Acne: Types, Causes, Treatment & Prevention

Acne is a common skin condition where the pores of your skin clog. Pore blockages produce blackheads, whiteheads and other types of pimples. Pimples are pus-filled, sometimes painful, bumps on your skin. 

Types of acne:

• Fungal acne (pityrosporum folliculitis): Fungal acne occurs when yeast builds up in your hair follicles. These can be itchy and inflamed.
• Cystic acne: Cystic acne causes deep, pus-filled pimples and nodules. These can cause scars.
• Hormonal acne: Hormonal acne affects adults who have an overproduction of sebum that clogs their pores.
• Nodular acne: Nodular acne is a severe form of acne that causes pimples on the surface of your skin, and tender, nodular lumps under your skin.

   

What causes acne?

Clogged hair follicles or pores cause acne. Your hair follicles are small tubes that hold a strand of your hair. There are several glands that empty into your hair follicles. When too much material is inside your hair follicle, a clog occurs. Your pores can clog with:

• Sebum: An oily substance that provides a protective barrier for your skin.
• Bacteria: Small amounts of bacteria naturally live on your skin. If you have too much bacteria, it can clog your pores.
• Dead skin cells: Your skin cells shed often to make room for more cells to grow. When your skin releases dead skin cells, they can get stuck in your hair follicles.

How can I make my acne go away at home?

If you have acne, you can start an at-home skin care routine to help your acne go away by:

• Washing your skin at least once daily with warm (not hot) water and a gentle cleanser. Cleansers are over-the-counter skin care products that help clean your skin.
  
  
  
• Washing your skin after you exercise or sweat.
• Avoid using skin care products with alcohol, astringents, toners and exfoliants, which can irritate your skin.
• Removing your makeup at the end of the day or before you go to bed.
• Choosing an oil-free moisturizer to apply on your skin after cleansing.
• Avoid popping, picking or squeezing your acne. Let your skin heal naturally to prevent scars from forming on your skin.

Management and Treatment

How is acne treated?

There are several ways to treat acne. Each type of treatment varies based on your age, the type of acne you have and the severity. A healthcare provider might recommend taking oral medications, using topical medications or using medicated therapies to treat your skin. The goal of acne treatment is to stop new pimples from forming and to heal the existing blemishes on your skin.

Topical acne medications

Your healthcare provider may recommend using a topical acne medication to treat your skin. You can rub these medications directly onto your skin as you would a lotion or a moisturizer. These could include products that contain one of the following ingredients:

• Benzoyl peroxide: This is available as an over-the-counter product (such as Clearasil®, Stridex® and PanOxyl®) as a leave-on gel or wash. It targets surface bacteria, which often aggravates acne. Lower concentrations and wash formulations are less irritating to your skin.
• Salicylic acid: This is available over the counter for acne as a cleanser or lotion. It helps remove the top layer of damaged skin. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging.
• Azelaic acid: This is a natural acid found in various grains such as barley, wheat and rye. It kills microorganisms on the skin and reduces swelling.
• Retinoids (vitamin A derivatives): Retinol, such as Retin-A®, Tazorac® and Differin®, which is available without a prescription, breaks up blackheads and whiteheads and helps prevent clogged pores, the first signs of acne. Most people are candidates for retinoid therapy. These medications aren’t spot treatments and must be used on the entire area of skin affected by acne to prevent the formation of new pimples. You often need to use these for several months before noticing positive results.
• Antibiotics: Topical antibiotics like clindamycin and erythromycin control surface bacteria that aggravate and cause acne. Antibiotics are more effective when combined with benzoyl peroxide.
• Dapsone: Dapsone (Aczone®) is a topical gel, which also has antibacterial properties. It treats inflamed acne.

Oral acne medications

Oral acne medications are pills that you take by mouth to clear your acne. Types of oral acne medications could include:

• Antibiotics: Antibiotics treat acne caused by bacteria. Common antibiotics for acne include tetracycline, minocycline and doxycycline. These are best for moderate to severe acne.
• Isotretinoin (Amnesteem®, Claravis® and Sotret®): Isotretinoin is an oral retinoid. Isotretinoin shrinks the size of oil glands, which contributes to acne formation.
• Contraceptives: The use of certain contraceptives can sometimes help women and people AFAB who have acne. The U.S. Food and Drug Administration (FDA) approved several types of birth control pills for treating acne. Some brand names include Estrostep®, Beyaz®, Ortho Tri-Cyclen® and Yaz®. These pills contain a combination of estrogen (the primary AFAB sex hormone) and progesterone (a natural form of steroid that helps regulate menstruation).
• Hormone therapy: Hormone therapy is helpful for some people with acne, especially if you experience acne flare-ups during menstruation or irregular periods caused by excess androgen (a hormone). Hormone therapy consists of low-dose estrogen and progesterone (birth control pills) or a medication called spironolactone that blocks the effect of certain hormones at the level of your hair follicles and oil glands.

Additional acne therapies

If topical or oral medications don’t work well for your acne or if you have scars from your acne, a healthcare provider may recommend different types of acne therapies to clear your skin, including:

• Steroids: Steroids can treat severe acne with injections into large nodules to reduce inflammation.
• Lasers: Lasers and light therapy treat acne scars. A laser delivers heat to the scarred collagen under your skin. This relies on your body’s wound-healing response to create new, healthy collagen, which encourages growth of new skin to replace it.
• Chemical peels: This treatment uses special chemicals to remove the top layer of old skin. After removal of the top layer of skin, new skin grows in smoother and can lessen acne scars.

Prevention

You can’t completely prevent acne, especially during hormone changes, but you can reduce your risk of developing acne by:

• Washing your face daily with warm water and a facial cleanser.
• Using an oil-free moisturizer.
• Wearing “noncomedogenic” makeup products and removing makeup at the end of each day.
• Keeping your hands away from your face.