when they’re squeezed.
• Whiteheads – these are similar in appearance to blackheads but have a white head and don’t empty in the same way.
• Papules – small red bumps that can feel sore or uncomfortable
• Pustules – these look like papules but have a white center that’s caused by pus in the spot
• Nodules – large lumps under the skin that feel hard and painful
• Cysts – these are large lumps under the skin that look like boils and are filled with pus. Cysts can cause permanent scars and infection.

Can acne lead to other problems?

Acne can cause infections in the skin which can lead to illness and the need for further treatment to get rid of the infection and side effects. Acne can also lead to scarring and uneven skin texture.

Having acne can also go much further than skin deep. Research has shown that acne can have an impact on your mental health and self esteem, contributing towards depression, anxiety, low self-esteem and a poor self-image.^[2] Because of this, it can reduce your quality of life.