Acne vulgaris

Overview

Acne vulgaris is a very common skin condition that causes spots, such as pimples, blackheads, and whiteheads. It happens when tiny holes in the skin called pores get blocked with oil and dead skin cells.

Yes, acne is extremely common. Almost everyone has some acne at some point in their life, especially during their teenage years.

Acne most often affects teenagers and young adults, but it can happen at any age. It affects both boys and girls, though boys may get more severe cases.

Symptoms

Common symptoms

• Blackheads (small dark spots on the skin)
• Whiteheads (small white or flesh-colored bumps)
• Pimples (red, swollen bumps that may have pus at the tip)
• Deep, painful lumps under the skin (called cysts or nodules)

Symptoms in children

• In younger children, acne may first appear as whiteheads and blackheads on the forehead, nose, and chin.
• It can be mild or moderate, but if it appears before age 8, a doctor should check for other causes.

Symptoms in older adults

• In adults, acne often appears on the lower face, jawline, and neck.
• It may come and go with stress or hormone changes, such as during pregnancy or menopause.

Causes

Main causes

• Too much oil produced by the skin’s glands
• Clogged pores from dead skin cells and oil
• Bacteria that normally live on the skin can get trapped and cause inflammation
• Hormone changes, especially during puberty or menstrual cycles

Risk factors

• Being a teenager or young adult
• Hormonal changes (like during pregnancy or using hormonal contraception)
• A family history of acne
• Stress, which can make acne worse
• Certain oily or greasy products on the skin (like heavy makeup)

When to see a doctor

See a doctor urgently if:

• If you have signs of infection: spreading redness, fever, or a lot of pain.
• If acne suddenly gets much worse or you have many deep, painful bumps.

Book a routine appointment if:

• If over-the-counter acne products haven’t helped after a few months.
• If acne is causing you to feel very upset, sad, or self-conscious.
• If you are getting scars or dark spots after acne heals.

Diagnosis

A doctor or nurse can usually diagnose acne just by looking at your skin. They will ask about your symptoms, how long you have had them, and what treatments you have tried.

Tests that may be done

• No tests are needed for most people with acne.
• In rare cases, a doctor may take a small sample of fluid from a pimple to check for infection.

What to expect at your appointment

The doctor will look at the areas of your skin with acne and may grade it as mild, moderate, or severe. They will ask about your medical history and any medicines you take. This helps them suggest the best treatment plan for you.

Treatment

Treatment for acne aims to clear spots, prevent new ones, and reduce scarring. It depends on how severe your acne is and what works best for you. Many treatments are available, from simple skin care routines to medicines your doctor can prescribe.

Self-care at home

• Wash your face gently twice a day with a mild, non-soap cleanser.
• Use 'non-comedogenic' products — these do not block pores.
• Avoid picking, squeezing, or touching spots.
• Shampoo your hair regularly, especially if it is greasy.

Medical treatments

Doctors may recommend creams, gels, or lotions that you put on your skin. These can help unblock pores, kill bacteria, or reduce oil. For more severe acne, doctors might suggest tablets or other medicines that work throughout the body. Light-based treatments or chemical peels are also options in some cases. Always follow your doctor’s instructions and do not change doses without asking.

When is surgery considered?

Surgery is not usually needed for acne itself. In some cases, doctors use special tools to remove large cysts or drain deep pimples. For scarring, treatments like laser or minor skin procedures may help, but these are not common for active acne.

Living with this condition

Living with acne means taking gentle care of your skin every day. Avoid harsh scrubs, and do not wash your face too often — it can make acne worse. Give treatments time to work, often several weeks or months.

Lifestyle tips

• Keep your hands away from your face.
• Change pillowcases and washcloths often.
• Avoid heavy, oily makeup or skincare products.
• Try to manage stress through activities you enjoy.

Diet and exercise

Eating a balanced diet with plenty of fruits and vegetables is good for overall health. There is no strong evidence that specific foods cause acne, but some people find that dairy or sugary foods make their acne worse. Regular exercise can help by reducing stress and improving blood flow, but shower soon after sweating.

Mental health and emotional wellbeing

Acne can affect how you feel about yourself. It may cause embarrassment, low self-esteem, or even depression. It is normal to feel this way. If acne is making you feel very down, talk to your doctor or a mental health professional. You are not alone, and help is available.

Prevention

You cannot always prevent acne, but you can reduce its likelihood and severity. Gentle skin care, avoiding heavy or oily products, and managing stress can help. If you know certain things make your acne worse, try to avoid them.

Complications

If left untreated

• Scars that can be permanent (pits or raised marks on the skin)
• Dark spots or red marks that last for months after spots heal
• Feelings of low self-worth, anxiety, or depression

Long-term outlook

The outlook for acne is very good. Most people see their acne improve over time, especially with proper treatment. Even if you have scars, there are treatments to help reduce them. With patience and the right care, many people achieve clear skin. You can expect improvement, though it may take weeks or months.

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