Acne happens when the sebaceous (oil-producing) glands in your skin are overactive. If too much oil is produced, this combines with dead skin cells to clog up your pores, resulting in whiteheads and blackheads. The clogged pores provide a perfect breeding ground for the bacteria that live on your skin, leading to inflammation and spots.
Acne is one of the most common skin problems, affecting around eight in 10 people aged between 11 and 30, most commonly boys aged 16 to 19 and girls aged 14 to 17. Boys tend to get acne more often than girls. Acne is usually mild but around three in every 10 teenagers have severe acne that can cause scarring if left untreated.
Acne usually comes and goes for several years, eventually resolving as you get older, usually in your mid-20s. However, around three in every 100 people still get acne after age 35.
It can cause a lot of distress if it's severe, especially as it can cause scarring. Fortunately, there are treatments that can make a big difference.
There are six types of acne-related skin blemishes, which can be mild, moderate or severe:
In almost all cases, these skin blemishes occur on the face. However, over half of cases of acne also cause skin blemishes on the back and in about 15% of cases, blemishes also occur on the chest.
Your GP will look closely at your skin to assess the types of spots you have and their severity. Your acne may be classed as follows:
Your GP may also ask you questions about other symptoms to find out if there’s an underlying medical cause. If you are a woman and suddenly develop acne, it could be caused by a hormonal imbalance, particularly if you also develop excessive body hair and irregular or light periods. You may have a condition called polycystic ovary syndrome (PCOS), which can be diagnosed with an ultrasound scan and blood tests.
If you have severe acne, your GP may refer you to a dermatologist (a doctor specialising in treating skin problems). Symptoms of severe acne include many painful nodules, scarring or a high risk of scarring, and papules and pustules on your back, chest and face.
The treatment recommended will depend on the severity of your acne.
Acne occurs when your hair follicles (tiny holes in your skin through which individual hairs grow, also known as pores) become blocked. This happens when the oil-producing gland (sebaceous gland) attached to the hair follicle produces too much oil (sebum). These glands produce sebum to lubricate your skin and hair but when they produce too much, the sebum mixes with dead skin cells and clogs your hair follicles.
If the clogged hair follicle is just underneath the surface of your skin it causes a whitehead; if it is open to the surface of the skin it causes a blackhead. Bacteria that normally live on the surface of your skin — called Propionibacterium acnes — grow more in these clogged hair follicles, causing them to become red and sore. This causes cysts, nodules, papules or pustules to develop.
Acne treatments, therefore, aim to unblock the clogged hair follicles and clear the bacterial infection.
Hormonal imbalances trigger acne in teenagers, specifically increased testosterone levels during puberty in both girls and boys. In boys, testosterone promotes the growth and development of the penis and testicles and in girls, it helps maintain muscle and bone strength. Increased testosterone levels cause the sebaceous glands to produce too much sebum, which leads to acne.
Acne can also run in families ie if one of your parents had acne, you are more likely to develop acne. If both of your parents had acne, you are more likely to develop severe acne and at a younger age. If one or both of your parents had acne as an adult, you are also more likely to develop adult acne.
Adult acne is more common in women and is most likely due to the hormonal changes that women go through at certain times in their life or due to certain health conditions, such as:
Other triggers for acne include:
Acne can also be made worse by:
Contrary to popular myth, acne isn’t caused by:
Acne is not infectious and it can’t be treated by:
Acne can be effectively treated with medications.
You can often improve mild acne at home by:
You can also try creams and lotions for sensitive skin or alcohol-based gels for oily skin. Over-the-counter medications for mild acne can also help.
When using an acne cream, start with a low dose as some acne creams can irritate the skin, causing redness or a burning sensation when you first start using them.
For moderate to severe acne, your doctor can prescribe:
This removes dead skin cells and kills bacteria. It doesn’t make your skin more sensitive to light. It is applied twice a day for at least a month. Side effects include a burning or stinging sensation and red, itchy and/or dry skin.
This reduces the growth of bacteria, whiteheads and blackheads. It is applied one to two times a day, 20 minutes after washing your face. It makes your skin more sensitive to sunlight and UV light — you must therefore avoid too much sun and not use sunbeds or sun lamps.
You will need to use it for six weeks to clear your acne. Side effects include dry, tight skin, a burning, itching or stinging sensation, redness and skin peeling.
These kill bacteria and are usually applied one to two times a day for six to eight weeks. However, the bacteria causing your acne may become resistant to the antibiotics. Side effects include skin irritation and peeling, redness and a burning sensation.
Eg tretinoin and adapalene. These remove dead skin cells and are applied once a day before bedtime for six weeks. They're not suitable if you are pregnant.
In women, acne often flares up in response to hormonal changes. Taking the combined oral contraceptive pill can help, although it can take up to one year for it to be fully effective.
A different version of the oral contraceptive pill called co-cyprindiol is sometimes prescribed to treat severe acne when antibiotics have not worked. Improvements occur after around two to six months of use.
Rare risks of taking co-cyprindiol include developing a blood clot and developing breast cancer later in life. It shouldn't be taken if you're pregnant or breastfeeding. Other side effects include:
This is a strong acne medication, given as capsules, which reduces sebum production, kills bacteria, unclogs pores and reduces inflammation.
Side effects include muscle, joint and back pain, mood changes, liver and pancreas problems and if you are pregnant, miscarriage and birth defects.
You should not take this drug if you are pregnant and while on it, you will need to use two forms of birth control during sex.
These are used alongside a topical treatment for severe acne. You will usually be prescribed tetracyclines. Tetracyclines can make your skin more sensitive to sunlight and UV light, so you should avoid too much sun and not use sunbeds or sun lamps.
Tetracyclines can also interfere with the oral contraceptive pill, making it less effective for the first few weeks of your treatment.
If you are pregnant or breastfeeding, you will be prescribed erythromycin.
You may need to take these antibiotic tablets for four to six months. You can expect to start to see improvements after around six weeks.
To reduce your symptoms, make sure you do not:
Make sure you do:
Other everyday tips for managing your acne include:
Do not use toothpaste to treat your acne. Although it contains antibacterial substances, it also contains substances that can damage your skin. See your pharmacist or GP for medications specifically designed to treat acne.
Acne scarring can happen due to damage in the deeper layers of the skin, which is caused by inflammation from the spot itself, most often with cysts and nodules. It can also be caused by squeezing or picking spots.
There are three types of acne scars:
Getting help for acne as soon as possible will reduce the risk of scarring. If you already have acne scars, there are treatments to minimise your scars, although they will not be able to completely remove your scars.
The top layer of your skin is removed using lasers or a special wire brush. After dermabrasion, your skin will be red and sore for a few months. Over time, your skin will heal and your scars will look better
For mild to moderate scars, there are two types of laser treatment:
Surgery can remove ice pick and boxcar scars using punch techniques. There are three types of punch technique:
Surgery can also remove rolling scars using subcision techniques. This involves removing the upper layer of the skin above the scar tissue. This allows blood to pool here and form a clot. The blood clot helps new connective tissue form, which pushes the rolling scar up to form a more level surface
Surgery using a subcision technique can be followed up with dermabrasion or laser treatment to further minimise the scar.
How can you cure acne?
There isn’t a permanent cure for acne, however, there are many treatments to relieve your symptoms. For mild acne, avoid scratching, picking or squeezing your spots and use a mild cleanser. Make sure you don’t wash affected areas more than twice a day as this can further irritate your skin. For moderate to severe acne, there are over-the-counter creams, gels and lotions, as well as stronger prescription alternatives and tablets that your GP can prescribe.
Does acne go away naturally?
For most people who develop acne between the ages of 11 to 30, acne goes away as they get older. For those with acne as a teenager, it usually goes away by their mid-20s.
Does masturbation cause acne?
No, masturbation does not cause acne or make it worse.
What age is acne the worst?
Acne is most common in teenagers, affecting eight in 10 teenagers to some extent. This is because acne is often triggered by hormonal imbalances, which even out with age.
How do you get clear skin overnight?
You can’t get clear skin overnight if you have acne. However, you can take steps to reduce your symptoms by avoiding scratching or squeezing your spots and using a mild cleanser to clean your face no more than twice a day. You can also see your GP to discuss prescription medications — these usually take two to three months to show any improvements.
Does drinking water help acne?
Drinking lots of water doesn’t help treat acne. However, staying hydrated is an important part of a healthy lifestyle.
Does ice help acne?
Ice can help reduce inflammation and swelling caused by inflammatory spots — this includes cysts, nodules, papules and pustules. However, it doesn’t have any effect on non-inflammatory spots ie blackheads and whiteheads.
Which foods cause acne?
There is no evidence that certain foods cause acne. However, it is still important to eat a healthy, balanced diet for your general health and wellbeing.
What does acne look like?
Acne usually appears as oily skin with red lumps, pus-filled spots, blackheads and whiteheads. It almost always occurs on the face but can also occur on your chest and back.
Is toothpaste good for pimples?
Toothpaste is not good for pimples. Although toothpaste contains antibacterial substances, it also contains substances that can damage your skin.
How do I know if my acne is hormonal?
If you develop acne in your teenage years, it is likely due to the hormonal changes that occur at this age. If you are a woman in your 20s or 30s and have acne, it may still be hormonal. You may notice that your acne gets worse just before your period or during the first three months of pregnancy. Acne is also a symptom of a hormonal disorder called polycystic ovary syndrome, which is characterised by weight gain, excessive hair growth and ovarian cysts.
Why am I getting acne in my 30s?
Although acne is usually triggered by hormonal imbalances and is therefore common during the teenage years, there are other factors that contribute to it, which is why you can still get acne in your 30s.
Genetics has a role to play — if one or both of your parents had adult acne, you are more likely to develop it too. If you wear make-up every day, are stressed or taking certain medications, you can also develop acne in adulthood. In women, the hormonal changes of having a period every month can also trigger acne, as well as the hormonal disorder, polycystic ovary syndrome.
Is acne a sign of poor health?
Acne is not a sign of poor health, poor hygiene or poor diet. It is usually triggered by hormonal imbalances.