Acne is one of the most common skin conditions, yet despite the abundance of advice available, accurate information about acne and its treatment can sometimes be lacking. This can make the journey toward clear skin more difficult. In this guide, we aim to help you better understand acne and how to treat it successfully.

What causes acne?

Acne occurs when pores on your skin become clogged. This process begins with the accumulation of dead skin cells. Normally, these dead cells rise to the surface of the pore and shed. However, if the body produces too much sebum (the oil that prevents skin dryness), these dead skin cells stick together and become trapped inside the pore. Sometimes, bacteria that naturally live on the skin, Propionibacterium acnes, also become trapped inside the clogged pore. These bacteria now find ideal conditions to grow and multiply. As a result, the pore becomes inflamed (red and swollen). If the inflammation spreads to deeper layers of the skin, cysts and nodules can develop. On the skin, different types of blemishes can appear, such as blackheads, clogged pores, papules, pustules (commonly known as pimples), cysts, and nodules. Acne can appear on the face, neck, chest, upper arms, back, and buttocks.

Who gets acne?

If you suffer from acne, you may feel like you’re the only one, but many people deal with this condition. Acne mainly affects teenagers and young adults, though it can occur at any age. Increasingly, women in their 30s, 40s, and even 50s are also experiencing acne. While we are not entirely sure why this happens, we know that adult acne can be just as frustrating as acne during adolescence.

Why is it important to treat acne?

There are many myths surrounding acne, including the idea that you should just “let acne run its course.” Experts, however, know that leaving acne untreated is not always the best advice. Here’s why:

• Lowered self-esteem: Many people with acne report feeling bad about their appearance, leading them to withdraw socially and perform poorly at school or work.
• Depression: Acne can not only cause low self-esteem but also lead to depression, which in severe cases can cause suicidal thoughts. This is especially common among teenagers for whom appearance is highly important during this period of growth.
• Dark spots on the skin: These occur after acne heals (post-inflammatory hyperpigmentation), and it can take months or even years for them to fade.
• Scarring: Cystic and nodulocystic acne can often leave permanent scars. However, scarring can be prevented by seeking early treatment, especially for those between the ages of 8–12. If someone in your immediate family has had cystic or nodulocystic acne, seeing a dermatologist early can help prevent permanent scars.

How to treat acne

Many effective treatments are available, but this doesn’t mean that all treatments will work equally well for everyone. It does, however, mean that all types of acne can be managed. Mild acne can often be treated with over-the-counter products containing benzoyl peroxide or salicylic acid. While these treatments can be effective, improvement is not immediate. It typically takes 4–8 weeks to see results, and once the skin clears, the treatment should continue for several months to prevent acne from returning.

When to see a doctor

If you have a lot of acne, cysts, or nodules, over-the-counter treatments may not be enough. A dermatologist might recommend the following treatments:

1. Topical treatments: Most acne medications are applied to the skin. Some work by killing bacteria, while others reduce oil production. These treatments may contain retinoids, higher concentrations of benzoyl peroxide, antibiotics, or salicylic acid, depending on your specific needs.
2. Oral treatments: These are often necessary for inflammatory acne (red and swollen). Options include:
   • Antibiotics (to kill bacteria and reduce inflammation)
   • Oral contraceptives or other hormone treatments (useful for females)
   • Isotretinoin (the only medication that addresses all causes of acne)

Procedures for treating acne

Office-based procedures include:

• Lasers and light therapy: These devices reduce the number of Propionibacterium acnes bacteria.
• Chemical peels: These are more powerful than over-the-counter peels and are effective for treating blackheads and papules.
• Drainage and extraction: This procedure removes the contents of large cysts and is useful when cysts don’t respond to medication, helping to reduce the risk of permanent scarring.

Helpful tips for treating acne:

1. Clean your skin twice a day and after sweating.
2. Use your fingertips to gently apply a mild cleanser. Avoid using washcloths, sponges, or towels as they can irritate the skin.
3. Avoid harsh scrubs, as they can worsen acne.
4. Rinse your skin with lukewarm water.
5. Avoid squeezing pimples, as this increases the risk of permanent scarring.
6. Keep your hands off your face to prevent skin irritation.
7. Avoid tanning and tanning beds: Tanning damages your skin, and some acne medications make the skin more sensitive to UV rays. Using tanning beds increases the risk of melanoma, the deadliest form of skin cancer, by 75%.
8. Consult a doctor if you feel embarrassed by your acne, if over-the-counter products haven’t helped, or if you have scars or dark spots.

Conclusion

Today, every case of acne can be treated. Skilled doctors can help heal existing acne, prevent new breakouts, and reduce the likelihood of scarring. If you have any concerns about your skincare routine, don’t hesitate to seek professional advice.