Living with acne

Overview

Acne is a common skin condition that happens when hair follicles in your skin become blocked with oil and dead skin cells. This can lead to blackheads, whiteheads, pimples, and sometimes deeper lumps. Acne is not dangerous, but it can be upsetting and affect your confidence.

Yes, acne is very common. Most people will have at least a few spots at some time in their lives, especially during their teenage years.

Acne can affect anyone. It is most often seen in teenagers and young adults, but it can also continue into the 30s and 40s. Some people have acne because of hormonal changes, like during pregnancy or around the time of a woman's period.

Symptoms

Common symptoms

• Blackheads – small, dark bumps that appear on the surface of the skin.
• Whiteheads – small, skin-coloured bumps with a white centre.
• Pimples – red, swollen bumps that may have a white tip of pus.
• Papules – small, tender, red bumps.
• Nodules – large, painful, hard lumps under the skin.
• Cysts – large, painful, pus-filled lumps that can cause scars.

Causes

Main causes

• Acne happens when hair follicles (pores) become blocked with oil and dead skin cells.
• Hormones, especially during puberty, can increase the amount of oil your skin produces.
• Bacteria that live on the skin can get trapped in blocked pores and cause inflammation and pus.

Risk factors

• Being a teenager or young adult
• Hormonal changes, such as during the menstrual cycle, pregnancy, or with hormonal conditions
• Having a family history of acne
• Using heavy or greasy make-up, skin creams, or hair products
• Stress and anxiety
• Sweating a lot or wearing tight clothing that rubs the skin

When to see a doctor

See a doctor urgently if:

• You have very painful, large lumps under your skin.
• Your acne is severe, spreads quickly, or leaves scars.
• You notice signs of infection, such as spreading redness, warmth, or pus with a bad smell.

Book a routine appointment if:

• You are self-conscious or upset about your acne.
• Over-the-counter treatments are not working after a few weeks.
• You want advice about how to avoid scars or dark marks.

Diagnosis

Your doctor will look at your skin and ask about your health, skin care routine, and family history. This is usually enough to diagnose acne.

Tests that may be done

• No routine tests are needed for acne.

What to expect at your appointment

Your doctor will examine your skin and may ask how long you have had acne and what you have already tried. They will talk to you about treatment options and may ask you to follow up to see how things are going.

Treatment

There are many effective treatments for acne. Most work by reducing oil, clearing blocked pores, killing bacteria, or reducing inflammation. Some treatments are put on the skin, while others are taken as pills. Your healthcare provider will help choose the right plan for you.

Self-care at home

• Gently wash your face once or twice a day with a mild, non-comedogenic cleanser (won't block pores).
• Use an oil-free moisturiser to keep your skin from drying out.
• Resist the urge to pick, squeeze, or pop spots – this can make acne worse and lead to scarring.
• Shower after exercising or sweating, especially if you sweat a lot on your chest or back.
• Avoid heavy, oily make-up and hair products. Look for labels like 'non-comedogenic' or 'water-based'.

Medical treatments

A healthcare professional can prescribe treatments like gels, creams, lotions, or tablets. Some treatments are designed for short-term use, while others are used for longer. Always use prescribed treatments as directed and talk to your doctor if you have side effects. Never share acne medicines with other people.

When is surgery considered?

Very large cysts or painful nodules may need a small procedure to drain them, done by a doctor or dermatologist. This is not common, but can be offered in a clinic. Other treatments, such as certain types of light therapy or chemical peels, may be used to treat scars or stubborn acne.

Living with this condition

Living with acne can be frustrating, but try to be patient. Most treatments take 4 to 8 weeks to show a clear improvement. Keep your skincare routine simple, and be consistent. It can also help to protect your skin from the sun and to wear sunscreen that doesn't block pores.

Lifestyle tips

• Get enough sleep – lack of sleep can increase stress and make acne look worse.
• Try to manage stress, for example with exercise, breathing exercises, or hobbies you enjoy.
• Drink plenty of water to stay hydrated.
• Keep your hair off your face and wash your hair regularly, especially if it is oily.

Diet and exercise

No single food causes acne, but some people notice that eating a lot of sugary snacks or dairy products can make it worse. A healthy, balanced diet with vegetables, fruit and whole grains is best for skin and overall health. Regular exercise helps reduce stress and improve blood flow. Just remember to wash after workouts.

Mental health and emotional wellbeing

Acne can make you feel embarrassed, anxious, or low. Your feelings are valid, and you don't have to cope alone. Talk to someone you trust, like a family member, friend, or your healthcare provider. If you ever feel hopeless or have thoughts about harming yourself, this is a crisis — please contact your local emergency number or a mental health crisis line immediately.

Prevention

You cannot always prevent acne, but you can reduce flare-ups by caring for your skin gently, avoiding greasy products, and not picking at spots. If you know what triggers your acne (like certain make-up or foods), you can try to avoid those triggers.

Complications

If left untreated

• Permanent acne scars or long-lasting dark spots on the skin
• Feelings of low self-esteem, anxiety, or depression
• Rarely, severe acne can cause painful infections or deep boils that need medical treatment

Long-term outlook

Most cases of acne can be improved with the right care. Even with severe acne, there are many effective treatments. If you already have scars, there are treatments that can help soften them. With support, you can manage acne and feel better about your skin.

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