It’s common in teenagers and young adults, but it can strike at any age. “People think of acne as a teenage problem, but I see it primarily in adult women,” said Dr. Amy McMichael, chair of the dermatology department at Wake Forest Baptist Health in North Carolina and a member of the American Academy of Dermatology. “People are just fed up with it — they’ve tried pretty much everything out there on the market nowadays.”
Symptoms of acne
Acne can show up as different types of blemishes on the skin, typically on the face, neck, chest, back and shoulders. According to the AAD, you might see:
- Papules and pustules, or pimples
Acne is fairly universal in terms of how it looks, but there is more post-inflammatory hyperpigmentation (PIH) in darker skin, said McMichael. “The acne lesion may take 1 to 2 weeks to improve, but the PIH can last for many weeks to months.”
Causes of acne
Acne starts when dead skin cells don’t shed properly. Instead, they clog your pores. Then, your skin’s oil can trap those cells in the pores. Bacteria that live on our skin, called P. acnes, can get caught in the clogged pores as well, multiplying and triggering acne symptoms.
Those toners and witch hazel? They’re probably not making a difference. “Acne has nothing to do with cleaning,” McMichael said. “It has nothing to do with your face being dirty.” If you have acne, you might have more oil than average, and you may be genetically predisposed to the type of bacteria that lives on your skin, she said.
Can you eat your way to clear skin? “People are always trying to associate diet with acne,” McMichael said. And it’s possible there’s a link, at least with your overall eating habits. If you ate some potato chips yesterday, that’s probably not causing your acne today. But a study of 24,000 people in France that was recently published in JAMA Dermatology found an association between acne and a diet higher in fat, sugar and milk.
Your dermatologist will examine your skin to make sure acne is what you have — it’s important to rule out other skin conditions that can look like acne, such as rosacea and keratosis pilaris. If it’s acne, it will get a grade from 1 (mild) to 4 (severe). Severe acne may include acne that covers the face, chest and back or cystic acne, which involves large, painful cysts or nodules that may leave scars. Your dermatologist can use your acne’s grade to help guide treatment options.
Treatment for acne
Most people are eager to know how to get rid of acne. You might be able to treat mild acne with over-the-counter products containing benzoyl peroxide or salicylic acid, according to the AAD.
If at-home treatments for acne aren’t working, a dermatologist can help. “There are different ways to treat the problems because there are many different factors that create acne. You need to unplug pores, calm down inflammation, suppress the bacteria and get rid of the pink spots — and afterward, the dark spots,” said Dr. Carolyn Jacob, medical director of Chicago Cosmetic Surgery and Dermatology and a member of the American Academy of Dermatology.
The AAD says your dermatologist may recommend:
- Treatments you can apply to your skin, such as prescription-strength benzoyl peroxide or salicylic acid, retinoids or antibiotics
- Oral medications like antibiotics or birth control pills
- Laser treatments (or other light therapies), chemical peels or drainage and extraction procedures
Acne is treatable, but don’t expect instant results. “You have to be patient. It takes two to three months before you start seeing benefits, because your skin takes 28 days to cycle,” said Jacob. “To unplug those pores and see improvement takes that long.” In her patients, she aims to clear acne in six months and get rid of spots and discoloration in eight months.
It’s important to treat your acne. Untreated, acne can lead to low self-esteem and depression. It can also cause dark spots that take a long time to fade, as well as permanent acne scarring. Scar treatment can help diminish acne scars. Your dermatologist may use laser treatments, chemical peels or fillers, or perform a minor skin surgery to treat scars from acne, according to the AAD.
After your skin clears, your dermatologist will recommend an ongoing treatment program to help you avoid new breakouts.