What acne is and how it shows up
Acne is inflammation of the oil glands and hair follicles. Follicles get blocked by excess oil and dead skin cells, and bacteria multiplying inside cause inflammation. This produces blackheads and whiteheads, red tender pimples, pustules and, in severe cases, deep painful lumps and cysts. Acne most often affects the face, chest and back. It is a common condition, not a sign of dirty skin or poor care.
Pimples on the face: what may be behind them
Breakouts on the face are most often acne, but other conditions look similar: rosacea, perioral dermatitis, a reaction to cosmetics, folliculitis. They cannot be told apart from a photo or a description, and each is treated differently. So if home care is not working, it is better to see a dermatologist. For other breakouts, see Rash; for contact reactions, Dermatitis.
Acne in teenagers
In teenagers, acne is tied to hormonal changes and for many it clears with age. But there is no need to wait for them to "grow out of it": early care and well-chosen treatment lower the risk of scars and distress about appearance. If breakouts are widespread, painful or leave marks, take the teenager to a dermatologist.
Acne in adults and in women
Acne can appear after 25 or 30, more often in women. Hormone shifts through the cycle, pregnancy, menopause and polycystic ovary syndrome all play a part. If acne comes with irregular periods, excess hair growth on the face and body, or hair loss, consider seeing a gynecologist-endocrinologist or an endocrinologist, as hormones may be involved. For your cycle, see Irregular periods; for hair, Hair loss. Some acne medicines must not be used in pregnancy, so tell your doctor if you are pregnant or planning to be.
Pimples on the back and chest
Acne on the back and chest is common. It helps to wear loose, breathable clothing, shower after workouts and use non-irritating body products. If breakouts on the back are widespread and painful, an examination is needed: you may need stronger treatment than for the face.
Should you squeeze pimples, and what about diet
Do not squeeze or pick pimples: it makes inflammation and lasting scars more likely. Harsh scrubbing irritates the skin and can worsen acne. Dirt does not cause acne, and for most people the effect of chocolate and greasy food is slight. Stress does not cause acne but can make it worse.
What you can do before the visit
- Wash with a mild cleanser twice a day and remove makeup at night.
- Choose products labeled non-comedogenic and avoid very greasy products on your skin.
- Do not scrub with a washcloth or exfoliants, and do not squeeze or pick spots.
- Do not try several new products on your skin at once: it is harder to tell what helps and what irritates.
- Ask a pharmacist about over-the-counter products (for example, with benzoyl peroxide or salicylic acid) and follow the directions.
- If home care does not help within a few weeks, see a doctor and do not step up treatment on your own.
How a doctor treats acne
The doctor examines the skin, judges severity, asks about the cycle, medicines, family history and skin care, and may order tests if a hormonal cause is suspected. Treatment depends on severity: products applied to the skin (for example retinoids or antibacterial ones), a course of antibiotic tablets, hormonal medicines for women and, for severe acne, medicines that only a doctor can prescribe. The effect usually shows after weeks, so it is important not to stop treatment early and to come to follow-up visits.