What is Acne?

Overview  |  Symptoms  |  Complications  |  Causes  |  Diagnosis  |  Treatment

Acne, or acne vulgaris, is a condition that causes spots to develop on the skin – usually the face, but sometimes the chest and back can also be affected. It is very common, with most of us being affected at some point in our lives. Acne can range in severity; for most people it is relatively mild while others may have a severe form of acne which can often lead to scarring. Acne tends to begins during puberty and disappears some years later, however acne can also continue into adulthood.

Symptoms of Acne

The main symptom of acne is spots that can appear on the face, chest and back. Most people with acne also suffer from oily skin. Symptoms of acne also depend on the severity of the condition.

Mild acne: Mild-to-moderate acne sufferers will have blocked pores and spots that have white or blackheads.

Severe acne: Moderate-to-severe acne sufferers tend to have larger, pus-filled spots that are typically inflamed and painful. They may also have nodules, which are painful lumps felt under the skin. Cysts may also be present, which are large and pus-filled; these often lead to scarring.

Complications of Acne

Complications from acne are unlikely to occur with mild acne. When acne is severe and the spots are cysts and nodules, there is a high chance of scar tissue developing. However, there are a lot of options available that can help reduce the overall appearance of acne scars including laser treatment and dermabrasion.

Causes of Acne

Under the surface of the skin there are sebaceous glands which produce oil (sebum), keeping the skin supple, smooth and healthy. Hair follicles grow through pores in the skin and help bring the oil from the sebaceous gland up to the surface.

When someone is suffering from acne, it means that their sebaceous gland is producing an excessive amount of oil which, when combined with dead skin cells, blocks the follicle. During teenage years, an increase in testosterone levels is thought to be the cause of  acne.

How is Acne Diagnosed?

If your acne is really mild, then you can usually treat it at home with an over-the-counter cream. If you are suffering from moderate-to-severe acne then it is worth seeing your doctor as having acne can sometimes lead to feelings of anxiety or low-self esteem.

Your doctor will examine your skin and make a diagnosis based on the type of spots,  how inflamed they are and how painful – the treatment plan is based on the severity of acne. For women, sudden acne may be caused by a hormone imbalance, which can be linked to  polycystic ovary syndrome (PCOS).

Treating Acne

There are several methods of treatment for acne which vary based on severity. Mild acne can usually be treated at home or with an over-the-counter cream, whereas moderate-to-severe acne will likely need a stronger treatment. Acne cannot be treated overnight, so be patient as it can take up to three months to work.



  • It is important that the affected area is kept clean. This can be done by ensuring that it is washed twice a day – any more could be an irritant and make it worse. You can use a mild soap or facial cleanser and lukewarm water. Try not to scrub or use hot water as this may also make symptoms worse.
  • Remove make-up before going to bed.
  • As tempting as it may be, do not squeeze or pick spots as this could spread bacteria or cause long-term scarring.
  • Try to avoid having hair fall across your face.
  • Wash hair regularly.
  • Try to avoid products that clog pores; don’t wear a lot of make-up.
  • Try to keep towels and make-up brushes clean.

Topical Treatments

Benzoyl Peroxide

Available in a gel or cream form, Benzoyl peroxide works by killing bacteria on the affected area that have caused hair follicles to become infected, while preventing dead skin from blocking pores. It can take up to six weeks to clear acne. There are some side effects with benzoyl peroxide including skin irritation. Excessive exposure to sunlight and UV rays should also be avoided as skin will be extra sensitive to sunlight.


Topical antibiotics, available in cream or gel form, reduce the bacteria that is associated with acne. The cream should be applied once or twice a day and used for six to eight weeks. Topical antibiotics may cause skin irritation, but it is uncommon.


Available in a  cream or gel form, retinoids reduce the amount of sebum that is produced; it also helps to keep pores unblocked by stopping dead skin cells from blocking hair follicles. Retinoids are also useful for reducing mild inflammation caused by acne. Retinoids usually take six weeks to work.  You should not use retnoids while pregnant; you should also avoid sun exposure and UV rays.

Azelaic Acid

Doctors usually recommend azelaic acid if other tropical treatments cause too much irritation to the skin. Azelaic acid removes dead skin and any bacteria that is present. It is available in a gel or cream form and applied once or twice daily. It can take up to a month before you see any improvement.


Oral Antibiotics

If acne is particularly severe, oral antibiotics are recommended as well as a topical treatment. It can take up to six weeks before you notice an improvement. Some form of antibiotics can make skin sensitive to sunlight and UV rays, so exposure should be kept to a minimum. Antibiotics also interfere with the contraceptive pill, therefore, it is important to use another form of contraception, such as condoms.

Hormone Therapy

If topical treatments and antibiotics have proven unsuccessful, your doctor may recommend the contraceptive pill, even if you are not sexually active.  The contraceptive pill works by suppressing testosterone production, resulting in a reduction in the amount of sebum produced and a clearer skin. It may take up to a year for acne to clear up.