In the simplest sense, acne is caused when pores containing hair follicles and sebaceous (oil) glands become clogged. The sebaceous gland is responsible for producing sebum, an oily substance necessary for skin to stay hydrated and soft. However, too much sebum can plug the opening at the top of the pore, trapping a buildup of oil, dead skin cells, and bacteria leading to acne lesions.
Oral isotretinoin is very effective. But because of its potential side effects, doctors need to closely monitor anyone they treat with this drug. Potential side effects include ulcerative colitis, an increased risk of depression and suicide, and severe birth defects. In fact, isotretinoin carries such serious risk of side effects that all people receiving isotretinoin must participate in a Food and Drug Administration-approved risk management program.
Another once-daily gel your dermatologist might prescribe for acne is Aczone 7.5 percent. The active ingredient, dapsone, is both antimicrobial and anti-inflammatory, and it’s proven to help with blackheads, whiteheads, and deeper painful pimples. Oftentimes, Aczone is used alongside other acne treatments. And like many of those other remedies, Aczone can cause skin to dry out.
Acne vulgaris is diagnosed based on a medical professional's clinical judgment.[15] The evaluation of a person with suspected acne should include taking a detailed medical history about a family history of acne, a review of medications taken, signs or symptoms of excessive production of androgen hormones, cortisol, and growth hormone.[15] Comedones (blackheads and whiteheads) must be present to diagnose acne. In their absence, an appearance similar to that of acne would suggest a different skin disorder.[28] Microcomedones (the precursor to blackheads and whiteheads) are not visible to the naked eye when inspecting the skin and can only be seen with a microscope.[28] There are many features that may indicate a person's acne vulgaris is sensitive to hormonal influences. Historical and physical clues that may suggest hormone-sensitive acne include onset between ages 20 and 30; worsening the week before a woman's period; acne lesions predominantly over the jawline and chin; and inflammatory/nodular acne lesions.[1]
Frankincense oil is a personal favorite for me and my wife, Chelsea. Containing antibacterial and anti-inflammatory properties, it’s amazing for almost all skin types and perfect for acne-prone skin. Frankincense invites new cell growth, which can help reduce the appearance of scars. It also helps prevent or eliminate bacteria, part of what can cause acne in the first place.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the First Year. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.

The Pore Targeting Treatment gel and Complexion Perfecting Hydrator moisturizer slip on nicely, with the former powered by skin-loving glycerin and the latter by a whole slew of delicious ingredients, like licorice root extract, sodium hyaluronate, bisabolol, and allantoin. The three-step solution is easy to use and makes cleansing the face a quick, efficient process.

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Dermabrasion is an effective therapeutic procedure for reducing the appearance of superficial atrophic scars of the boxcar and rolling varieties.[32] Ice-pick scars do not respond well to treatment with dermabrasion due to their depth.[32] The procedure is painful and has many potential side effects such as skin sensitivity to sunlight, redness, and decreased pigmentation of the skin.[32] Dermabrasion has fallen out of favor with the introduction of laser resurfacing.[32] Unlike dermabrasion, there is no evidence that microdermabrasion is an effective treatment for acne.[8]
Scientists initially hypothesized that acne represented a disease of the skin's hair follicle, and occurred due to blockage of the pore by sebum. During the 1880s, bacteria were observed by microscopy in skin samples affected by acne and were regarded as the causal agents of comedones, sebum production, and ultimately acne.[164] During the mid-twentieth century, dermatologists realized that no single hypothesized factor (sebum, bacteria, or excess keratin) could completely explain the disease.[164] This led to the current understanding that acne could be explained by a sequence of related events, beginning with blockage of the skin follicle by excessive dead skin cells, followed by bacterial invasion of the hair follicle pore, changes in sebum production, and inflammation.[164]
We suggest avoiding spot treatments. “Benzoyl peroxide, when placed on red spots, can actually cause more irritation and inflammation to the area. It’s best used to prevent red bumps and pustules, and applied all over the area you want to treat,” said Townsend, who was also quick to naysay a spot-treat-only approach: “Acne affects all of the pores. If someone is going to spot treat against my advice, I still suggest they spot treat one day and treat the whole face the next.”
Acne vulgaris is a chronic skin disease of the pilosebaceous unit and develops due to blockages in the skin's hair follicles. These blockages are thought to occur as a result of the following four abnormal processes: a higher than normal amount of oily sebum production (influenced by androgens), excessive deposition of the protein keratin leading to comedo formation, colonization of the follicle by Cutibacterium acnes (C. acnes) bacteria, and the local release of pro-inflammatory chemicals in the skin.[50]
Back acne (sometimes called "bacne") is a potentially embarrassing and sometimes painful condition where clogged hair follicles on the back cause pimples and blackheads. Back acne can be caused by the same factors as other types of acne: diet, hormones, certain medications, genetics or any combination thereof. But when you're considering how to get rid of back acne, also remember that most people have their back covered the majority of the day. The clothing we wear matters, and the way in which we wash the skin on our back is key for clear skin, the whole body over. Learn more about common back acne causes, the best acne products for your body, and how to prevent acne on the back from returning in this section.
Many treatment options for acne are available, including lifestyle changes, medications, and medical procedures. Eating fewer simple carbohydrates such as sugar may help.[7] Treatments applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid, are commonly used.[8] Antibiotics and retinoids are available in formulations that are applied to the skin and taken by mouth for the treatment of acne.[8] However, resistance to antibiotics may develop as a result of antibiotic therapy.[16] Several types of birth control pills help against acne in women.[8] Isotretinoin pills are usually reserved for severe acne due to greater potential side effects.[8][17] Early and aggressive treatment of acne is advocated by some in the medical community to decrease the overall long-term impact to individuals.[4]
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the First Year. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.
Hydrated skin provides the right moisture and balance the skin needs to thrive. Additionally, water helps flush out toxins, something we need on a daily basis. And those omega-3s are pretty awesome at providing a reduction in inflammation. Wild-caught salmon is one of my favorite sources, in addition to sardines, walnuts, flaxseed oil and almonds. (10)

In general, it is recommended that people with acne do not wash affected skin more than twice daily.[15] For people with acne and sensitive skin, a fragrance free moisturizer may be used to reduce irritation. Skin irritation from acne medications typically peaks at two weeks after onset of use and tends to improve with continued use.[15] Cosmetic products that specifically say "non-comedogenic", "oil-free", and "won't clog pores" are recommended.[15]
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Complementary therapies have been investigated for treating people with acne.[151] Low-quality evidence suggests topical application of tea tree oil or bee venom may reduce the total number of skin lesions in those with acne.[151] Tea tree oil is thought to be approximately as effective as benzoyl peroxide or salicylic acid, but has been associated with allergic contact dermatitis.[1] Proposed mechanisms for tea tree oil's anti-acne effects include antibacterial action against C. acnes, and anti-inflammatory properties.[65] Numerous other plant-derived therapies have been observed to have positive effects against acne (e.g., basil oil and oligosaccharides from seaweed); however, few studies have been performed, and most have been of lower methodological quality.[152] There is a lack of high-quality evidence for the use of acupuncture, herbal medicine, or cupping therapy for acne.[151]


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Genetics play a big part in who gets acne and how severely, but each blemish can be blamed on some combination of sebum production, a bacteria called Propionibacterium acnes (P. acnes), plugged follicles, and inflammation. Finding a good treatment is really about finding the right combination of ingredients to troubleshoot each of those issues. Some factors that might worsen acne include hormones, certain medications, diet and stress.
The Daily Skin Clearing Treatment is an all-over 2.5 percent benzoyl peroxide cream that also touts calming bisabolol and allantoin to alleviate the dryness and irritation that can crop up mid-treatment. Anyone frustrated with oil-slick skin will also love this part of the regimen — it creates a satin mattifying effect, instantly transforming shininess into a glow.
Hypertrophic scars are uncommon, and are characterized by increased collagen content after the abnormal healing response.[32] They are described as firm and raised from the skin.[32][34] Hypertrophic scars remain within the original margins of the wound, whereas keloid scars can form scar tissue outside of these borders.[32] Keloid scars from acne occur more often in men and people with darker skin, and usually occur on the trunk of the body.[32]

Chemical peels can be used to reduce the appearance of acne scars.[32] Mild peels include those using glycolic acid, lactic acid, salicylic acid, Jessner's solution, or a lower concentrations (20%) of trichloroacetic acid. These peels only affect the epidermal layer of the skin and can be useful in the treatment of superficial acne scars as well as skin pigmentation changes from inflammatory acne.[32] Higher concentrations of trichloroacetic acid (30–40%) are considered to be medium-strength peels and affect skin as deep as the papillary dermis.[32] Formulations of trichloroacetic acid concentrated to 50% or more are considered to be deep chemical peels.[32] Medium-strength and deep-strength chemical peels are more effective for deeper atrophic scars, but are more likely to cause side effects such as skin pigmentation changes, infection, and small white superficial cysts known as milia.[32]
Popping pimples seems to be the quickest way to make the red spots on our skin disappear. But it can permanently damage your skin! When you squeeze a pimple, you’re actually forcing the oil substance and dead skin cells deeper into the follicle. The extra pressure exerted will make the follicle wall rupture, and spill the infected materials into the innermost part of our skin. This skin damage will lead to the loss of tissue, and finally cause acne scars.[2]

This article was medically reviewed by Hilary Baldwin, MD. Baldwin, medical director of the Acne Treatment Research Center, is a board-certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center.
Hormonal treatments for acne such as combined birth control pills and antiandrogens may be considered a first-line therapy for acne under a number of circumstances, including when contraception is desired, when known or suspected hyperandrogenism is present, when acne occurs in adulthood, when acne flares premenstrually, and when symptoms of significant sebum production (seborrhea) are co-present.[128] Hormone therapy is effective for acne even in women with normal androgen levels.[128]
Acne that’s more inflammatory is denoted as moderate acne. This happens when there are occasional nodules and possibly mild scarring. Severe acne occurs when there are a lot of inflammatory lesions, nodules and possibly scarring. It’s also considered severe if the acne is still present after six months of treatment or if it causes serious psychological issues.
Benzoyl peroxide attacks the P. acnes bacteria. However, one of its main side effects is dryness: If you’re going to use anything with benzoyl peroxide, make sure to moisturize afterwards. Sulfur and azelaic acid are less common and less severe alternatives to benzoyl peroxide. Dr. Peter Lio, assistant professor of clinical dermatology at Northwestern University, says sulfur-based treatments are “a good fit for patients who can’t tolerate the side effects of benzoyl peroxide.”
You’ve probably heard of the benefits of retinoid creams for anti-aging, but vitamin A is also efficient at clearing up acne. “[Retinoids] cause skin cells to turn over at a faster rate, decrease oil production, and help skin exfoliate,” board-certified dermatologist Rita Linkner, M.D., tells SELF. Another benefit: Acne is inflammation, and retinoids are anti-inflammatory.
Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.
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