Acne is a skin condition that’s relatively common, appearing consistently in around 10% of the global population, 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.
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. 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. 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 — with one study finding that 85% of their adult acne patients were female. It’s considered to be the eighth most common skin disease in the world.
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.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Acne
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. 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. 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. Because of this, it can reduce your quality of life.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Acne
What medications are there for acne?
There are different treatments for acne depending on its severity and cause. Some of the most common medications and treatments for acne are:
Over-the-counter treatments - if your acne is mild then over the counter gels or creams should be able to help. These usually include benzoyl peroxide.
Topical treatments - these can include retinoids, azelaic acid and topical antibiotics that you apply directly to your skin. These are usually a gel, cream or lotion.
Tablets and pills - antibiotic tablets or the combined oral contraceptive pill can be used to treat acne.
Topical treatments are usually most suitable for people who find it difficult to take medication in tablet form. Tablets and pills may be more appropriate if you have sensitive skin and may not be able to tolerate creams, gels or lotions on your skin. The oral contraceptive pill is used for hormonal acne in women to regulate the levels of hormones in the body, dealing with the imbalance responsible for hormonal acne.
There are also non-drug treatments for acne such as skincare, comedone extractors, facial treatments and photodynamic therapy. These aren’t medically monitored and are usually unsuitable for more severe acne.
Is there a ‘best’ treatment for acne?
When it comes to acne treatment, there are a few factors to take into account. It depends on the severity of your acne, individual suitability for certain types of medication and the cause of your acne. It also depends on other medication that you’re taking, any other skin conditions you may have and what type of medication you prefer to take.
The best treatment will be the most suitable treatment for you, which will vary from one person to the next.
Does acne always need treatment?
Because acne is so common, it’s worth remembering that it doesn’t always require treatment and will probably go away with time and care. By making sure you don’t pick and touch the spots when they appear, maintaining good hygiene and avoiding overusing cosmetics will control mild acne breakouts.
If your acne is severe, painful, extremely regular or causing you emotional distress, then seeking medical advice and support from medication may be a good idea. If your acne is hormonal, then some contraceptive pills can help to rebalance your hormones and deal with the acne.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Acne
Acne: FAQ
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
How is acne diagnosed?
Answer:
Diagnosing acne is usually pretty straightforward. A medical professional will look at your skin and advise if what you’re experiencing is acne or another skin condition. For mild acne, a pharmacist can usually help you to diagnose this, whereas a physician is usually the best person for a diagnosis of more severe cases of acne.
If you’re experiencing adult acne that seems to have started suddenly, then this should be mentioned during your consultation, as it can be a symptom of an underlying condition or hormonal changes, such as PCOS (polycystic ovary syndrome) or menopause.
Are there treatments for acne scars?
Answer:
Acne scarring can be a problem even after it’s healed, particularly if you experience hyperpigmentation or keloid scarring. There aren’t any treatments available for purchase that have been clinically proven to treat acne scars. Some cosmetic treatments can benefit your acne, so if scarring is something you’re conscious of then you may wish to explore these.
Acne scars can be caused when you damage the skin by picking or squeezing spots (including using tools), so you should avoid this, however tempting you might find it. It can help to prevent acne from occurring in the first place.
Does acne treatment always work?
Answer:
The effectiveness of acne treatments varies from person to person, but in general acne treatments are effective. It can take months to see the benefits of acne treatments though. Different types of acne treatment work differently, and it depends how your acne responds to the medication.
Acne treatment aims to reduce the severity and recurrence of acne, as well as improve its appearance. The approach taken depends on how severe the acne is and the results depend on which part of the acne process is being targeted. If you feel that your acne treatment isn’t working as you want it to, let our physician know. It may be better to try a different treatment for your acne if you’ve given it time to produce results.
Can you get side effects from acne treatment?
Answer:
Each medication for acne comes with the possibility of unwanted side effects. In general, topical medications can cause itching, dry skin or burning in the area that they’ve been applied. Some topical acne treatments should be avoided if you’re trying to conceive. Oral treatments for acne may make you feel sick, trigger headache or diarrhea. You can discuss any concerns about side effects with our physician.
More information on the specific side effects of each acne medication can be found on the product pages for each one.
Loureiro, K.D., Kao, K.K., Jones, K.L., Alvarado, S., Chavez, C., Dick, L., Felix, R., Johnson, D. and Chambers, C.D. (2005).
Minor malformations characteristic of the retinoic acid embryopathy and other birth outcomes in children of women exposed to topical tretinoin during early pregnancy. American Journal of Medical Genetics Part A, 136A(2), pp.117–121.
Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.
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