Kids Health Info

Acne

  • Acne is a common skin condition that causes outbreaks of spots, pimples and, sometimes, deeper lesions called nodules. Acne usually affects teenagers; however, adults in their 20s and even into their 40s can develop acne.

    Acne usually clears up after several years, but for some people it can last a lot longer. Depending on how severe the acne is, special treatment with creams or medication may be needed to get rid of it.

    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).

    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?

    During puberty, both males and females have higher levels of a male hormone called testosterone in their blood. Testosterone triggers the acne by causing the oil glands, which are called the sebaceous (seb-ay-shus) glands, to produce excess oil. The sebaceous glands are connected to hair follicles on your face, neck, chest and back.

    This extra oil causes the hair follicles (pores) in your skin to become blocked. Bacteria can grow in these blocked pores. These bacteria produce chemicals that can cause the wall of the follicle to break. When the wall is broken, sebum (oil), bacteria and dead skin cells escape from the pores. This is how pimples and nodules are formed.

    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.

    Hygiene

    Even though acne is not caused by dirt, taking care of your skin with good hygiene is important. The darkness of a blackhead is not dirt, but is due mostly to dried oil and shed skin cells in the openings of the hair follicles. For the normal care of your skin, you should wash your face with a gentle, pH balanced soap-free face wash and warm water twice a day. 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.

    Makeup

    When buying makeup, make sure it's non-comedogenic or non-acnegenic, which means that using the cosmetic should not result in whiteheads and blackheads.

    Makeup should be taken off every night with face wash and water.

    Non-prescription creams

    Many non-prescription acne lotions and creams can help mild acne, and 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. 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.

    Don't squeeze

    Don't pick, scratch, pop or squeeze your pimples yourself. 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 soap 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, one thing is certain – 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. Too much sun over many years could also cause early ageing of the skin and skin cancer.

    When to see a doctor

    If your acne is not improving with non-prescription acne creams or your acne is severe and causing you distress, see your GP. In some cases, the GP will refer you to a dermatologist (a doctor specialising in skin conditions).

    Your doctor will assess your skin and determine if your skin condition is acne. Occasionally, an acne-like rash can be due to another cause, such as makeup or lotions you've used, or oral medication. It's important to provide the doctor with a history of what you are using on your skin and what medicines you are taking.

    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 in the hair follicle.
    • When large red bumps are present, your doctor may inject medication directly into the bumps.

    In cases of severe acne, the doctor may prescribe other oral (taken by mouth) medications. These may include female-type hormones and other medications that decrease the male-type hormones. Isotretinoin (also known by brand names, such as Roaccutane) is another type of medication that is sometimes used to treat severe acne that has not responded to other treatment. Patients using isotretinoin must fully understand the side effects of the medicine. Frequent follow-up visits with a dermatologist are needed to monitor its side effects. You must not get pregnant while on this medicine as it can cause severe birth defects if taken during pregnancy.

    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 and warm water twice a day, and do not squeeze your pimples yourself.
    • 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.

    For more information

    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 tea tree oil, colloidal oatmeal, green tea extract, alpha hydroxy acid (fruit acid) and azelaic acid. Talk to your doctor or pharmacist about any of these treatments before using them.

    What are the side effects of Roaccutane?

    The possible side effects of Roaccutane include: dry, fragile, peeling skin; headache; depression; pain the joints or muscles; vision and eye problems; hair loss or extra hair; nausea. Some people should not take this medication, such as those with liver disease or who have had allergic reactions to vitamin A or retinoids, and anyone who is pregnant or who plans to become pregnant. If you have been prescribed Roaccutane, you will need regular appointments with your doctor, who will monitor you carefully for side effects. Some people experience no side effects or only mild effects.


    Developed by The Royal Children's Hospital Dermatology and General Medicine departments. We acknowledge the input of RCH consumers and carers.

    Reviewed July 2018.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


How did you like this fact sheet?
Click here to do a short RCH survey.

Kids Health Info app

The app will enable you to search and browse more than three hundred medical fact sheets and work offline.

Apple store Google play


Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.