Acne is a skin condition that occurs when the hair follicles become plugged with oil and dead skin cells. Acne usually appears on your face, neck, chest, back and shoulders. Effective treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one goes away, others seem to crop up. Acne is most common among teenagers, with a reported prevalence of 70 to 87 percent. Increasingly, acne, now can be seen in pre-teens as well. Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower are the risks of lasting physical and emotional damage.


The main symptoms of a acne include:

  • Whiteheads (closed plugged pores)
  • Blackheads (open plugged pores — the oil turns brown when it is exposed to air)
  • Small red, tender bumps (papules)
  • Pimples (pustules), which are papules with pus at their tips
  • Large, solid, painful lumps beneath the surface of the skin (nodules)
  • Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)

Possible Cause

Four main factors cause acne:

  • Excessive oil
  • Dead skin cells
  • Clogged pores
  • Bacteria

Hair follicles are connected to oil glands. These glands secrete an oily substance (sebum) to lubricate the hair and skin. Sebum normally travels along the hair shafts and through the openings of the hair follicles onto the surface of the skin.

When your body produces an excess amount of sebum and there is a lot of dead skin cells, the two can clog the hair follicles. They form a soft plug, creating an environment where bacteria can thrive. If the clogged pore becomes infected with bacteria, it results in inflammation.

The plugged pore may cause the follicle wall to bulge, which is what we call a whitehead or the plug may be open to the surface and the clogged up bacteria and oil turns brown when it's exposed to the air leading to a blackhead.

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected. Blockages and inflammation that develop deep inside hair follicles produce cyst-like lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne.

Aggravating factors for an existing case of acne:

  • Hormones. Androgens are hormones that increase during puberty in boys and girls and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. Low amount of androgens circulating in a woman’s blood.
  • Certain medications. Drugs containing corticosteroids, androgens or lithium.
  • Diet. Studies indicate that certain dietary factors, including dairy products and carbohydrate-rich foods — such as bread, bagels and chips — may trigger acne. Chocolate has long been suspected of causing acne. A recent study of 14 men with acne showed that eating chocolate was related to an increase in acne.
  • Stress also promotes acne.

Acne myths:

  • Greasy foods. Eating greasy food has little to no effect on acne. Though working in areas such as a kitchen which involves a lot of exposure to heat and oil that sticks to the skin and blocks the follicles and thus promotes acne.
  • Dirty skin. Acne isn't caused by dirt. In fact scrubbing the skin or cleansing with soaps or chemicals that remove oil, dead skin and other substances to a certain extent may help, but excessive use of chemicals can in turn irritate the skin can be a causative factor for acne.
  • Cosmetics. Oil-free makeup doesn't clog pores (non comedogenics) and removing makeup regularly and timely does not trigger acne. The oil free make up does not have a drug interaction with the cosmetics you may use.

Risk Factors for acne include:

  • Hormonal changes. Such changes are common in teenagers, women and people using certain medications which contain corticosteroids, androgens or lithium.
  • Family history. An acne breakout can be due to genetic factors as well. If both parents had acne, then you are likely to develop it too.
  • Greasy or oily substances. You may develop acne where your skin comes into contact with oily creams or with grease in a work area.
  • Friction or pressure on your skin. This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks.
  • Stress. It is never a causative factor but an aggravating one.

Care and Treatment

Once your acne improves, you may need to continue your acne medication or other treatment to prevent new breakouts. The preventive treatment may include topical or other oral medicines that may not be as strong as the ones you took initially. You may have casual therapy session to improve your emotional state as well and to keep your doctor updated with your progress report. You may also keep asking for tips for a clear skin from your doctor as well.

Some acne-prevention tips:

  • Wash acne-prone areas only twice a day. Washing removes excess oil and dead skin cells. But too much washing can irritate the skin. Wash affected areas with a gentle cleanser and use oil-free, water-based skin care products.
  • Using an over-the-counter acne cream or gel to help dry excess oil. Look for products containing benzoyl peroxide or salicylic acid as the active ingredient.( make sure you get a patch test done to avoid a reaction).
  • Use oil free makeup.
  • Remove makeup before going to bed. Going to sleep with make up on doesn’t allow any time for your skin to breathe or rejuvenate. Also, it's a good idea to throw out old makeup and regularly clean your cosmetic brushes and applicators with soapy water.
  • Wear loose fitting clothing. Tightfitting clothing traps heat and moisture and can irritate your skin. When possible, avoid tightfitting straps, backpacks, helmets, hats and sports equipment to prevent friction against your skin.
  • Shower after strenuous activities.
  • Avoid touching or picking at the problem areas.

When to Call the Doctor

If the home remedies don't work, you should first see your primary health care provider. If acne persists even after the prescribed medicines, then you may want to get a through medical examination and treatment from a doctor who specializes in the skin (dermatologist).

The Food and Drug Administration warns that some popular acne lotions, cleansers and other skin products can cause a serious reaction. This type of reactions are quite rare, so be careful and remember to do a patch test before you apply any of these over the counter drugs.

Seek emergency medical help if after using a nonprescription skin product you experience:

  • Fainting
  • Difficulty in breathing
  • Swelling of the eyes, face, lips or tongue
  • Tightness around the throat

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