Acne: Types, Causes, and Treatments That Work
Author: Disabled World (DW)
Updated/Revised Date: 3 Nov 2026
Table of Contents:
Synopsis - Definition - About This Section - FAQs - Publications - Subtopics
Synopsis
Learn what causes acne, the types from blackheads to cysts, how it affects teens and adults, plus treatments for pimples, body acne, and lasting acne scars today.
At a Glance
- 1 - Cigarette smoking raises the risk of acne and worsens its severity.
- 2 - Acne affects up to 50 million Americans each year, more than any other skin condition.
- 3 - Acne is most common during adolescence, affecting an estimated 80 to 90 percent of teenagers in the Western world.
- 4 - Severe nodular or scarring acne is usually treated with isotretinoin, a medicine related to vitamin A, under close medical supervision.
Topic Definition
- Acne Vulgaris
Acne vulgaris is a common skin condition that develops when pores become clogged with sebum, the oil produced by the skin's sebaceous glands, leading to whiteheads, blackheads, pimples, and in more serious cases nodules or cysts. It tends to appear on areas rich in oil glands such as the face, neck, shoulders, chest, and back, and it affects hundreds of millions of people of every age, race, and sex, though it is most closely tied to the hormonal changes of puberty. Rising levels of androgens boost oil production, which is why the condition so often begins around the age of twelve and can continue into adulthood, with women frequently experiencing outbreaks linked to their menstrual cycle. Beyond the visible pimples and the scars they can leave behind, acne carries a real social and emotional weight, and treatment ranges from over-the-counter topical products to prescription medication overseen by a dermatologist.
Overview
What is Acne?
Acne vulgaris (acne) is a common skin condition in which hair follicles become clogged with sebum, the oil made by the skin's sebaceous glands, and dead skin cells. It causes whiteheads and blackheads, pimples, and in more severe cases painful nodules or cysts on the face, neck, shoulders, chest, back and upper arms. Acne is the most common skin condition in the United States, affecting up to 50 million Americans each year, and about 85 percent of people have at least minor acne at some point between the ages of 12 and 24 [American Academy of Dermatology, n.d.]. It affects people of every age, race and sex, and adult acne, especially in women, is common.
Acne is more than a cosmetic problem. It can leave scars and dark spots, and research has linked it with anxiety, low self-esteem, depression and social withdrawal. Effective treatments are available for every type of acne, and starting treatment early helps prevent scarring.
Types of Acne Lesions
- Comedones: blackheads and whiteheads. Blackheads are open pores plugged with oil and dead skin that darkens at the surface. Whiteheads are closed pores filled with oil under the skin. Squeezing them can push material deeper and cause inflammation and scarring.
- Papules: small, solid, red and often tender bumps without pus.
- Pustules: small red bumps filled with pus, a mix of white blood cells, bacteria and dead skin cells.
- Macules: flat red or dark spots left behind after a pimple heals.
- Nodules: large, hard, painful lumps deep in the skin that often leave scars.
- Cysts: deep, pus-filled lumps that are often painful and can scar. Acne with many nodules and cysts (nodulocystic acne) is a severe form that needs treatment from a dermatologist.
What Causes Acne?
Four things work together to cause acne: the skin makes too much oil; dead skin cells clog the hair follicles; bacteria called Cutibacterium acnes (formerly Propionibacterium acnes) grow in the clogged follicles; and the skin reacts with inflammation. Androgen hormones, such as testosterone, increase oil production, which is why acne usually starts at puberty in both boys and girls. In women, acne often flares before menstrual periods, during pregnancy, around menopause, or with conditions such as polycystic ovary syndrome. Other factors that can trigger or worsen acne include some medicines, oily cosmetics and hair products, friction or pressure from helmets, tight clothing or backpacks, stress and smoking. The link between diet and acne is still being studied; some research suggests that high-glycemic foods and dairy may worsen acne in some people.
Acne mostly affects skin with many oil glands, including the face, upper chest and back. Body acne on the chest, shoulders and back is common and is treated in much the same way as acne on the face.
Treatment for Mild Acne
Mild acne with blackheads, whiteheads and a few pimples can often be treated with over-the-counter products used every day for at least 6 to 8 weeks:
- Benzoyl peroxide: kills acne bacteria and helps clear pores.
- Salicylic acid: helps unclog pores and reduce blackheads and whiteheads.
- Adapalene: a retinoid gel, available without a prescription in the United States since 2016, that keeps pores from clogging.
- Azelaic acid, sulfur and resorcinol: other ingredients that can help some people.
Irritation, dryness and redness are common side effects at first. Using a gentle cleanser and an oil-free moisturizer usually helps. See a doctor if over-the-counter products do not work or if side effects are severe.
Treatment for Moderate and Severe Acne
A dermatologist can prescribe stronger treatments, often in combination: prescription retinoids such as tretinoin and tazarotene; topical antibiotics such as clindamycin, always used with benzoyl peroxide to prevent antibiotic resistance; oral antibiotics such as doxycycline for a limited time; and, for women, birth control pills or spironolactone, which lower the effect of androgens. Clascoterone cream, approved by the U.S. Food and Drug Administration in 2020, blocks androgens in the skin. Isotretinoin, a medicine related to vitamin A, is used for severe nodular or scarring acne and acne that has not responded to other treatment. Because it causes serious birth defects, people who can become pregnant must follow a strict pregnancy prevention program while taking it.
During pregnancy, many acne medicines, including isotretinoin, oral tetracycline antibiotics and topical retinoids, should not be used, so ask a doctor which treatments are safe.
Acne Scars
Acne scars form when inflamed lesions damage the deeper layers of the skin. Common types include ice pick scars (narrow, deep pits), boxcar scars (wider pits with sharp edges), rolling scars (gentle waves in the skin), and raised scars. Dark or red marks left after pimples heal (post-inflammatory hyperpigmentation or erythema) are not true scars and usually fade over months, although sun protection helps them fade faster.
Treatments for scars include chemical peels with glycolic, salicylic or lactic acid; microneedling; dermabrasion; laser resurfacing; and fillers for some depressed scars. A dermatologist can recommend the best option for each type of scar, and it is best to get acne under control first.
Skin Care Tips for People with Acne
- Wash your face twice a day and after sweating with lukewarm water and a gentle, non-abrasive cleanser. Pat your skin dry and do not scrub.
- Keep your hands away from your face, and do not pick, pop or squeeze pimples.
- Choose makeup, sunscreen and hair products labeled oil-free or non-comedogenic.
- Shave carefully, and try both electric and safety razors to see which irritates your skin less.
- Protect your skin from the sun and do not use tanning beds. Sunlight does not cure acne, and many acne medicines make the skin more sensitive to the sun.
- Be patient: most treatments take 6 to 8 weeks to show results.
Quick Facts Regarding Acne
- Acne is commonly classified by severity as mild, moderate, or severe.
- Cigarette smoking increases the risk of developing acne and worsens its severity.
- During puberty in both sexes, acne is often brought on by an increase in androgens, such as testosterone.
- Acne occurs most commonly during adolescence, affecting an estimated 80 to 90% of teenagers in the Western world.
- Research indicates that increased acne severity is associated with high stress levels.
- Acne scars are the result of inflammation within the dermal layer of skin, and some degree of scarring is estimated to affect most people with acne vulgaris.
Frequently Asked Questions
Does chocolate cause acne?
The link between diet and acne remains unclear, and there is no strong evidence that chocolate alone causes breakouts, though individual triggers can vary from person to person.
Should I pop my pimples?
Squeezing pimples is discouraged because opening a lesion in non-sterile conditions invites bacteria, raises the risk of infection, and can lead to lasting scars.
How long does acne treatment take to work?
Topical treatments for mild acne usually need sustained use over several months before clear results appear, so patience and consistency are important.
Can adults get acne for the first time?
Yes, some people develop acne for the first time as adults, often linked to hormonal shifts, and it affects a notable share of adult men and women.
Is acne caused by poor hygiene?
Acne is driven mainly by hormones and oil production rather than dirt, and over-washing or harsh scrubbing can actually irritate the skin and make it worse.
Does stress make acne worse?
Research indicates that higher stress levels are associated with increased acne severity, so managing stress may help alongside standard treatment.
Can diet changes improve acne?
Evidence linking specific foods to acne is limited, but a balanced diet supports overall skin health, and anyone concerned about flare-ups should speak with a doctor.
Does sunscreen cause acne?
Some heavy sunscreens can clog pores, but those labeled non-comedogenic or oil-free are less likely to cause breakouts. Sun protection is still important, especially when using acne treatments that make skin more sensitive to the sun.
References
- American Academy of Dermatology. (n.d.). Skin conditions by the numbers.
- Reynolds, R. V., et al. (2024). Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 90(5), 1006.e1-1006.e30.
Curated and edited by Ian C. Langtree, Founder and Editor-in-Chief, Disabled World. This section is maintained by the Disabled World editorial team. Last updated: