Acne, also known as acne vulgaris, is a skin condition concerning sebaceous (oil) glands and hair follicles.

It mainly affects teenagers and young adults but can appear at any age. It usually starts with puberty – between the age of 7 to 12 – and disappears after 20. But, it can last until adulthood or appear during it. Baby acne is also common, affecting ⅓ of infants. Acne manifestations between the ages of 1 and 7 are unusual and might indicate other conditions.

What causes acne?

Hormonal changes are a primary cause of acne. Sex organs (testicles and ovaries) and adrenal glands produce hormones called androgens which cause excessive oil production in the sebaceous glands and increased skin peeling in the upper part of the hair follicle. Lastly, bacteria in the follicle and immune system also impact acne formation.

Manifestation similar to acne vulgaris might form due to:

  • Chemical substances, including excessive use of cosmetics
  • Rubbing in certain areas (under a headband)
  • Use of certain medications

Acne can cause temporary or permanent changes in the skin, especially hyperpigmentation which can appear as dark spots and patches or scarring on the skin. The effect on mental health is also considerable when anxiety, depression, low self-esteem, low productivity, and school or work absence occur.

Treatment of acne

Do the pimples bother you, and you’re seeking a solution? See your GP or a dermatologist. The physician might prescribe medication for you depending on the acne’s type and severity.

Topical treatment:

  • Retinoids: reduce blackheads formation; some are anti-inflammatory and reduce oil production – mustn't be used during pregnancy and breastfeeding (salicylic or azelaic acid might be an alternative)
  • Benzoyl peroxide: aims for bacteria in the follicle
  • Antibiotics: used in more severe cases

Other means include:

  • Antibiotics
  • Birth control, antiandrogens: suppress sex hormone production; therefore, the oil production
  • Isotretinoin: is the most effective acne medication, prescribed mainly for severe acne; its high effectiveness is, on the other hand, compromised with many side effects and limitations.

Treating hyperpigmentation and scars is also possible.

How to take care of acne-prone skin?

  • Apply SPF cream every day.
  • Cleanse your skin twice a day with a non-comedogenic pH cleanser (softly massage it to the skin with the tips of your fingers, aggressive rubbing isn’t desirable).
  • Moisturise it after the cleansing,
  • Do not touch the acne with your hands, and do not pop the pimples.
  • Sleep sufficiently (7–9 hours a day).
  • Do not smoke.
  • Eat a balanced diet (try limiting milk consumption and keep an eye on calcium intake).
  • Avoid stress (meditation, yoga, regular exercise, spending time with friends).
  • Don’t be afraid to go to therapy whenever you feel like you need it.


What are the symptoms?

Acne manifests as inflammatory or non-inflammatory lesions on the skin, mainly on the face. Adolescents primarily get acne in the T-zone (forehead, nose and chin), then on the neck, chest, upper back and arms, which are areas with large amounts of hormonally reactive oil glands

Non-inflammatory lesions:

  • Closed comedo (“whiteheads”)
  • Open comedo (“blackheads”)

Inflammatory lesions:

  • Bumps (papules)
  • Pimples (pustules)
  • Cysts and nodules in the deeper layers of skin

The process of lesion formation:

  1. First, there’s so-called microcomedone – a small plug of dead skin in the pore.
  2. Oil and dead skin pile up, forming a closed comedo – “whitehead”.
  3. It becomes a “blackhead” when the comedo opens.
  4. Bacteria in the hair follicle initiate an immune response, which might form papules and pustules.
  5. If the follicle bursts, its contents spread in the area and might cause the formation of cysts and nodules.

Other factors also contribute to acne?

  • Genetics: Genetics impact the size and function of the oil glands, skin peeling ability and hormonal dispositions. Individuals with relatives affected by acne have a 3 times higher chance of acne formation.
  • Rubbing: Rubbing the skin with soaps, detergents, astringents, etc., makes acne worse, leading to comedo bursting and spreading the inflammation.
  • Diet: An association between acne manifesting and milk and a high-glycemic-load diet (those raising one’s blood glucose level) was proven true. But, there’s good news as well. There’s no proof that chocolate makes acne worse; in fact, dark chocolate contains antioxidants that improve skin quality.
  • Stress: Makes acne worse.
  • UV radiation: The sun's drying effect causes the skin to produce more oil, thickens the top layer, and clogs the pores.
  • Polluted air: Dust particles might penetrate the skin and damage it.

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