Acne: Your GoodRx Guide

Definition

Acne is the medical term for a condition that causes pimples to develop in the skin. 

It is the most common skin disorder in North America. It affects about 85% of teenagers, although it can happen to babies, children, and adults of any age.

Pimples are caused by clogged oil pores in the skin, otherwise known as hair follicles. Pores are tiny openings all over the skin that allow for housekeeping of the hair follicle. The pore allows oil to come out onto the skin to keep it soft, and also allows dead skin cells, bacteria, and other gunk to be expelled from the hair follicle.

In acne, the oil, bacteria, dead skin cells, and other gunk become trapped in the hair follicle. Sometimes the skin produces excess oil or isn’t able to get rid of dead skin cells very well. The result is acne — the skin gets inflamed and can turn red or swell under the surface. 

Sometimes acne goes away on its own as we get older. But if acne doesn’t go away and isn’t treated, it can cause:

• Skin darkening or redness

• Permanent scarring

• Social embarrassment 

• Feelings of depression and anxiety

• Poor self-esteem

Causes

Acne can be caused by a combination of different things: 

• Hormonal changes, for example during adolescence, menstruation, and pregnancy

• Medications, such as certain birth control pills or corticosteroids

• Genetics (having parents who had acne)

Sometimes acne can be caused by medical conditions that increase the levels of androgen hormones in the body, such as: 

• Polycystic ovary syndrome (PCOS) 

• Congenital adrenal hyperplasia

• Other disorders of the adrenal glands or ovaries

These skin care behaviors can make acne worse:

• Using soaps or astringents on your skin

• Aggressive scrubbing of your skin

• Using oil-based skin products and makeup

More research is needed, but there may be a link between acne and:

• A diet high in refined sugars and carbohydrates

• Stress

Symptoms

Acne spots come in different shapes and sizes. Some terms used to describe acne spots include:

• Blackheads (also known as open comedones)

• Whiteheads (also known as closed comedones)

• Red bumps and pus bumps (also called pimples)

• Cysts (deep bumps that can be painful)

Over time, acne can lead to scarring, which can also vary in type. These include: 

• Atrophic: depressed scars that look like craters (also called icepick, rolling, or boxcar)

• Hypertrophic: thickened scars with raised scar tissue (also called hypertrophic scars or keloids)

• Post-inflammatory: skin discoloration (red, white, and/or dark marks)

Acne is most common on the face, neck, chest, upper back, and upper arms. This is because these locations have the most oil pores.

Medications

Many products are available over the counter for mild acne. You may need to use a combination of products to get a good result.

The more common medications recommended by dermatologists to treat mild acne are applied directly to the skin:

• Benzoyl peroxide (kills skin bacteria)

• Salicylic acid (removes dead skin layers and unclogs pores)

• Topical retinoids (removes dead skin layers and unclogs pores)

Treatment for moderate and severe acne usually involves a combination of medications used for mild acne, sometimes at a higher strength, plus antibiotic creams or pills. Many treatments for moderate and severe acne require a prescription. Options include: 

• Topical retinoids, including tretinoin, adapalene, tazarotene (Tazorac), and trifarotene (Aklief)

• Antibiotics, such as clindamycin and doxycycline

• Hormone therapy, such as birth control pills, spironolactone (Aldactone), and steroids

• isotretinoin (Accutane)

There is no single medicine or combination of medications that works best for everyone. Most people need to try different treatments until they find what works best for them. Dermatologists usually recommend sticking with a treatment plan for 2 to 3 months before moving on to something else. 

Treatments

While medications are the mainstay of treatment for acne, other options are available. These are commonly offered in a dermatologist’s office: 

• Physical removal of whiteheads and blackheads, called comedone extraction 

• Steroid injections into painful acne cysts to decrease inflammation

• Chemical peels

• Lasers and lights

Last, but not least, it’s important to mention the role of skin care in the treatment and prevention of acne. Some helpful tips include: 

• Wash your face twice a day with warm water and a gentle non-soap facial skin cleanser. Avoid scrubbing your face as this can make acne worse and damage the skin.

• Always wash your face after sweating or wearing makeup.

• Try not to pick or squeeze pimples. We know this can be really hard, especially when a pimple is painful or really visible. But picking a pimple can make it worse, lead to infection, and damage the skin. 

• Don’t use skin products — moisturizers, sunscreens, or makeup — that contain oil. Look for products that say "non-comedogenic" on the label.