Acne is a very common skin condition that causes your skin
to break out in “spots” or “pimples.” Acne usually starts during puberty;
however, it may sometimes occur in children, and can persist into adulthood.
Acne usually goes away after several years, but for some
people it can go on for a lot longer.
Treating acne takes time. Depending on how severe the
acne is, special treatment with prescription creams or oral medication may be
needed to treat existing spots and prevent new ones developing.
Severe acne can be very upsetting and affect a person's
confidence and self-image, and untreated or complicated acne can leave lifelong
scars.
Acne is a medical condition. It is not a disease caused by
dirtiness and is not contagious.
Symptoms of acne
Acne can consist of the skin being affected by large amounts of:
- blackheads (small black spots)
- whiteheads (small white spots)
- pimples (inflamed red spots, which sometimes have a yellow centre of pus)
- nodules (bumps under the skin, which can be painful) or cysts (firm lesions that contain fluid)
It is most common on the face, but can also occur on the back, chest, shoulders and neck. The occasional pimple or blackhead is not considered to be acne.
What causes acne?
Pimples appear when the oil glands (pores) in your skin get
blocked. During puberty, and in females before their period, higher levels of
hormones cause the oil glands to enlarge and produce more oil (sebum). Your
face, neck, chest, shoulders and upper back are most likely to be affected by acne
because they have the most oil glands.
This extra oil causes the pores in your skin to become
blocked and dead skin cells to get trapped, producing blackheads and
whiteheads. Bacteria can grow in these blocked pores. These bacteria produce
chemicals that can cause inflammation resulting in redness, swelling and pain.
Acne can run in families. Having parents with a history of
acne is associated with a higher risk of developing acne.
Care at home
There is no instant or permanent cure for acne, but it is possible
to control it. Proper treatment for your acne will help to prevent permanent
scars. The following recommendations will help take care of your skin:
Good skin care
Even though acne is not caused by dirt, taking care of your
skin is important. The darkness of a blackhead is not dirt, but is due to dried
oil and trapped dead skin cells in the pores. For the normal care of your skin,
you should wash your face with a gentle, pH balanced soap-free cleanser twice a
day. Cleansers that contain salicylic acid can help break down sebum and help
unblock pores. It's important not to wash too often as this may actually
aggravate your acne. Regular shampooing of your hair is also recommended,
especially if your hair is oily and rests against your forehead. Try to pull
your hair back from your face and neck as much as possible.
Makeup, moisturisers and sunscreen
When buying makeup, choose oil-free or matte-finish products
or a mineral powder. These are non-comedogenic or non-acnegenic, which means
they should not block your pores. Only apply moisturiser to acne affected areas
if they are dry or irritated. Using too much moisturiser can make acne worse.
Also look for oil-free and non-comedogenic products. Sunscreen gels, liquids,
light creams and sprays are best for acne prone skin.
Makeup should be taken off every night with a mild ‘soap
free’ cleanser or micellar water. Do not use make-up remover wipes.
Non-prescription creams
Many non-prescription acne lotions and creams can help mild
acne by cleaning the skin and drying up excess oil. These are available over
the counter at a pharmacy or chemist. However, many of these products will make
your skin dry if used too often. If you use these products, follow the
instructions carefully. Be patient, it may take two to three months to see
improvement in your acne. Ask your pharmacist for advice on the best product to
use, as using the wrong products can irritate your skin and make your acne
worse. Do not rely on advertisements, celebrity endorsements, or advice from
friends.
Don't squeeze
Don't pick, scratch, pop or squeeze your pimples. When the
pimples are squeezed, more redness, swelling, inflammation and scarring may
result.
Shaving
If you shave your face and have acne, try both an electric
and a safety razor to see which is more comfortable. If you use a safety razor,
soften your facial hair thoroughly with a shaving cream for sensitive skin and
warm water. To avoid nicking pimples, shave as lightly as possible. Shave only
when needed and always use a sharp blade.
Diet
Acne is not generally caused by the foods you eat. Doctors
have different opinions on the importance of diets in the management of acne.
However, it is generally agreed that following a strict diet will not
clear your skin by itself. On the other hand, some people find their acne seems
to become worse when they eat certain foods. If that's the case, avoid the
foods that worsen your acne.
Sunlight
Acne may improve after you've been out in the sun, but
sunlight only helps for the short term. In the long run, sunlight may actually
worsen acne. Many acne treatments make the skin more sensitive to sunlight and
increases the risk of burning. Too much sun over many years could also cause
early ageing of the skin and skin cancer. Practice good sun protection and sun
avoidance.
When to see a doctor
If acne is to be controlled successfully, the treatment needs to be an ongoing process. The treatment your doctor will recommend will vary according to your type of acne.
Your doctor may open pimples or remove blackheads and whiteheads, using a safe method that will avoid scarring.
They may prescribe creams or lotions that are applied to the skin to help unblock the pores and reduce the bacteria. These may make the skin dry and peel. Your doctor will advise you on how to use the medicine and about any side effects.
Antibiotics by mouth may be given for moderate or severe acne, especially when there is a lot of acne on the back or chest. The antibiotics are used to reduce the inflammation.
When large red bumps are present, your doctor may inject medication directly into the bumps.
For more information
See your GP or dermatologist
HealthDirect Australia: All about acne
Key points to remember
- Acne is a common medical condition, not caused by dirt and generally not caused by diet.
- Wash your face with a gentle soap-free face wash twice a day, and do not squeeze your pimples.
- Untreated acne can leave lifelong scars
- See a GP if your acne is not improving with non-prescription acne creams or your acne is severe and causing you distress.
Common questions our doctors are asked
Are there any natural remedies that are helpful for acne?
We don't recommend using natural remedies without seeking medical advice, because they might not be right for you, they may irritate your skin further, or they may interact with other treatments you are using. However, research has found that some natural products may be useful in treating acne, including alpha hydroxy acid (fruit acid) and azelaic acid. Talk to your doctor or pharmacist about any of these treatments before using them.
Does isotretinoin cause depression?
Having acne can make you feel unhappy and depressed. There are several studies that have found no link between isotretinoin and depression or suicide. Instead, some studies have shown a reduction in depression when acne improves with taking isotretinoin. Talk to your doctor if you have a history of depression or low mood.
Developed by The Royal Children's Hospital Dermatology and General Medicine departments. We acknowledge the input of RCH consumers and carers.
Reviewed May 2022
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.