Dealing with acne

Facial acne

Acne usually starts in puberty, but it affects adults too. Around 80% of teenagers get some form of acne, and there are many myths about what causes it. Here are the facts and details of treatments.

Acne consists of spots and painful bumps on the skin. It's most noticeable on the face, but can also appear on the back, shoulders and buttocks. Severe acne can cause scarring.

What causes acne?

Acne is mostly caused by the way skin reacts to hormonal changes. The skin contains sebaceous glands that naturally release sebum, an oily substance that helps protect it. 

During puberty, raised levels of the hormone testosterone can cause too much sebum to be produced. This happens in both boys and girls.

The sebum can block hair follicles. When dead skin cells mix with the blockage, it can lead to the formation of spots. Bacteria in the skin multiply, which can cause pain and swelling (inflammation) beneath the blockages.

There are different kinds of spots:

  • blackheads – small, blocked pores
  • whiteheads – small, hard bumps with a white centre
  • pustules – spots with a lot of pus visible 
  • nodules – hard, painful lumps under the skin

Inflammatory acne is when the skin is also red and swollen. This needs to be treated early to prevent scarring.

Try not to pick or squeeze spots as this can cause inflammation and lead to scarring. Spots will eventually go away on their own, but they might leave redness in the skin for some weeks or months afterwards.

Acne can become worse during times of stress. In women, it can be affected by the menstrual cycle. Sometimes acne can also occur during pregnancy.

If you have acne, wash your skin gently with a mild cleanser and use an oil-free moisturiser. Scrubbing or exfoliating can irritate the skin, making it look and feel sore.

Myths about acne

There are several myths about what causes acne:

Food

Many people say that eating chocolate or greasy food causes acne, but this isn't true. There isn't any evidence that acne is caused by what you eat. However, eating a balanced diet is good for your general health, so aim to have a healthy diet.

Bad hygiene

Some people believe that acne is caused by bad personal hygiene, but this is not true. If you are going to get acne, you will get it no matter how much you clean your skin. Too much cleaning may make the condition worse by removing the protective oils in your skin.

Make-up

There is also a myth that wearing make-up can cause spots, but there is no evidence that this is the case. The less you touch your skin, the fewer bacteria will be spread to your skin. If you wear make-up, wash your hands before putting your make-up on and always remove it before going to bed.

Treatments for acne

Acne will usually go away on its own, but it can take many years. There are treatments for acne that can help clear it more quickly.

Over-the-counter treatments that you buy from a pharmacy can help with mild acne. Ask a pharmacist for advice on which treatment could help and how long you will have to use it. You may not see results for several weeks or months. Find your nearest pharmacy.

If over-the-counter treatments don't help, treatments are available on prescription. Your GP can assess how bad your acne is and discuss the options with you. Don't be afraid to tell your GP how your acne affects your life and how it makes you feel.

Mild, non-inflammatory acne consists of whiteheads and blackheads. Treatments include gels or lotions that can contain retinoids (vitamin A), topical (applied to the skin) antibiotics, benzoyl peroxide (which is antibacterial) or azelaic acid.

These medications, or a combination of them, can also be used to treat mild-to-moderate inflammatory acne, which has some pustules and nodules. It can take up to eight weeks before you see a difference in your skin, and treatment may need to be continued for six months.

In women, contraceptive pills that contain oestrogen can also help clear acne.

If acne is severe, your GP can refer you to a dermatologist, who may prescribe a stronger medication called isotretinoin (Roaccutane).

Find out about acne treatments, including isotretinoin.

Some light and laser therapies claim to help get rid of acne. However, few if any of these are available on the NHS.

Page last reviewed: 22/06/2014

Next review due: 22/06/2016

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Comments

The 23 comments posted are personal views. Any information they give has not been checked and may not be accurate.

dexclear said on 31 May 2014

I have suffered bad skin for many years. After a skin biopsy a few years ago, it revealed the presence of demodex mites. I believe that dermatologists underestimate the role that they play in skin conditions. Treating demodex mites in my case resulted in a skin breakout before getting through to clearer skin. On message boards I have read similar anecdotes. I'm convinced that demodex mites have been responsible for my condition.

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Inrgal said on 24 January 2013

Very interesting article I read. It sure does help a lot. I have tired tomatoes in the past and it did clear my skin but I think you have to make sure you keep it clean after you stop using it on the skin. Applying it once a week helps a lot. http://articles.timesofindia.indiatimes.com/2012-11-15/beauty/29739359_1_tomatoes-taste-acne-skin

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Anonymous said on 27 November 2012

I disagree, diet does play a role for many. I suffered from acne from a teenager into my mid twenties and tried many expensive and painful acne treatments, to no effect (my dad's entire family still suffers from it). Now I am totally acne free. The source. My diet, primarily dairy intake.

How did I figure it out? My husband suffers from excema and found his dry skin oozed fluid soon after eating/drinking dairy products. Additionally, an avid runner, he discovered that dairy caused significant mucus buildup in his lungs and sinuses that exhibited itself most clearly when he ran.

When I started dating him, I stopped having dairy/cheese/butter in the house because I knew how his skin reacted. I started drinking soy milk, then replaced it with almond milk in place of cow's milk (rice oil or olive oil for cooking). Something strange happened almost immediatly, my skin healed and cleared up for the first time in my life. I was also able to take up running for the first time because I wouldn't be coughing up a lung when I tried to exert myself.

From this discovery I started researching the foods I was putting into my body on the internet. Stopped drinking/eating artifical crap as staples of my diet, started eating real food and understanding different foods as medicine for the inside and out. Now I am the healthiest and fittest I've ever been in my life (over 4st lighter with a perfect hourglass shape/instead of an unhealthy apple).

If I ever want to test my dairy theory, I only need eat it for a few weeks straight and pimples return without fail.

My moisturizer regime...olive oil on my skin after I shower/bath at night, left 30 minutes to absorb, and that's it. I don't even wash my face with soap unless it's actually dirty (too drying). I don't wear makeup, no need. I have only been able to convince one open-minded cousin of this discovery and he has clear skin too. I also only drink water first, herbal/green tea second, beer/wine as a rare treat

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GemmaJB said on 04 September 2012

I went to the doctors while i was in the last term of year 10, they gave me everything for acne but nothing worked for me, then they send me to the hospital and i got given Roaccutane, i was on them for 4 months. But 3 months later the Acne came back just as bad. I went back to the hospital and he transferred me to Hammersmith hospital in London to have Laser surgery! Been having it for 3 and a half years and i'm so glad i got the chance to have laser! changed my life.. will be carrying on until the treatment has finished then after i will be getting the scares removed! Don't give up you'll get there in the end! Oh and i'm only 19 so i do know how it feels x

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TamL said on 09 August 2012

The best acne treatment I have ever used was a small 100% natural device called Clea.
It really worked for me, I dont have severe acne but the few spots I do get it really worked. I saw a difference in 5 hours after the first 2 min treatment and my spot was gone the next day. Its a heat plate that opens pores and kills the bacteria in my spot. I could not live without it now, its so small and discreat, I take it everywhere I go.

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Eric Davis said on 31 March 2012

Me and my brother both had severe acne and where determined to jointly address it and find a solution (we are both very determined). We did weeks and weeks of research and the main causes of acne seemed to be 1. too much sebum production 2. bacteria and 3. demodex mites (this can also be a cause of rosacea). We also went on hundreds of forums and three main things seemed to work 1. jojoba oil 2. lavender oil 3. tea tree oil. See the connection - they are all natural which I suppose makes sense because none of the otc stuff seems to really work. To cut a long story short we found an acne treatment
that contains these three ingredients (synchronicity or what) and gave it a go. It has worked just like we thought it would. All of our acne is gone and our skin is much better. Never give up in your search to help your acne.

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GBloom said on 14 November 2011

After trying many over the counter products unsuccessfully, I refused to believe this product would work. A friend initially recommended it to me and then I saw it finish in the top 3 acne products on embarrassing bodies, I thought it must be worth a go. I'm so glad I tried it! It has worked incredibly to alleviate my breakouts and keep my skin clear. They have a fab offer on the duo packs now too, so give it a try and it will hopefully work for you too :)

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ZoeChadwick said on 27 October 2011

I don't have any experience of acne but one of my friends had a severe case and she tried everything but nothing seemed to work, she found a home remedy website and it said to try salt and water, her acne has cleared now. Hope this helps.

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osmith said on 17 March 2011

Hi, i am currently using an acne treatment called Aknicare - so far it's working well. i've suffered from acne for years and never seem to find anything that works. Can anyone recommend a treatment or has anyone used Aknicare?

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lil123 said on 02 March 2011

I seemed to have tried everything and nothing works. Can anyone recommend any treatments that work? I am using Aknicare at the moment which seems to be working well so far.

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Niminim said on 07 February 2011

I suffered from spots for 22 years. In the beginning all grown ups just said it was puberty etc. It caused me severe psychological problems and nothing I tried helped.
I got better as I started cutting out certain foods. It turned out I'm intolerant to dairy (got a little better) gluten (helped me a lot, my friend also did and his spots went within 2 weeks and he had lots) and yeast but I still always had something, until I realised I was intolerant to corn/ maize (including modified maize starch which is in most premade foods). I stopped eating that too, which basically means all I eat is food I make myself and it only took 2 weeks before my skin was as clean as I haven't seen it since I was 9 years old! I wish someone could have told me to try cutting these foods out when I was young so If you are willing to do anything to get rid of yours, try cutting all these things out. If you get better you can then try eating them again one by one. If you're intolerant you'll get spots within a few days of eating it. It sucks having to avoid so much but I wish someone could've told me this 20 years ago.
I asked my doctor recently to see an "intolerance expert". He said NHS does not recognise intolerances as a problem (!!)

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Johnclave said on 02 February 2011

Acne is a most common problem in the world it mainly affects the teenagers and to some extend to adults.Acne can also be due to the various skin issues depending on the skin acne is usually caused by an increase in male sex hormones.Benzoyl peroxide, antibiotics, retinoids, antiseborrheic medications, salicylic acid, alpha hydroxy acid, azelaic acid, nicotinamide are some of its treatments that can be used
http://www.biblehealth.com/acne/cause-of-acne-why-acne-is-caused.html

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SeanGauld said on 29 June 2010

I am replying to: Anonymous said on 18 August 2008
There is a huge difference, Spots don't turn in to yellow heads, Spots, I see as, are scabby, if you run your nail over the spot it will pick it, Acne is under the skin or yellow heads. Also, if it hurts to the touch then it is Acne.
Anyone who is unsure please go to your DR as you will be spending money on spot cream but won't work.
Antibiotics are useful but I have noticed your body gets immune to them. Consult in your DR.
If you have a Severe form of Acne you can have screening, I know this because I was discussing it with my DR.
Sadly there isno treatment to remove Acne but it can be controlled on the NHS.

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SeanGauld said on 29 June 2010

Makeup can cause spots but can't imagine it can cause Acne.
Acne is a skin condition which not every one is affected with. There is Mild, Medium and severe forms of Acne.
I, myself have a mild condition but really gets me down, I have red lumps in 3 different places on my face. The question which I would like some one to answer is can the heat and sweat cause these sore lumps?
I have been prescribed ISOTREX which is a GEL, you apply it to your face or affected areas but WILL leave dry skin. This can only be prescribed. I have Oxytetracycline and they work P/T.
Sick of them.
Please, some one, answer my question about the heat and sweat?
Thanks
Sean Gauld

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hjohns said on 16 June 2010

I had acne for about 15 years and got a lot of help from my GP and the NHS generally. The thing that helped most, and I'm quite evangelical about it, was red/blue light therapy. Details of encouraging clinical trials here - http://www.acnebusters.co.uk/blue-light.html - it's worth a go but you need to stick it regularly in the first few months.
Helen

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User426479 said on 08 February 2010

The information above states to stop eating a food if you think it affects your acne - can I urge people to see a doctor before doing anything like this. I was desperate to be free from acne so I tried cutting out foods - I have since learned this can lead to health problems, for example i cut out dairy products but have now found out this can lead to oesteoperosis due to lack of calcium.

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SHH said on 25 January 2010

I am a 27yr old who has just been told I have acne. I was one of the many people who thought it was just teenagers that get it but now obviously realise it is wrong. it can and does affect adults aswell as teens. I have been prescribed antibiotics for this problem and was also told I wiil have to take them for at least 3mths and to wash gently with a mild soap and water only. I too had a problem with picking at the spots because it wasbetter than the discomfort and soreness of the spots. however I realise this is a stupid thing to do because it can spread them further and cause scarrring.

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Timibabyz said on 12 June 2009

does makeup cause spots????????/

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sarahandleebaker said on 31 March 2009

I urge anyone with servere acne NOT to pick at their spots.I am scarred for life because of picking really nasty nodules and spots and can,t get laser treatment on nhs.Go to the doctor who will help you find what will best suit your skin.

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hahughes said on 17 January 2009

This was very helpfull... i suffer acne... and i usually use products to remove then.. some really help.. i do pick my acne and it seems to make it look worse but i've never had a scar... but after reading that i don't think i will pick my acne again. so this was really helpfull and probly helped me avoid future scaring :)

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User54803 said on 21 October 2008

Home made acne treatment would be the best option mainly for the teenagers as their skin is very soft so any cosmetic product can’t give the natural skin to them.
Teen acne may be very annoying mostly for those teenagers who want to look good. However, there are many acne treatments and products are available in the market but choosing any natural way of treating acne would be very advantageous as it doesn’t have any side effect and it keeps your skin very healthy.

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Anonymous said on 18 August 2008

how do you know if you have acne or just alot of spots?

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Anonymous said on 28 June 2008

this is really useful also i find the fact that acne is not caused by eating different food or a unbalanced diet. this is really interesting and has helped me.

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