If you're a teen, chances are pretty good that you have some acne. Almost 8 in 10 teens have acne, along with many adults.
Acne is so common that it's considered a normal part of puberty. But knowing that doesn't always make it easier when you're looking at a big pimple on your face in the mirror. So what is acne, and what can you do about it?
What Is Acne and What Causes It?
Acne is a condition of the skin that shows up as different types of bumps. These bumps can be blackheads, whiteheads, pimples, or cysts. Teens get acne because of the hormonal changes that come with puberty. If your parents had acne as teens, it's more likely that you will, too. The good news is that, for most people, acne goes away almost completely by the time they are out of their teens.
The type of acne that a lot of teens get is called acne vulgaris (the meaning of "vulgaris" isn't as bad as it sounds — it means "of the common type"). It usually shows up on the face, neck, shoulders, upper back, and chest.
The hair follicles, or pores, in your skin contain sebaceous glands (also called oil glands). These glands make sebum, which is an oil that lubricates your hair and skin. Most of the time, the sebaceous glands make the right amount of sebum. As a teen's body begins to mature and develop, though, hormones stimulate the sebaceous glands to make more sebum, and the glands may become overactive. Pores become clogged if there is too much sebum and too many dead skin cells. Bacteria (especially one called Propionibacterium acnes) can then get trapped inside the pores and multiply, causing swelling and redness — the start of acne.
If a pore gets clogged up and closes but bulges out from the skin, you're left with a whitehead. If a pore gets clogged up but stays open, the top surface can darken and you're left with a blackhead. Sometimes the wall of the pore opens, allowing sebum, bacteria, and dead skin cells to make their way under the skin — and you're left with a small, red bump called a pimple (sometimes pimples have a pus-filled top from the body's reaction to the bacterial infection).
Clogged pores that open up very deep in the skin can cause nodules, which are infected lumps or cysts that are bigger than pimples and can be painful. Occasionally, large cysts that seem like acne may be boils caused by a staph infection. That doesn't happen often, though.
There are a few myths out there about things that cause acne. Acne isn't caused by eating greasy foods like french fries or pizza, chomping on chocolate, or drinking sodas. Some people do find that they notice their breakouts get more severe when they eat too much of a certain food, though. If you're one of them, it's worth trying to cut back on that food to see what happens.
Stress doesn't usually cause acne either (although it can make existing acne worse because stress increases sebum production).
There are also myths about what helps make acne better. Acne isn't really helped by the sun. Although a tan can temporarily make acne look less severe, it won't help it go away permanently — and some people find that the oils their skin produces after being in the sun make their pimples worse.
What Can I Do About Acne?
To help prevent the oil buildup that can contribute to acne, wash your face twice a day with a mild soap and warm water. Don't scrub your face hard with a washcloth — acne can't be scrubbed away, and scrubbing may actually make it worse by irritating the skin and pores. Try cleansing your face as gently as you can.
If you wear makeup or sunscreen, make sure it's labeled "oil free," "noncomedogenic," or "nonacnegenic." This means it won't clog your pores and contribute to acne. And when you are washing your face, be sure you take the time to remove all of your makeup so it doesn't clog your pores.
If you use hair sprays or gels, try to keep them away from your face, as they can also clog pores. If you have long hair that touches your face, be sure to wash it frequently enough to keep oil away. And if you have an after-school job that puts you in contact with oil — like in a fast-food restaurant or gas station, for example — be sure to wash your face well when you get home. It can also help to wash your face after you've been exercising.
Many over-the-counter lotions and creams containing salicylic acid or benzoyl peroxide are available to help prevent acne and clear it up at the same time. You can experiment with these to see which helps. Be sure to follow the instructions exactly — don't use more than you're supposed to at one time (your skin may get too dried out and feel and look worse) and follow any directions to see if you're allergic to it first.
What if I Get Acne Anyway?
Sometimes even though they wash properly and try lotions and oil-free makeup, people get acne anyway — and this is totally normal. In fact, some girls who normally have a handle on their acne may find that it comes out a few days before they get their period. This is called premenstrual acne, and about 7 out of 10 women get it from changes in hormones in the body.
Some teens who have acne can get help from a doctor or dermatologist (a doctor who specializes in skin problems). A doctor may treat the acne with prescription medicines. Depending on the person's acne, this might mean using prescription creams that prevent pimples from forming, taking antibiotics to kill the bacteria that help create pimples, or if the acne is severe, taking stronger medicines such as isotretinoin, or even having minor surgery. Some girls find that birth control pills help to clear up their acne.
If you look in the mirror and see a pimple, don't touch it, squeeze it, or pick at it. This might be hard to do — it can be pretty tempting to try to get rid of a pimple. But when you play around with pimples, you can cause even more inflammation by poking at them or opening them up. Plus, the oil from your hands can't help! More important, though, picking at pimples can leave tiny, permanent scars on your face.
Reviewed by: Eliot N. Mostow, MD, MPH
Date reviewed: March 2007