Acne is a common skin condition that affects both teenagers and adults. It is a serious health issue that can cause physical discomfort and have a significant impact on mental health. Understanding acne, its causes, and the right treatment options can help manage breakouts effectively. This guide covers different types of acne, treatment options, and when to seek medical advice.
What is acne?
Acne occurs when hair follicles become clogged with oil and dead skin cells. This leads to whiteheads, blackheads, and inflamed spots. It commonly appears on the face, chest, back, and shoulders [1]. While acne is often linked to teenagers, adults can experience it too. In fact, about 8 in 10 people aged 11 to 30 get acne, with it being most common in girls aged 14 to 17 and boys aged 16 to 19. [1]
Causes of acne
Several factors contribute to acne, including:
Hormonal changes – Increased hormone levels during puberty, pregnancy, or conditions like polycystic ovary syndrome (PCOS) can trigger acne. [2]
Excess oil production – Overactive sebaceous glands can lead to clogged pores.
Bacteria – The bacteria Cutibacterium acnes (C. acnes) can cause inflammation and worsen breakouts.
Diet – Some studies suggest that high-glycaemic foods and dairy may aggravate acne in certain individuals, though evidence remains inconclusive.
Stress – Increased stress levels can lead to hormonal imbalances, potentially worsening acne.
Smoking – Research indicates that smoking may increase the risk of acne, particularly non-inflammatory types.
Cosmetic products – Some skincare and makeup products can clog pores, leading to breakouts.
Medications – Certain drugs, such as steroids and hormonal treatments, can trigger acne.
Types of acne
Acne varies in severity and appearance. The main types include:
Blackheads (open comedones) – Small black or yellowish bumps that are not filled with dirt. [3]
Whiteheads (closed comedones) – Look like blackheads but may be firmer and do not empty when squeezed. [3]
Papules – Small red bumps that may feel tender or sore. [3]
Pustules – Like papules but have a white tip in the middle, caused by a build-up of pus. [3]
Nodules – Large hard lumps that build up under the skin and can be painful. [3]
Cysts – Large pus-filled lumps that look like boils and carry a higher risk of permanent scarring. [3]
How to tell if acne is hormonal or bacterial
Hormonal acne – Often appears around the jawline, chin, and lower face. It worsens before menstruation and may be linked to conditions like PCOS. More than 8 in 10 adults with acne are women, with hormonal changes being a major cause. [2]
Bacterial acne – Caused by an overgrowth of C. acnes, leading to inflamed pimples and cysts. It can occur anywhere on the face or body.
Acne treatment
Treatment depends on the type and severity of acne. Options include:
Skincare routine – Using gentle cleansers, oil-free moisturisers, and non-comedogenic products can help.
Over-the-counter treatments – Products containing benzoyl peroxide, salicylic acid, or niacinamide can reduce breakouts.
Prescription treatments – If acne is severe or persistent, a GP or dermatologist may prescribe stronger treatments.
Lifestyle changes – A balanced diet, stress management, and proper skin care can improve skin health.
Acne medication
For moderate to severe acne, medical treatments may be necessary:
- Topical treatments – Prescription creams or gels containing retinoids, antibiotics, or azelaic acid. These can be irritating, so some people may need to start slowly, using them a few times a week before gradually increasing to nightly application.
- Oral antibiotics – Used for inflammatory acne to reduce bacteria and swelling. To minimise the risk of antibiotic resistance, oral antibiotics should always be paired with a non-antibiotic topical treatment, such as lymecycline with Epiduo.
- Hormonal treatments – For women with hormonal acne, contraceptive pills or anti-androgen medications may help regulate hormone levels and reduce breakouts.
- Isotretinoin (Roaccutane) – A powerful medication for severe acne, prescribed under medical supervision.
Home remedies for acne
Some people find home remedies helpful in managing mild acne:
Tea tree oil – Has antibacterial properties that may reduce inflammation.
Aloe vera – Soothes irritated skin and may help with healing.
Honey and cinnamon – Known for antibacterial effects.
Green tea extract – May reduce oil production when applied topically.
While home remedies can support skin health, they should not replace medical treatment for persistent or severe acne.
Which treatment is best for acne?
There is no single best treatment, as effectiveness varies from person to person. Factors like acne type, skin type, and underlying causes influence the right approach. A GP or dermatologist can recommend the best option based on individual needs.
Acne treatments take time to work, and noticeable improvements may take at least 8 weeks. If a treatment does not show results after 8–12 weeks, a different approach may be considered. If multiple treatments are ineffective or if acne is causing significant scarring, a referral to a dermatologist may be recommended.
When to seek a doctor
It is best to seek medical advice if:
- Acne is severe, painful, or cystic.
- Over-the-counter treatments do not work.
- Acne is causing emotional distress or scarring.
- There are signs of an underlying hormonal issue.
Acne is a serious condition that affects both physical and mental health, with approximately 15-20% of GP consultations relating specifically to the skin [4]. If over-the-counter treatments aren't working, don't hesitate to seek professional medical advice. With the right approach, most people can successfully manage their acne and improve their skin health.
How HealthHero can help
HealthHero offers online dermatology consultations, connecting you with experienced professionals who can assess your skin and recommend the right treatment. If acne is affecting your confidence or not improving with standard treatments, expert advice can make a difference. For more information, visit HealthHero dermatology.
