(Pimples; Blackheads; Whiteheads; Acne Vulgaris)
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- Changes in levels of male hormones called androgens
- Increased sebum production
- Changes inside the hair follicle
- Age: 12-24 years old
- Race: Caucasian
Changes in hormone levels, such as during:
- Before a menstrual period
- Certain medicines (such as, androgens, lithium, and barbiturates)
- Certain cosmetic products
- Excess oil in the skin
- Papules—small, pink bumps that may be tender to the touch
- Pimples—inflamed, pus-filled bumps that may be red at the base (also called pustules)
- Nodules—large, painful, solid lumps that are lodged deep within the skin
- Cysts—deep, inflamed, pus-filled lumps that can cause pain and scarring
Over-the-counter topical medicines (such as, cleansers, creams, lotions, and gels)—to reduce the amount of oil and/or bacteria in the pores. These medicines may contain one or more of the following ingredients:
- Benzoyl peroxide
- Salicylic acid
Prescription topical medicine—includes cleansers, creams, lotions, and gels to reduce the amount of oil and/or bacteria in the pores. Examples include:
- Antibiotics, such as clindamycin (Cleocin T), erythromycin
- Tretinoin (Retin-A, Avita)
- Adapalene (Differin)
- Azelaic acid (Azelex)
- Tazarotene (Tazorac)
- Dapsone (Aczone)
Oral antibiotics—to control the amount of bacteria in pores, including:
- Sulfamethoxazole and trimethoprim
Oral medicines—to control androgen levels, including:
- Birth control pills—Pills that have a combination of hormones (estrogen and progestin) may be the most effective in improving acne.
Oral retinoids—to reduce the size and secretions of sebaceous glands. This medicine is only used for severe cases of cystic acne.
- Isotretinoin (Accutane)—must not be taken by women who are pregnant or who may become pregnant due to the risk of serious birth defects.
- Corticosteroids—the injection of corticosteroid directly into the cyst; mostly used for large, cystic acne lesions
- Acne surgery—specialized extractors are used to open, drain, and remove contents of acne lesions
Acne scar revision—procedures done to minimize acne scars, such as:
- Chemical peels—uses glycolic acid and other chemical agents to loosen blackheads and decrease acne papules
- Dermabrasion—"sandpapers" the skin to smooth it out
- Scar excision—uses a tiny punch tool or a scalpel to remove scars
- Collagen fillers—fill the pits of scars with a collagen substance
- Laser resurfacing—removes scars and tightens underlying skin
- Phototherapy—skin is exposed to an ultraviolet (UV) light source for a set amount of time to treat acne
- Gently wash your face with mild soap and warm water twice a day (no more than twice) to remove excess oil. Scrubbing or washing too often can make acne worse.
When washing your face:
- Use your hands rather than a washcloth.
- Use mild soap.
- Allow your face to dry before applying any lotion.
- Do not pick at or squeeze blemishes.
- Use lotions, soaps, and cosmetics labeled noncomedogenic. This means it won't clog your pores.
- Use topical acne treatments only as directed. Using them more often could make your condition worse.
- Recognize and limit emotional stress.
- Wear sunscreen year-round. This is especially important if you are using medicine that can make your skin more sensitive to the sun.
The Acne Resource Center Online http://www.acne-resource.org
The American Academy of Dermatology http://www.aad.org
Canadian Dermatology Association http://www.dermatology.ca
Acne. American Academy of Dermatology website. Available at: http://www.aad.org/skin-conditions/dermatology-a-to-z/acne. Accessed October 29, 2012.
Acne. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/. Updated August 27, 2012. Accessed October 29, 2012.
Phototherapy. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated December 30, 2011. Accessed October 29, 2012.
Questions and answers about acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Acne/default.asp. Updated October 2010. Accessed October 29, 2012.
9/2/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Arowojolu A, Gallo M, Lopez L, Grimes D, Garner S. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev. 2009;(3):CD004425.
- Reviewer: Purvee S. Shah, MD
- Review Date: 09/2012 -
- Update Date: 00/91/2012 -