What Causes Acne?

Acne is caused by a bacterial skin infection, but it can be exacerbated or improved by certain skin hygiene habits.

Acne vulgaris, usually called acne for short, is a common skin condition characterized by chronic or recurrent development of papules, pustules, or nodules on the skin. Acne is common among adolescents and young adults but can occur at any age

Acne typically appears on the face, chest, upper back, and shoulders.

Acne symptoms include:

• Small, red, tender bumps (papules)
• Pimples (pustules), which are papules with pus at the tip
• Whiteheads (closed plugged pores)
• Blackheads (open plugged pores)
• Large, solid, painful lumps under the skin (nodules)
• Painful, pus-filled lumps under the skin (cystic lesions)

The cause of acne is clogged pores, which are caused by: 

• Hormones 
  • This is why acne is common during puberty and adolescence, when hormones increase
• Inflammation 
  • Inflammation causes redness and soreness in acne lesions 
• Genetics
  • It tends to run in families
• Stress 
  • Stress can affect hormones, which can cause acne
  • This occurs more often in females than males
• Though not conclusively proven, other possible causes of acne may include:
  • Vitamin deficiency 
    • Inadequate levels of the antioxidants vitamin A, C, and E may inhibit the skin's ability to fight inflammation
    • Low levels of vitamin D may play a role
  • Diet 
    • Diets low in omega-3’s, antioxidants, and zinc may result in increased acne
    • High-glycemic diets may also cause acne

Acne is diagnosed by a dermatologist with a skin examination. 

Some other skin conditions may look like acne, but are not, and require different treatment. This is why it is important to get a diagnosis from a dermatologist to rule out conditions that resemble acne, such as: 

• Rosacea
• Hidradenitis suppurativa (also called acne inversa)
• Perioral dermatitis
• Keratosis pilaris
• Sebaceous hyperplasia
• Folliculitis 
• Ingrown hairs
• Basal cell carcinoma, a type of skin cancer

Acne can often be treated at home with self-care. Home treatments for acne include: 

• Wash twice daily and after sweating
• Rinse with lukewarm water
• Use gentle, non-abrasive cleanser and apply with fingertips
  • Washcloths and sponges may irritate the skin
  • Don’t scrub the skin
• Use gentle products on the skin
  • Choose alcohol-free products
  • Avoid products that can irritate skin because this can aggravate acne
• Shampoo oily hair daily
• Don’t pick, pop, or squeeze acne
  • Let skin heal naturally
  • Picking at acne can make it take longer to go away and can increase the risk of scarring
• Don’t touch your face because bacteria on your fingers can get into pores and cause acne
• Avoid the sun and tanning beds
  • Ultraviolet (UV) light damages the skin
  • Some acne medications make the skin sensitive to UV light

Treatments for acne depend on the type of breakout you have. 

• Whiteheads, blackheads, or both
  • Usually requires topical (on the skin) medications 
  • Retinoids
  • Benzoyl peroxide
  • Azelaic acid
  • Salicylic acid
  • Topical antibiotics
  • Combination of the above
• Pimples
  • Usually requires topical (on the skin) medications 
  • Benzoyl peroxide
  • Retinoids
  • Azelaic acid 
  • Benzoyl peroxide plus a retinoid or a topical antibiotic 
  • Women may need a birth control pill or patch approved to treat acne
• Acne nodules and cysts
  • Prescription topical medication plus an oral antibiotic
  • Topical retinoids
  • Oral retinoids
  • Azelaic acid
  • Salicylic acid
  • Hormonal therapies
  • Benzoyl peroxide
  • Topical and oral antibiotics
  • Women may need a birth control pill or patch approved to treat acne

Other treatments for acne include: 

• Laser or light therapy
  • May help clear acne
  • Works best combined with other acne treatments
• Corticosteroid injections
  • Used for large, painful, deep acne breakouts
  • Relieves pain and inflammation quickly
  • Usually reserved for treating a few severe acne breakouts due to possible side effects 

Complications of acne include:

• Areas of darkened skin (hyperpigmentation)
• Scarring
• Negative psychosocial effects 
  • Low self-esteem
  • Depression
  • Anxiety