Acne

Definition

Acne is a skin condition characterized by whiteheads, blackheads, and inflamed red pimples or "zits."

Alternative Names

Acne vulgaris; Cystic acne; Pimples; Zits

Causes

Acne occurs when tiny holes on the surface of the skin called pores become clogged. Each pore is an opening to a canal called a follicle, which contains a hair and an oil gland. Normally, the oil glands help keep the skin lubricated and help remove old skin cells. When glands produce too much oil, the pores can become blocked, accumulating dirt, debris, and bacteria. The blockage is called a plug or comedone.

The top of the plug may be white (whitehead) or dark (blackhead). If it ruptures, the material inside, including oil and bacteria, can spread to the surrounding area and cause an inflammatory reaction. If the inflammation is deep in your skin, the pimples may enlarge to form firm, painful cysts.

Acne commonly appears on the face and shoulders, but may also occur on the trunk, arms, legs, and buttocks.

Acne is most common in teenagers, but it can happen at an age, even as an infant. Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. However, people in their 30s and 40s may also have acne.

Acne tends to run in families and can be triggered by:

Despite the popular belief that chocolate, nuts, and other foods cause acne, this does not seem to be true.

Symptoms

Exams and Tests

Your doctor can diagnose acne based on the appearance of the skin. Testing is usually not required.

Treatment

Take the following self-care steps to lessen the effects of acne:

If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These creams and lotions are applied directly to the skin. They may contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid. They work by killing bacteria, drying up the oil, and causing your skin to peel.

If the pimples are still a problem, a dermatologist can prescribe stronger medications and discuss other options with you.

Prescription medicines include:

Birth control pills can sometimes help clear up acne. (In some cases, though, they may make it worse.)

Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion, or removal or drainage of cysts.

A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays is not recommended because it increases the risk of skin cancer.

Outlook (Prognosis)

Acne usually subsides after adolescence, but may last into middle age. The condition generally responds well to treatment after a few weeks, but may flare up from time to time. Scarring may occur if severe acne is not treated. Some people, especially teenagers, can become significantly depressed if acne is not treated.

Possible Complications

Possible complications include:

When to Contact a Medical Professional

Call your doctor or a dermatologist if:

For infant acne, call your pediatrician if it does not clear up on its own in 3 months.

American Academy of Dermatology. AcneNet page. Available at: http://www.skincarephysicians.com/acnenet/acne.html. Accessed March 23, 2005.

Habif TP. Acne, Rosacea, and Related Disorders. In: Clinical Dermatology. 4th ed.Mosby, Inc., 2004; 162-194.