Acne vulgaris; Cystic acne; Pimples; Zits
Acne is a skin condition that causes pimples or "zits." Whiteheads, blackheads, and red, inflamed patches of skin (such as cysts) may develop.
Acne occurs when tiny holes on the surface of the skin become clogged. These holes are called pores.
Acne is most common in teenagers, but anyone can get acne, even babies. The problem tends to run in families.
Some things that may trigger acne include:
Research does not show that chocolate, nuts, and greasy foods cause acne. However, diets high in refined sugars or dairy products may be related to acne in some people.
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.
Your health care provider can diagnose acne by looking at your skin. Testing is not needed in most cases. Bacterial culture may be performed to rule out infection if large pus bumps persist.
Steps you can take to help your acne:
What NOT to do:
If these steps do not clear up the blemishes, try over-the-counter acne medicines that you apply to your skin.
A small amount of sun exposure may improve acne slightly, but tanning mostly hides the acne. Too much exposure to sunlight or ultraviolet rays is not recommended because it increases the risk for skin cancer.
MEDICINES FROM YOUR HEALTH CARE PROVIDER
If pimples are still a problem, a provider can prescribe stronger medicines and discuss other options with you.
Antibiotics may help some people with acne:
Creams or gels applied to the skin may be prescribed:
For women whose acne is caused or made worse by hormones:
Minor procedures or treatments may also be helpful:
People who have cystic acne and scarring may try a medicine called isotretinoin (Accutane). You will be watched closely when taking this medicine because of its side effects.
Pregnant women should NOT take Accutane, because it causes severe birth defects.
Most of the time, acne goes away after the teenage years, but it may last into middle age. The condition often responds well to treatment after 6 to 8 weeks, but may flare up from time to time.
Scarring may occur if severe acne is not treated. Some people become very depressed if acne is not treated.
Call your provider if:
If your baby has acne, call the baby's provider if acne does not clear up on its own within 3 months.
Habif TP. Acne, roacea, and related distorders. In: Habif TP, ed. Clinical Dermatology. 6th ed. St. Louis, MO: Elsevier Saunders; 2016:chap 7.
Zaenglein AL, Thiboutot DM. Acne vulgaris. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 36.
Last reviewed on: 7/23/2015
Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.