What is acne?

Acne is the medical term for pimples. Pimples occur when pores become clogged with dead skin and sebum and bacteria build up. Then the skin may become inflamed and may turn red or swell.

Can I do anything myself to reduce acne?

Yes. The way you take care of your skin can help with acne. Here’s what you should do:

Do not wash your face more than twice a day. Use warm water — not hot — and don’t use harsh soaps. Instead, use a soap-free facial cleanser. Don’t rub your face, as this can make acne worse and damage the skin.

Do not pick or squeeze pimples. This may make acne worse and damage the skin. It may also lead to infection.

Avoid cosmetics and skin products with essential oil ingredients. It may make acne worse. If you use a moisturizer for your face, one that says “non-comedogenic” is often best.

Can I treat acne?

If you have mild acne, you can try over-the-counter acne products. These products contain benzoyl peroxide, salicylic acid, adapalene, or other acne treatments. In rare cases, people may have a severe allergic reaction to acne products that contain benzoyl peroxide or salicylic acid, so try them on only a small area for the first three days. If your acne has not improved after 3 months or if you have moderate or severe acne, ask your doctor or nurse for advice.

How is acne treated?

Doctors can treat acne with different types of medications. Sometimes doctors suggest trying more than one medication at a time.

There is no one drug or combination of medicines that works for everyone. Instead, people often need to try different medications until they find one that works best for them.

Some acne medications require a prescription to obtain, while others do not. Your doctor may suggest:

Medicines that you put directly on your skin – this may be in the form of a gel, cream or lotion. There are different types. Examples are:

Retinoids – These are medications that help keep pores from becoming clogged. Examples of retinoids are tretinoin, adapalene, and tazarotene. Retinoids may also help improve dark spots on the skin that are caused by acne.

Benzoyl peroxide or antibiotics – Benzoyl peroxide and antibiotics reduce acne by killing the bacteria inside the pimples. It also helps reduce inflammation. Benzoyl peroxide is available without a prescription. Other antibiotics are available by prescription.

Medicines you take in tablet form – these include:

Antibiotics – Antibiotic tablets work just as well as antibiotic gels or lotions. But they are often stronger and can cause troublesome side effects.

Birth control pills or spironolactone – some of the skin reactions that lead to acne are controlled by hormones. For this reason, birth control pills can sometimes help treat acne. Spironolactone is another medication that can block the action of hormones that may make acne worse. One of these medications may be an option for women or teenage girls with acne.

Isotretinoin – Isotretinoin is a retinoid that comes in tablet form. It is very effective against severe acne. But it can also cause serious side effects and birth defects. Women who want to take isotretinoin must follow very strict safety rules for contraception.

Other treatments – Examples of other types of treatments that may help some people with acne include chemical peels, special light treatments, or lasers. People who receive these treatments often need other acne treatments as well.

What if I want to get pregnant?

If you want to become pregnant, talk to your doctor before you start trying to conceive. Many of the medications used to treat acne are not safe for the fetus.

Will my diet affect acne?

Some studies have found that acne seems to be more common in people who drink a lot of milk. But more research is needed to understand the link between the types of foods people eat and acne.

This text is extracted from UpToDate Feb 22, 2023.