Understanding Acne: Causes, Treatments, Prevention and Expert Insights

Hello, I’m Dr. Aarti Sarda, a board-certified dermatologist with years of experience helping patients achieve clearer, healthier skin. Acne is one of the most common skin concerns I encounter in my practice, affecting people of all ages—from teenagers navigating puberty to adults dealing with hormonal fluctuations. It’s not just a cosmetic issue; it can impact self-esteem and lead to scarring if left untreated. In this blog, I’ll provide a comprehensive overview of acne, including its causes, treatment options, prevention strategies, and some practical know-how to empower you on your skincare journey. Remember, while this information is based on established medical knowledge, it’s always best to consult a dermatologist for personalized advice.

What is Acne? Types and Symptoms

Acne, also known as acne vulgaris, is a chronic skin condition that occurs when hair follicles become clogged with oil (sebum), dead skin cells, and bacteria. This leads to inflammation and the formation of various lesions on the skin. It most commonly affects areas with a high concentration of oil glands, such as the face, forehead, chest, upper back, and shoulders.

Common Types of Acne

Acne isn’t one-size-fits-all; it presents in different forms, which influence how we approach treatment:

• Comedonal Acne: Includes blackheads (open comedones, appearing black due to oxidation) and whiteheads (closed comedones, with a white top).
• Inflammatory Acne: Red, swollen papules (small bumps) and pustules (pus-filled pimples).
• Nodular Acne: Deeper, tender lumps under the skin that can be painful.
• Cystic Acne: Severe form with large, pus-filled cysts that often lead to scarring
• Hormonal Acne: Common in adults, especially women, linked to hormonal changes and often appears along the jawline or chin.
• Fungal Acne (Pityrosporum Folliculitis): Caused by yeast overgrowth, often itchy and mistaken for bacterial acne.

Other variants include acne in children or due to specific triggers like medications.

Symptoms to Watch For

Symptoms vary by severity but typically include:

• Oily skin.
• Pimples, bumps, or lumps that may be red, painful, or filled with pus.
• Dark spots (hyperpigmentation) or scarring after lesions heal, especially in people with skin of color.
• Tenderness, itching, or discomfort in affected areas.

Severity is graded from mild (a few comedones) to severe (widespread nodules and cysts). If acne affects your daily life or causes emotional distress, it’s time to seek professional help.

Causes of Acne

Acne develops from a combination of factors rather than a single cause. At its core, it’s due to overactive sebaceous glands producing excess sebum, which mixes with dead skin cells to clog pores. Bacteria (like Propionibacterium acnes) then thrive in this environment, causing inflammation.

Key contributors include:

• Hormonal Changes: Androgens (like testosterone) stimulate oil production, explaining why acne peaks during puberty, menstrual cycles, pregnancy, or conditions like polycystic ovary syndrome (PCOS).
• Genetics: If your parents had acne, you’re more likely to develop it.
• Bacteria and Inflammation: Excess bacteria lead to infected pores.
• Lifestyle and Environmental Factors: Stress (raising cortisol), high-glycemic diets (e.g., sugary foods, skim milk), oily cosmetics, tight clothing, humidity, and certain medications (e.g., steroids, birth control).
• Other Triggers: Picking at skin, smoking, or exposure to greasy substances (e.g., in kitchens or with hair products).

Contrary to myth, acne isn’t caused by poor hygiene or eating chocolate/greasy foods alone, though diet can play a role in some cases.

Treatment Options for Acne

The good news is that acne is treatable! Treatment is tailored to your age, acne type, severity, and skin type. It often takes 4-8 weeks to see improvement, so patience is key. We aim to reduce oil production, unclog pores, kill bacteria, and prevent scarring.

Over-the-Counter (OTC) Treatments

Start here for mild acne:

• Benzoyl Peroxide: Kills bacteria and reduces inflammation (e.g., 2.5-10% washes or creams).
• Salicylic Acid: Exfoliates and unclogs pores.
• Adapalene: A retinoid that prevents comedones.
• Azelaic Acid: Antibacterial and anti-inflammatory, great for sensitive skin.

Apply to the entire affected area, not just spots, and use sunscreen as these can increase sun sensitivity.

Prescription Treatments

For moderate to severe cases:

• Topical Medications: Retinoids (e.g., tretinoin), antibiotics (e.g., clindamycin), or combinations.
• Oral Antibiotics: Tetracyclines (e.g., doxycycline) for 3-6 months to fight bacteria.
• Hormonal Therapies: Birth control pills or spironolactone for women with hormonal acne.
• Isotretinoin: Powerful for severe acne; requires monitoring due to side effects like dryness, potential mood changes, and birth defect risks (strict pregnancy prevention needed).

Procedures and Therapies

• Chemical Peels: Using salicylic or glycolic acid to exfoliate.
• Light/Laser Therapy: Targets bacteria or scars.
• Steroid Injections: For large cysts.
• Extraction: Manual removal of comedones.

For children, gentle topicals like benzoyl peroxide are safe, but consult a pediatric dermatologist.

How to Prevent Acne

While you can’t always prevent acne (especially hormonal types), these steps can minimize breakouts:

• Daily Skincare Routine: Wash twice daily with a gentle, non-comedogenic cleanser and warm water. Avoid harsh scrubs.
• Moisturize and Protect: Use oil-free moisturizers and broad-spectrum sunscreen (SPF 30+).
• Product Choices: Opt for non-comedogenic makeup, sunscreens, and hair products. Remove makeup before bed.
• Lifestyle Habits: Manage stress through exercise or meditation, eat a balanced diet low in refined sugars, avoid touching your face, and shower after sweating.
• Avoid Triggers: Steer clear of tight gear, greasy environments, and picking at pimples to prevent worsening or scars.

Consistency is crucial—stick to your routine!

Additional Know-How: Myths, Facts, and When to Seek Help

Myths vs. Facts

• Myth: Acne is just for teens. Fact: It can persist into adulthood or start later.
• Myth: Sun exposure clears acne. Fact: It can worsen it and increase scarring risk.
• Myth: Popping pimples helps. Fact: It spreads bacteria and causes scars.
• Fact: Early treatment prevents permanent damage. Acne can affect mental health—seek support if needed.

When to See a Dermatologist

Consult me or another specialist if:

• OTC treatments fail after 4-6 weeks.
• Acne is moderate/severe, painful, or scarring.
• It affects your self-esteem or daily life.
• You have signs of hormonal issues (e.g., irregular periods).

We’ll create a customized plan, possibly including lab tests for underlying conditions like PCOS.

Final Thoughts

Acne is manageable with the right approach, and clearer skin is achievable for most people. If you’re struggling, don’t hesitate to reach out—I’m here to help. Schedule an appointment at my clinic or follow me on social media for more tips. Remember, healthy skin starts with knowledge and consistency!

Stay radiant,  

Dr. Aarti Sarda, MD Dermatology