Whether it's one pimple or a cluster of blemishes, acne is a common problem that affects people of all ages â€” boys, girls, men, and women, according to the Mayo Clinic. (1)
Acne, or acne vulgaris, occurs when glands in the skin produce and secrete too much of the skin's natural oil, called sebum.
Sebum, along with dead skin cells, can clog pores, resulting in acne. And sometimes, bacteria called Cutibacterium acnes (C. acnes) gets into pores, causing inflamed acne. (1)
Signs and Symptoms of Acne
Acne is the most common skin condition affecting people in the United States, according to the American Academy of Dermatology (AAD). (2)
As many as 50 million Americans live with acne, and most of them are in their teen or young adult years. About 85 percent of teenagers will eventually get acne, notes the AAD. (3)
Acne is a broad term for different types of breakouts that all have different symptoms, according to Johns Hopkins Medicine. (4) The National Institutes of Health and New York University Langone Health note that there are six specific types of acne: (5,6)
- Whiteheads A whitehead forms when a closed pore becomes impacted with oil and dead skin cells. It appears as a white bump on the skinâ€™s surface.
- Blackheads In a blackhead, the pore is only partially clogged and remains open. Blackheads turn black when oil and dead skin cells react to oxygen in the air.
- Papules Papules are tiny red, hard pimples. They form when bacteria get trapped in a pore.
- Pustules Pustules are similar to papules, but contain pus thatâ€™s made of dead white cells.
- Nodules These large inflamed lesions occur when a pimple extends into the deeper layers of the skin.
- Cystic acne This type of severe acne is similar to nodules and forms when the deeper layer of skin becomes inflamed. The difference is that cysts contain pus. These red lumps are soft, painful, and difficult to treat. Usually, they require a visit to a dermatologist.
In the same way that acne can take various forms, the severity of acne also varies depending on the type.
Blackheads and whiteheads are noninflammatory and typically easier to control, per the AAD. Papules and pustules are an inflammatory type of acne. But inflammation doesn't necessarily mean severe acne. (7)
Why You're Breaking Out â€” and How to Banish Blemishes in Your Trouble Spots
â€œPeople with mild acne can have some whiteheads and blackheads, and a few â€” but not more than 10 â€” inflamed, red pimples called papules or pustules,â€ says the San Franciscoâ€“based dermatologist Yoram Harth, MD, the medical director of MDacne.
Whiteheads and blackheads, while they're the less severe types, can still become a moderate problem. â€œPeople with moderate acne can have many blackheads and whiteheads, as well as 10 to 30 red, inflamed acne pimples,â€ Dr. Harth says.
Severe acne includes the presence of nodules and cysts, or many breakouts on different parts of the body â€” face, back, neck, and chest. (7)
Causes and Risk Factors of Acne
A number of factors can exacerbate acne or increase your risk.
Cosmetics or hair-care products Oily cosmetics can clog your pores, making you susceptible to breakouts.
Having a family history of acne There appears to be a connection between acne and genes. So if your parents struggled with acne, you may, too. (1)
Can 'Resetting' Your Hormones Improve Your Skin?
Something rubbing on the skin (like a hat, helmet, or face mask) Breakouts can also occur whenever thereâ€™s any type of pressure or friction on your skin, says Kara Shah, MD, a board-certified general and pediatric dermatologist with Kenwood Dermatology in Cincinnati. This is called acne mechanica. (1) In the time of COVID-19, maskne or â€œmask acneâ€ has unsurprisingly become a problem, given what dermatologists know about the effects of friction on skin.
How Is Acne Diagnosed?
A doctor or dermatologist can usually diagnose acne by looking at your skin, notes John Hopkins Medicine. (10) Theyâ€™ll examine your face, chest, back, and any other areas where acne appears.
Some skin conditions are sometimes mistaken for acne. If you believe you have acne yet your skin doesnâ€™t improve with treatment or worsens, your doctor can make an accurate diagnosis. (10)
Duration of Acne
The duration of acne varies from person to person. When acne develops in the teen years, it often becomes less of an issue by the time a person is in their mid-twenties, according to the NHS. (11)
Unfortunately, some people struggle with acne even through their twenties. In fact, about 3 percent of adults over 35 continue to have acne off and on. (11)
Treatment and Medication Options for Acne
Thereâ€™s no cure for acne, but treatments can get rid of and prevent new breakouts. (12) The acne treatment thatâ€™s best for you depends on the severity of your acne.
A good skin-care regimen is often the first line of defense for mild acne or the occasional pimple. But sometimes, treatment is needed to keep skin healthy.
According to the Mayo Clinic, these solutions include medicated cleansers, lotions, creams, gels, and face pads. They typically contain acne-fighting ingredients such as: (13)
- Benzoyl peroxide
- Glycolic acid
- Salicylic acid
- Azelaic acid
- Topical retinoids
These ingredients work by either preventing the plugging of hair follicles, fighting bacteria on the skin, reducing oil production, or exfoliating the top layer of skin. (13)
How to Treat Teenage Acne
Harth explains that to heal body acne â€” such as back acne â€” you will need an effective anti-acne treatment, such as benzoyl peroxide, which is the most effective for body acne, notes the AAD. (14)
Options for ointments, creams, and lotions that you can receive from your dermatologist include: (13)
- Topical antibiotics (Benzaclin Pump, BenzaClin, Neuac, Onexton, Duac, and Acanya)
- Oral antibiotics (Minocin, Oracea)
- Retinoids (Differin and Tazorac)
- Oral contraceptives for women (Ortho Tri-Cyclen, Yaz)
- Oral antihormonal medications for women (Spironolactone)
- Topical antihormonal medications for women such as Winlevi (clascoterone)
- Isotretinoin (Sotret, Claravis, Amnesteem, Accutane, and others), a pill that is selectively prescribed to manage very severe acne and is under close supervision by a healthcare professional
- Injections of a corticosteroid
For stubborn acne, your dermatologist may recommend an in-office treatment, such as laser resurfacing therapy or a chemical peel. (13) Other in-office treatments include light therapy, steroid injections, or drainage and extraction of cysts and pimples, according to the Mayo Clinic. (15)
The Importance of Consistency in Treating Acne
Youâ€™ll probably need to treat acne for an extended period â€” not only during a breakout. Also, donâ€™t stop an acne treatment until your doctor says it's okay â€” otherwise, you run the risk of having another breakout just when your skin starts to clear, notes the Society for Pediatric Dermatology. (16)
Alternative and Complementary Therapies
Although traditional acne therapies are proven effective, you may want to experiment with home remedies to complement your plan. While these options wonâ€™t be as effective as medications or procedures, they may come with fewer side effects. Some acne medicines can cause dizziness, upset stomach, sun sensitivity, and blood clots. (3)
Ingredients that may help fight acne include:
Prevention of Acne
It isnâ€™t enough to understand what causes acne. You should also take steps to stop pimples before they pop up.
- Wash your face twice a day. Use warm water and a mild cleanser, and don't scrub too hard, or else you could damage the protective layer of your skin and make acne worse, warns Harth. (9)
- Keep hair off your face. Greasy, oily hair can make your skin oily, which can clog your pores and cause acne. Wash your hair regularly and keep hair off your face. (9)
- Use oil-free skin-care products. Look for "noncomedogenic" skin-care products, which donâ€™t clog pores. Noncomedogenic products are less likely to result in acne breakouts.
- Don't sleep in your makeup. Removing all traces of makeup before bedtime keeps your pores open and prevents acne. Sometimes, warm water isn't enough to remove makeup. â€œYou will usually need to use oil-free makeup remover wipes in addition to your cleanser,â€ notes Harth. Some dermatologists recommend micellar water, too, as part of a double-cleanse routine to help remove makeup without leaving an oily residue behind.
- Don't touch your face. The more you touch your face, the greater the risk of transferring oil and dirt from your hands to your face, per the AAD. (23) Acne tends to occur on the face and forehead because this part of the body has more sebaceous glands. (1)
Diet Tips for Acne
Maybe you've heard that soda, chocolate, and junk food can cause acne. (1,4) Some people claim that these and other foods trigger their breakouts. Yet registered dietitians and researchers are split on whether food is a culprit.
According to Harth, multiple studies have found that acne tends to be worse in people who eat sugary foods, refined carbohydrates, and dairy.
Past research evaluating the association between diet and acne in teenage girls, however, did find a positive link between acne and the consumption of whole milk. (25)
Milk and other dairy products appear to raise levels of insulin-like growth factor 1 (IGF-1), which may trigger greater sebum production and contribute to breakouts.
While the juryâ€™s still out on whether diet choices definitely contribute to acne, Harth recommends erring on the side of caution. â€œThe best diet for people with acne should include anti-inflammatory foods with a low glycemic load,â€ he says.
The glycemic index (GI) ranks carbohydrates by how fast they increase blood sugar. Since low-GI foods eliminate blood sugar spikes, they might also reduce acne, per the AAD. (27) â€œGood examples are cold-water fish like mackerel, salmon, and sardines, leafy greens, nuts, certain seeds, and complex carbs like wild rice and quinoa," says Harth.
Acne Scars Are a Complication of Acne
An unfortunate side effect of acne is scarring, which may take weeks or months to disappear, according to KidsHealth.org. (28)
Scarring is more likely with moderate or severe acne, and includes black marks or spots where acne once appeared. (28) The best way to reduce the risk of scarring is to leave acne alone â€” no touching, squeezing, or picking at bumps. (28). If you canâ€™t keep your hands off your face, cover acne with a pimple patch. As a bonus, these patches contain salicylic acid to help treat breakouts.
If scars donâ€™t fade, work with your dermatologist to reduce their appearance.
Your doctor might recommend an acne medication that gets rid of blemishes and stimulates collagen production. Collagen can minimize the appearance of existing scars. (29)
According to KidsHealth.org and the American Society for Dermatologic Surgery, procedures to reduce or eliminate acne scars include: (28,30)
- Chemical peels
- Laser treatments
- Punch excisions
Research and Statistics: Who Has Acne?
Acne affects as many as 50 million people in the United States each year. And although itâ€™s common during puberty, there's been an increase in the number of adults getting acne. It affects up to 15 percent of women. (3)
According to the International Dermal Institute, clinical studies have found that persistent, low-grade acne affects about 40 percent to 55 percent of the adult population. (31)
But acne doesn't only affect people physically; it also affects some people financially. In 2013, an estimated 5.1 million people sought treatment for acne. (3)
Black Americans and Acne
According to past research, acne is one of the most common dermatological problems among Black people. (33) It can appear on any part of the body, but often appears near the hairline in Black women. (32) Acne in this area is likely the result of hair-care products clogging pores near the hairline.
Hispanic Americans and Acne
Acne is a common dermatological diagnosis among Hispanic Americans.
In a previous study of nearly 3,000 women treated with acne (between ages 10 and 70), acne was more prevalent in Hispanics (32 percent) compared with white participants (24 percent). (35) The research also found that hyperpigmentation, dyspigmentation, and atrophic scarring were more common among Hispanic individuals than white people.
Asian Americans and Acne
Among Asian Americans, acne is the second most common dermatological complaint, the first being dermatitis. (33) Dyspigmentation and scarring aren't as common among Asian Americans, but hyperpigmentation does affect a greater percentage of this group. (35)
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