Zits (Acne)

Acne is a skin condition that is common in adolescents. Acne usually gets better over time, but may continue into adulthood for some people.

What causes or increases my risk for acne?

Acne occurs when pores become blocked with dead skin cells, oil, or bacteria. Pores are openings in your skin where oil, sweat, and hair are produced. Acne may be caused by high hormone levels during puberty. Hormonal changes caused by birth control pills, menstrual cycles, or pregnancy can cause acne in females. Medicines such as antidepressants and antiseizure medicines can also cause acne. Sensitive skin or a family history of acne increases your risk. The following can make your acne worse:

  • Oil-based cosmetics or hair products, or suntan oil
  • Rubbing your skin too hard or picking at your pimples
  • Stress
  • Pressure on the skin from sports helmets or backpacks
  • Eating high amounts of sugar or dairy
  • Certain medical conditions such as Addison disease or Cushing syndrome
  • Smoking

What are the different types of acne?

Acne most often appears on the face, neck, upper chest, back, and upper arms.

  • Whiteheads are closed, white bumps that form when the pore is completely blocked.
  • Blackheads are tiny, dark spots that form when the pore is blocked but stays open.
  • Pimples are inflamed bumps that contain pus. They are often caused by clogged pores. Pimples develop when whiteheads or blackheads get infected.
  • Cystic acne is made up of large inflamed nodules or cysts that contain pus. They look like large pimples and form deep inside the skin. They may cause pain and scars.

How is acne diagnosed?

Your healthcare provider will examine your skin and ask if you have ever received treatment for acne. Tell him or her how long your acne lasts and which face care products you use. Your provider may ask if anything makes your acne better or worse. You may need blood tests to check your hormone levels.

How is acne treated?

Treatment depends on how severe your acne is. Your healthcare provider may recommend any of the following:

  • Over-the-counter acne medicines with benzoyl peroxide and salicylic acid may help to treat mild acne. They are available in the form of gels, lotions, creams, pads, or soaps. It may take several weeks for you to see an improvement. Follow the directions on the medicine label. Do not use more than directed. This medicine can cause dry and red skin if you use too much or use it too often.
  • Prescription medicines may be needed if over-the-counter medicines do not help after 2 months. You may need to take more than one kind of medicine to treat your acne. A type of prescription acne medicine called retinoids may cause serious birth defects. Do not use this medicine if you are pregnant or may become pregnant.
  • Light therapy may help decrease your acne. Ask your healthcare provider for more information about light therapy.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

  • Accutane
  • doxycycline
  • Aldactone
  • spironolactone
  • Bactrim

What else can I do to manage or prevent acne?

  • Wash your face 2 times a day with a gentle cleanser. This helps decrease oil buildup that leads to acne. Also wash your face if you have been sweating a lot, such as after exercise.
  • Use oil-free products. This includes sunscreen, moisturizers, and cosmetics. Hair products should also be oil-free.
  • Wash your hair regularly to decrease oil. Oily hair that touches your face can increase acne.
  • Avoid touching your face as much as possible. Do not pick, squeeze, or pop your pimples. This can make your acne worse because your hands contain oil. It can also cause scars to form on your face.
  • Avoid things that rub against your skin as much as possible. This includes hats, helmets, and backpacks.

When should I call my doctor?

  • You use retinoid medicine and you think you might be pregnant.
  • You use retinoid medicine and begin to have mood swings or personality changes.
  • You feel depressed.
  • You have a fever and inflammation of your skin.
  • Your acne does not get better, even after treatment.
  • You have questions or concerns about your condition or care.