Acne

(Pimples; Blackheads; Whiteheads; Acne Vulgaris)

Pronounced: AK-nee

by Jennifer Hellwig, MS, RD

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

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Definition

Acne occurs when the pores of the skin become clogged, inflamed, and sometimes infected. These clogged pores can result in blackheads, whiteheads, or pimples. Acne tends to occur in teenagers, but can also occur in adults.

 

Causes

Acne starts in the skin's sebaceous glands. These glands secrete an oily substance called sebum. The sebum normally travels through a tiny hair follicle from the gland to the skin's surface. Sometimes the sebum becomes trapped, mixing with dead skin cells and bacteria. This causes clogged pores called comedones.

Blackheads are comedones that reach the skin's surface. Whiteheads are comedones that stay beneath the surface of the skin. Small red bumps, pimples, and cysts may also develop.

The main causes of acne include:

• Changes in levels of male hormones called androgens
• Increased sebum production
• Changes inside the hair follicle
• Bacteria

 

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.

• Age: between 12-24 years old
• Race: Caucasian
• Changes in hormone levels, such as during:
  • Puberty
  • Pregnancy
  • Before a menstrual period
• Stress
• Certain medicines (eg, androgens, lithium, and barbiturates)
• Certain cosmetic products

 

Symptoms

Acne symptoms vary from person to person and can range from mild to severe. They include:

• Excess oil in the skin
• Blackheads
• Whiteheads
• Papules—small pink bumps that may be tender to the touch
• Pimples—inflamed, pus-filled bumps that may be red at the base (also called pustules)
• Nodules—large, painful, solid lumps that are lodged deep within the skin
• Cysts—deep, inflamed, pus-filled lumps that can cause pain and scarring

 

Diagnosis

The doctor will examine the areas of your skin with the most sebaceous glands like the face, neck, back, chest, and shoulders. If your acne is severe, you may be referred to a dermatologist, a skin specialist.

 

Treatment

Acne may require a combination of treatments. But, most acne does not require surgery. Some treatments may take several weeks to work. Your skin may actually appear to get worse before it gets better.

 

Prevention

It can be difficult to prevent acne from occurring. This is because it can be difficult to control the factors that cause it. But, there are some things you can do to keep your acne from getting worse:

• Gently wash your face with mild soap and warm water twice a day (no more than twice) to remove excess oil. Scrubbing or washing too often can make acne worse.
• When washing your face:
  • Use your hands rather than a washcloth.
  • Use mild soap.
  • Allow your face to dry before applying any lotion.
• Do not pick at or squeeze blemishes.
• Use lotions, soaps, and cosmetics labeled noncomedogenic. This means it won't clog your pores.
• Use topical acne treatments only as directed. Using them more often could make your condition worse.
• Recognize and limit emotional stress.
• Wear sunscreen year-round. This is especially important if you are using medicine that can make your skin more sensitive to the sun.

 RESOURCES:

The Acne Resource Center Online
http://www.acne-resource.org/

The American Academy of Dermatology
http://www.aad.org/

 CANADIAN RESOURCES:

Canadian Dermatology Association
http://www.dermatology.ca/

Dermatologists.ca
http://www.dermatologists.ca/

REFERENCES:

Questions and answers about acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/hi/topics/acne/acne.htm . Accessed June 4, 2008.

Safer D. Phototherapy. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated November 2008. Accessed October 20, 2009.

What is acne? American Academy of Dermatology website. Available at: http://www.skincarephysicians.com/acnenet/index.html . Accessed June 4, 2008.

¹9/2/2009 DynaMed Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Arowojolu A, Gallo M, Lopez L, Grimes D, Garner S. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev. 2009;(3):CD004425.

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Last reviewed October 2009 by Ross Zeltser, MD, FAAD
Last Updated: 10/20/2009