Acne - self-care
Acne is a skin condition that causes pimples or "zits." Whiteheads (closed comedones), blackheads (open comedones), red, inflamed papules, and nodules or cysts may develop. These most often occur on the face, neck, upper trunk and upper arms.
Acne occurs when tiny pores on the surface of the skin become clogged. The pores can become plugged by substances on the surface of the skin. More commonly they develop from a mixture of the natural oils of the skin and the dead cells shed from the inside of the pore. These plugs are called comedones. Acne is most common in teenagers. But anyone can get acne.
Acne - Animation
You can call them blackheads, pimples or zits, but by any name, acne can really ruin your day. Waking up to find a giant pimple in the middle of your forehead or chin, especially if it's picture day at school, or you have a big date, can be a real bummer. So, what causes acne? All over your skin you've got tiny little holes called pores. These holes are openings to your hair follicles. Each hole also contains an oil gland. The oil helps keep your skin lubricated and removes dead skin cells. Sometimes your oil glands work overtime, producing too much of the slimy stuff. The extra oil can fill up and block your pores, causing a backup of dirt, bacteria, and cells. At the top of the blockage sits a plug. If the top of the plug is white, you've got a whitehead, the type of pimple many of us are so tempted to pop. If the top of the plug is dark, you've got a blackhead. If the plug bursts open, you'll have a swollen red bump. The most common place to find acne is on your face. But you can also get breakouts on your shoulders, arms, legs, back, and buttocks. Although acne is known as a teenage affliction, you can get pimples at any age, especially if you sweat a lot, use greasy cosmetics, or eat a high-sugar diet. Hormones can also trigger acne outbreaks. Women who are just starting their period may notice more pimples than usual. You may also discover a few pimples on the day of a big test or presentation, because stress can lead to breakouts. So, you may ask, how do you get rid of acne? First, here's something you should never do when you've got acne. Don't squeeze or pick at the bumps. In fact, try not to touch your face at all. You'll just make the acne worse, and you could even leave permanent scars. To treat acne, the first step is gently cleaning your face twice a day with a pH balanced cleanser, such as Cetaphil or Dove. Use warm (not hot) water, and pat dry. Aggressive scrubbing may make acne worse. Many people benefit from adding an over-the-counter acne medicine that contains ingredients like benzoyl peroxide. These creams dry up the extra oil in your skin and kill bacteria. They may make your skin a little red or cause it to peel at first, but they work pretty well at clearing up breakouts. If over-the-counter treatments don't work, see your doctor or a dermatologist. Prescription creams or gels are stronger and may be more effective at clearing up stubborn acne. Many will prescribe antibiotics such as tetracycline, erythromycin, or doxycycline. You can either take these by mouth, or rub them on your skin. Another option is to have a laser treatment or skin peel. Talk to your doctor about these treatments if medicines haven't cleared up your acne. Acne is a rite of passage for teenagers, but pimples can plague people well into their 30s or 40s. You don't have to live with acne, because there are several very effective treatments for it. See your doctor or a dermatologist to discuss your options. Also make an appointment if your acne is getting worse even with treatment, or you've got scarring where your acne used to be.
Acne breakouts can be triggered by:
- Hormonal changes
- Use of oily skin or hair care products
- Certain medicines
- Sweat
- Humidity
- Diet
Daily Skin Care
To keep your pores from clogging and your skin from becoming too oily:
- Clean your skin gently with a mild, non-drying soap.
- It may help to use a wash with salicylic acid or benzoyl if your skin is oily and prone to acne. Remove all dirt or make up.
- Wash once or twice a day, and also after exercising. Avoid scrubbing or repeated, frequent skin washing.
- Shampoo your hair daily, if it is oily.
- Comb or pull your hair back to keep the hair out of your face.
- Avoid using rubbing alcohol or toners that are very drying to the skin.
- Avoid oil-based cosmetics.
Hair follicle sebaceous gland
Each pore on the surface of the skin is an opening to a canal called a follicle. The follicle also contains a hair and an oil gland (sebaceous gland). The oil gland helps remove old skin cells, keeps the skin lubricated, and prevents drying of tissues.
Acne medicines can cause skin drying or peeling. Use a moisturizer or skin cream that is water-based or "noncomedogenic" or that clearly states that is safe to use on the face and will not cause acne. Remember that products that say they are noncomedogenic might still cause acne in you personally. Therefore, avoid any product that you find makes your acne worse.
A small amount of sun exposure may improve acne slightly. However, too much exposure to sun or in tanning booths increases the risk for skin cancer. Some acne medicines can make your skin more sensitive to the sun. Use sunscreen and hats regularly if you are taking these medicines.
Minimizing dairy and high glycemic index foods may help decrease acne flares.
To further prevent acne:
- Do not aggressively squeeze, scratch, pick, or rub pimples. This can lead to skin infections as well as scarring and delayed healing.
- Avoid wearing tight headbands, baseball caps, and other hats.
- Avoid touching your face.
- Avoid greasy cosmetics or creams.
- Do not leave make up on overnight.
Acne Medicines
If daily skin care does not clear up blemishes, try over-the-counter acne medicines that you apply to your skin.
- These products may contain benzoyl peroxide, sulfur, adapalene, resorcinol, or salicylic acid.
- They work by killing bacteria, drying up skin oils, or causing the top layer of your skin to peel.
- They may cause redness or peeling of the skin.
If these acne medicines cause your skin to become irritated:
- Try using smaller amounts. A drop the size of a pea will cover the entire face.
- Use the medicines only every other or third day until your skin gets used to them.
- Wait 10 to 15 minutes after washing your face before applying these medicines.
Treatments From Your Health Care Provider
If pimples are still a problem after you've tried over-the-counter medicines, your health care provider may suggest:
- Antibiotics in the form of pills or creams that you put on your skin
- Prescription gels or creams containing a retinoid to help clear up the pimples
- Hormone pills for women whose acne is made worse by hormonal changes
- Isotretinoin pills for severe acne
- A light based procedure called photodynamic therapy
- Chemical peels
When to Call the Doctor
Contact your provider or your dermatologist if:
- Self-care steps and over-the-counter medicine do not help after several months.
- Your acne is painful (for example, you have a lot of redness around the pimples, or you have cysts).
- Your acne is getting worse.
- You develop scars as your acne clears up.
- Acne is causing emotional stress.
Reviewed By
Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
American Academy of Dermatology Association website. Can the right diet get rid of acne? www.aad.org/public/diseases/acne/causes/diet. Accessed February 29, 2024.
Draelos ZD. Cosmetics and cosmeceuticals. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2024:chap 153.
James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Acne. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 13.
Lalor L, Zaenglein AL. Acne vulgaris. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 3.
Paller AS, Mancini AJ. Acne vulgaris and other disorders of the sebaceous and sweat glands. In: Paller AS, Mancini AJ, eds. Paller and Mancini - Hurwitz Clinical Pediatric Dermatology. 6th ed. St Louis, MO: Elsevier; 2022:chap 8.
Zaenglein AL, Nelson AM, Lalor LEB. Acne vulgaris. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2024:chap 36.