Overview
Acne is a common skin condition that happens when hair follicles become blocked by oil, dead skin cells, and bacteria. It produces spots ranging from small blackheads and whiteheads to deeper, painful cysts. Acne most often affects the face, chest, and back.
How common is it?
Acne affects up to 95% of people at some point in their lives. It is most common in teenagers but can affect adults of any age, particularly women in their 20s and 30s.
Causes and risk factors
The sebaceous glands in skin produce an oily substance called sebum. When glands overproduce sebum and dead skin cells block the follicle opening, bacteria called Cutibacterium acnes multiply and trigger inflammation.
Common risk factors
- Hormonal changes during puberty, pregnancy, or menstrual cycle
- Family history of acne
- Certain medications including steroids and lithium
- High-glycaemic diets (some evidence)
- Stress increasing oil production
- Cosmetic products that block pores
Symptoms
- Blackheads (open clogged pores)
- Whiteheads (closed clogged pores)
- Small red tender bumps (papules)
- Pus-filled spots (pustules)
- Firm painful lumps under the skin (nodules)
- Painful pus-filled cysts
- Skin scarring after severe spots
When to see a doctor
See a doctor if over-the-counter products have not helped after 2 to 3 months, if acne is leaving scars, or if it is seriously affecting your confidence or mental health.
Diagnosis
Doctors diagnose acne by examining the skin. They assess the type and severity of spots to guide treatment. Blood tests are occasionally done if a hormonal cause is suspected in women.
Treatments
Topical retinoids and benzoyl peroxide
First-line treatments applied to skin. Retinoids unblock pores; benzoyl peroxide kills bacteria and reduces inflammation.
Antibiotic tablets or gels
Used for moderate to severe inflammatory acne. Usually prescribed for 3 to 6 months to avoid antibiotic resistance.
Isotretinoin (Roaccutane)
A highly effective oral vitamin A derivative for severe or scarring acne. Requires monitoring due to side effects including very dry skin and, in women, a strict pregnancy prevention programme.
Self-care and lifestyle
- Wash affected areas twice daily with a mild soap-free cleanser, not more
- Avoid squeezing spots, which worsens inflammation and increases scarring risk
- Use oil-free, non-comedogenic moisturisers and sun protection
- Change pillowcases frequently and keep hair off your face
Prevention
Acne cannot always be prevented, but consistent gentle skincare, avoiding pore-blocking products, and managing stress can reduce frequency and severity of breakouts.