What Is Acne?

Acne vulgaris, commonly known as acne, is a condition that causes flares or breakouts of pimples, zits, and blackheads in the skin. It's caused by the blockage of pores by oil and dead skin cells that can lead to inflammation.

It commonly affects the face during puberty, but can affect other parts of the body and happens to people of all ages. It may impact mood and self-esteem, but fortunately there are many treatment options.

Read on to learn more about the different types of acne and how to manage breakouts and acne scars.

Woman looking at pimple in the mirror

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Types of Acne

Acne can be classified by its causes (fungal, bacterial, hormonal), severity (mild to severe), or blemish type. The following is a list of the types of blemishes in acne:

  • Blackheads, open comedones (skin pores)
  • Whiteheads, closed comedones
  • Pimples, also known as papules, which are small red, inflamed bumps
  • Pustule, pus-filled pimples
  • Nodules and cysts, known as nodulocystic acne, blemishes that may affect deeper layers of skin and can leave scars

What Are the Symptoms of an Acne Breakout?

Acne breakouts can be recognized by the appearance of blemishes on the skin. These blemishes are small spots that have differences in coloration and texture, and may be painful.

Comedones are small and can be either darker (blackhead) or lighter (whitehead) than your skin. Pimples, nodules, and cysts, on the other hand, tend to be larger and may appear pink, purple, or brown depending on your underlying skin tone. You may be able to notice a white or yellow area within the pimple when it's filled with pus.

When inflammation is present, acne blemishes can be tender. Pustules can open up and cause crusted areas on the skin's surface. Even after they heal, acne breakouts can cause a darkening of the skin, known as post-inflammatory hyperpigmentation, especially in people with darker skin tones. Scarring can also occur, particularly with nodulocystic acne.

What Causes and Triggers Acne?

Acne is caused when there is blockage of a hair follicle or pore by oil and dead skin cells. Excess oil production and the presence of certain bacteria can make skin more prone to acne.

The following may contribute to acne breakouts:

  • Hormonal changes, such as during puberty, menses, and pregnancy lead to changes in skin oil production
  • Bacteria like Propionibacterium acnes
  • The fungus Malassezia folliculitis (also called Pityrosporum folliculitis)
  • Certain medications
  • Medical conditions like polycystic ovary syndrome (PCOS), Cushing's syndrome, acromegaly
  • Cosmetics and hair products
  • Some foods, such as white bread, chips, milk, and pastries

While stress is commonly blamed for acne, it is not thought to cause acne. However, it might lead to the worsening of existing acne.

Medications that Can Worsen Acne

Several medications can worsen acne breakouts. These include:

  • Corticosteroids
  • Contraceptives, including oral contraceptive pills, medroxyprogesterone injection (Depo-Provera), progesterone implanted devices (including rods implanted under the skin and intrauterine devices), although birth control can also help with acne
  • Testosterone and androgen steroids
  • B vitamins (vitamin B6, B12)
  • Seizure medications, like Curatil (carbamazepine), Dilantin (phenytoin), and Solfoton (phenobarbital)
  • Tuberculosis medications, such as Trecator (ethionamide), Hydra (isoniazid), and Rifandin)rifampin)
  • Medications for mood disorders (lithium)
  • Immunosuppressant medications like Neoral (cyclosporine )and Imuran (azathioprine)

Acne at Any Age

While acne is common during puberty, it can happen at any age. In fact, 1 in 5 babies frequently develop acne shortly after birth related to hormone shifts. Acne also affects adults, in some cases for the first time. Hormonal shifts like pregnancy and menses can cause acne in adults, as can the use of certain hair and cosmetic products.

Acne Treatment

While acne can be stubborn, you do not have to live with it forever. There are many treatments, ranging from simple self-care measures that you can take at home to topical treatments, many of which are available over the counter (OTC), without a prescription.

Acne that persists, affects a large area of skin, or penetrates deep in the skin benefits from evaluation by a dermatologist, a medical doctor who specializes in diagnosing and treating skin disorders, who can prescribe topical or oral medications.

At-Home Skin Care to Treat and Prevent Acne

Treating acne starts with certain simple measures you can take at home. The following are tips on how to treat and prevent acne:

  • Cleanse skin regularly with a nonabrasive cleanser and avoid scrubbing
  • Avoid irritating products like astringents, toners, and exfoliating agents
  • Use skin products that are labeled as noncomedogenic, oil-free, and alcohol-free
  • Avoid touching your face or picking at blemishes
  • Protect skin by avoid ultraviolet (UV) rays from sunlight or tanning beds

Should You Pop Zits or Leave Them Alone?

It's best to leave pimples and blemishes alone and resist the urge to pick at or pop them. Manipulating them can make the outbreak worse and may even cause infection and scarring. Instead, consider making an appointment with a dermatologist who can safely extract blackheads, whiteheads, and pimples using appropriate sterile tools and recommend appropriate acne treatment.

Topical Medications

Some topical medications for acne can be purchased without a prescription, while stronger versions and others may require a prescription. Be sure to read labels and follow instructions for application.

Topical OTC acne treatments include:

Prescription topical agents include:

  • Topical retinoids at stronger strengths
  • Topical antibiotics, like Cleocin (clindamycin) and Eryc (erythromycin)
  • Finacea or Azelex (azelaic acid)

Diet and Acne

There is conflicting evidence about diet and acne. However, some specific diets have been linked to an improvement of acne in studies, including:

  • A low-glycemic diet can decrease blood sugar spikes and, in turn, lessen inflammation.
  • A reduced-dairy diet can eliminate acne triggers such as milk and whey products.
  • A diet high in omega-3 fatty acids can decrease inflammation.

Treatment for Severe Acne

Acne may be considered severe when it is persistent, involves an extensive area, or includes nodules and cysts, which can cause scarring. Severe acne can benefit from evaluation by a dermatologist.

Dermatologists can help uncover the potential causes of acne, including any other condition that may be worsening acne. They can also recommend specific over-the-counter medications in combination or prescribe more potent acne treatments.

Prescription acne medications for severe acne include:

  • Oral antibiotics, like Sumycin (tetracycline), Periostat (doxycycline), and Solodyn (minocycline)
  • Iisotretinoin
  • Aldactone (spironolactone), particularly for hormonal acne in women

Acne in Transgender Individuals

Acne can worsen in people taking masculinizing hormones, like testosterone. In fact, one study showed that up to 94% of those on masculinizing hormones experience acne, particularly early on in therapy. Treatment for this type of acne is the same as for others, with one exception: Spironolactone may be avoided as it has feminizing effects, such as breast enlargement.

How to Get Rid of Acne Scars

Acne can cause scarring, particularly when it is picked at or when it affects deeper skin layers, such as in nodulocystic acne (a severe type of inflammatory acne). Scarring may become more noticeable with age as the skin's collagen, which provides structure and support, decreases.

Dermatologists can offer several treatment options for scarring, including:

  • Chemical peels
  • Laser treatment
  • Fillers

Tips for Preventing Future Acne Breakouts

In addition to the at-home measures discussed above, some other tips to prevent acne breakouts in those prone to acne include:

  • Wash skin regularly (twice a day and when sweaty) with a nonabrasive cleanser.
  • Avoid comedogenic cosmetics and skin products that contain alcohol and oils.
  • Avoid scrubbing skin and picking at blemishes.
  • Consider dietary changes like decreased milk intake, low-glycemic diet, and increased omega-3 fatty acids.
  • Manage stress levels.


Acne is a very common condition that can affect people at any age. Severe cases can lead to permanent scarring. Many treatments are available, from self-care measures to topical therapies and oral medications.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Angela Ryan Lee, MD
Angela Ryan Lee, MD, is board-certified in cardiovascular diseases and internal medicine. She is a fellow of the American College of Cardiology and holds board certifications from the American Society of Nuclear Cardiology and the National Board of Echocardiography. She completed undergraduate studies at the University of Virginia with a B.S. in Biology, medical school at Jefferson Medical College, and internal medicine residency and cardiovascular diseases fellowship at the George Washington University Hospital. Her professional interests include preventive cardiology, medical journalism, and health policy.