Acne

Acne is a disorder of the hair follicle and its oil gland. When dead skin cells and oil plug a pore, bacteria multiply and inflammation follows — producing the blackheads, whiteheads, papules, and cysts we recognize as acne.

Acne shows up as blackheads and whiteheads (comedones), red inflamed bumps (papules and pustules), and — in more severe cases — deep, tender nodules and cysts. It most often appears on the face, but the chest, back, and shoulders are common too.

Four factors drive acne: excess oil (sebum) production, sticky dead skin cells clogging pores, the bacterium Cutibacterium acnes, and inflammation. Hormones — especially androgens — amplify oil production, which is why acne often starts at puberty.

Common aggravators include hormonal shifts (menstrual cycles, PCOS), certain medications, high-glycemic diets and dairy in some people, friction from helmets or masks, and picking. Stress doesn't cause acne but reliably makes it worse.

Acne is diagnosed by a clinical exam — no tests are usually needed. A dermatologist will grade its severity and look for clues (like jawline distribution or excess hair) that suggest a hormonal driver worth investigating.

Start with a gentle cleanser and a proven OTC active: benzoyl peroxide for inflamed bumps, salicylic acid or adapalene for clogged pores. Give any routine 8–12 weeks, moisturize, and use non-comedogenic sunscreen. Resist the urge to pick.

Look for benzoyl peroxide 2.5–5%, adapalene 0.1% gel, or azelaic acid 10%. Pair actives with a barrier-supporting moisturizer to offset dryness.

When OTC isn't enough, dermatologists prescribe topical retinoids (tretinoin, tazarotene), topical or oral antibiotics, hormonal therapy (combined pill, spironolactone), or — for severe, scarring acne — oral isotretinoin.

In-office options can complement medication, especially for stubborn cysts or the marks acne leaves behind.

See a dermatologist if acne is painful or cystic, is scarring, isn't responding after a few months of OTC care, or is affecting your confidence. Earlier treatment prevents permanent scars.

Conditions mistaken for acne include rosacea (redness and flushing, no comedones), folliculitis (infected hair follicles), perioral dermatitis, and fungal acne (itchy, uniform bumps).