Acne

Causes of Acne

• Hormones increase during puberty. That causes oil glands to produce more oil, or sebum. This can plug the skin pores.
• Bacteria get into skin pores.
• Oil and grease from the scalp, hair products, skin products, and cosmetics can also plug the pores.
• Some medicines or supplements, including steroids, lithium, and barbiturates can make acne worse.
• Heredity (runs in families).

How a Pimple Forms

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.

During the teenage years, hormones stimulate the glands to 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.

Bacteria can get into these pores, causing an inflammatory response in the body. This causes the red bumps and pustules (pus-filled bumps) of acne. Sometimes, if the bacteria and sebum get trapped deeply under the skin, a painful acne cyst can form.

How Acne Gets Worse

• If you scrub with an abrasive soap, pick at your skin, or rub it too much the walls of the pores may break, causing more swelling. This can also lead to scarring.
• 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

Acne is treated using topical and oral medications.

Topical Medicines

The doctor often prescribes creams, lotions, solutions or gels that you put on the skin (topical medicines). Your doctor will tell you when to apply them.

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 to all areas of acne, including the face, back and chest and rub it in gently. Do not wash off.
• Keep the medicine away from your eyes and the corners of your mouth.
• Some medicines work better during the day, while others work better when applied at night. Make sure to use the medicines at the recommended time of the day.
• Some medicines may cause dryness and redness. You may apply an over-the-counter face lotion that is oil-free and non-comedogenic.
• If the topical medicines are causing severe dryness or irritation, use them every other day. 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. Benzoyl peroxide and salicylic acid are the ingredients commonly found in medicated acne washes. (Be aware that benzoyl peroxide can bleach towels and linens.)

Acne Pills

• Tell your doctor if you are taking any other medicines, such as birth control pills, antihistamines, asthma medicines and vitamins.
• 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.
• Common side effects are nausea, vomiting, diarrhea, stomach aches and headaches. Call your doctor if any of these occur.

Other Tips and Advice

• Try to be positive and not get discouraged. Acne treatment can take 2 to 3 months to see results.
• Wash your face gently 2 times a day with a mild soap or a wash that your doctor recommends. 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 to 4 times a week rather than every day. Be sure to use an oil-free, non-comedogenic moisturizer.
• Tell your doctor if you may be pregnant or are planning a pregnancy.

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

Helping Hands Patient Education Materials

Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.

HH-I-48  | ©1985, revised 5/15, Nationwide Children’s Hospital