Acne :: Nationwide Children's Hospital

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Acne is the most common skin problem that young people have. Almost everyone will develop acne to some degree, but some people have more pimples than others. Acne is not a skin problem that is treated quickly and then never comes back again. It requires time, patience, and consistent use of any medications you are given.

What Causes Acne?

Acne is the result of several factors:

  • Increasing hormones during puberty that cause oil glands to produce more oil, or sebum
  • Bacteria in skin pores
  • Certain medicines or supplements including steroids, lithium and barbiturates
  • Oil and grease from the scalp, hair products, skin products and cosmetics
  • Heredity

What Is a Pimple?

Picture 1 - Pores inside your skin.
Image of pores

A pimple starts when a pore (an opening in the skin) gets plugged. The pore has a tiny hair in it and oil glands at its base (Picture 1).

During the teenage years, the glands produce more oil, or sebum. The sebum plugs the pores. If the pore stays partially open, a blackhead forms. Blackheads are not black from dirt. You cannot wash them off.

If the pore closes completely, a whitehead forms.

Whiteheads can become pimples if the sebum gets through the pore wall and causes inflammation. If the sebum gets trapped deeply under the skin, a painful acne cyst can form.

What Makes Acne Worse?

  • If you scrub with an abrasive soap, pick at your skin or rub it too much, the walls of the pores may break creating more swelling. This causes more pimples.
  • Too much washing (more than 2 or 3 times a day), astringents or alcohol can make your skin too dry. This causes the oil glands to work harder.
  • Squeezing or popping pimples can cause more acne and scarring.
  • Usually, foods like chocolate, sweets, colas, and fried foods do not make acne worse. If one food does seem to make your acne worse, try to avoid it for a few weeks to see if that helps. A healthy, balanced diet is always recommended for healthy skin.
  • Some types of makeup, sunscreens and moisturizing lotions may block pores, making acne worse. Only use products that are “oil-free” or “non-comedogenic”, meaning they will not block pores.
  • Do not use greasy products like petrolatum, cocoa butter, baby oil, or baby lotion on your skin.

Treatment for Acne

There are many different medicines used to treat acne.

Topical Medicines

The doctor often prescribes creams, lotions, solutions or gels that you put on the skin. The doctor will tell you when to apply it. Generally you will place a thin layer of the medicine on all areas where the acne can be. Many patients use the medicines on areas of acne on the back and chest as well as the face. Sometimes the medicines can make your skin red and dry.

How to Use Topical Acne Medicines

  • First, wash your skin with your hands using the soap suggested by your doctor.
  • Rinse with water. Dry your face gently with a clean towel.
  • Apply a thin film of medicine and rub it in gently.
  • Keep the medicine away from your eyes and the corners of your mouth.
  • If these medicines cause dryness, apply an over-the-counter face lotion that is oil-free or non-comedogenic.
  • If the topical medicines are causing severe dryness or irritation, use them every other night. Keep using an oil-free, non-comedogenic face lotion.

Your doctor may also recommend that you wash your face with an acne wash that contains acne medicine. Benzoyl peroxide and salicylic acid are the ingredients commonly found in medicated acne washes. You do not need a prescription to get these washes. You can easily find them over the counter at most drug stores.

It often takes 1 to 2 months before you can see real improvement in your acne. At first your skin may actually seem worse. Be patient. Do not give up!

Acne Pills

There are different types of oral medicines to help with acne. Antibiotic pills are one of the most common kinds of medicine you take by mouth for acne. Be sure to read the special instructions and warnings on the medicine's label.

  • Tell your doctor if you are taking any other medicines, such as birth control pills, antihistamines, asthma medicines and vitamins.
  • Tell your doctor if you may be pregnant or are planning a pregnancy.
  • Continue to use the acne creams and gels prescribed by your doctor even when you are taking acne pills. Acne pills alone are not effective at treating all types of acne.

Other Tips and Advice

Picture 2 - Wash your face gently 2 times a day.
Image of girl washing face
  • Try to be positive and not get discouraged. With proper and regular treatment you can manage acne. Be patient. It does not happen overnight.
  • Wash your face gently 2 times a day with a mild soap or a wash that your doctor recommends (Picture 2). Do not use cleansing scrubs or abrasive pads. Do not use astringents.
  • Shampoo your hair regularly (3 to 5 times a week). Style it away from your face and forehead. Do not use a lot of mousse, gel or hairspray near your forehead.
  • Never squeeze pimples. Squeezing may make acne worse and cause permanent scars.
  • Follow your doctor's instructions carefully.
  • It is important to keep your follow-up appointments. There are many medicines available. The doctor may change your medicine if there is no improvement.
  • Tell your doctor if your skin becomes very dry or irritated or if the medicine is not working. If your skin is extremely dry, try using your acne cream 3-4 times a week rather than nightly. Be sure to use an oil-free, non-comedogenic moisturizer.

If you have any questions, be sure to ask your doctor or nurse, or call your doctor’s office.

Acne (PDF)

HH-I-48 11/85, Revised 12/13 Copyright 1985, Nationwide Children's Hospital

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