Acne is the medical term for pimples. It is quite common and usually starts in the early teenage years. For some, it is only a transient skin problem during adolescence, but for others, the condition persists well into adulthood. It is most commonly seen in teenagers and young adults of both genders.
It is normal to have occasional pimples. However, some patients may experience recurrent, tender, and scarring acne that requires medical treatment.
Acne occurs when the pores become clogged with sebum and dead skin cells. Eventually, skin bacteria invade the clogged pores. The acne-causing bacterium Cutibacterium acnes eventually leads to infection in the blocked pores. This results in red and swollen skin areas with small nodules and pustules.
There are three different levels of acne:
Typical teenage acne often starts with blackheads (comedones) and skin-coloured bumps on the skin. These bumps often appear densely packed, typically on the forehead. Many do not consider these as acne, but they are often the initial stage of an acne condition. Blackheads can also occur from using creams, sunscreens, and makeup that are too oily or, for example, very greasy hair products. Products containing high levels of fatty substances can physically block the openeing of the skin's sebaceous glands, leading to blackheads and acne. Squeezing blackheads is not recommended as it can worsen the condition and introduce more bacteria.
Moderat acne, also known as papulopustular acne, is characterized by red bumps (papules) and pus-filled inflamed pimples (pustules).
Severe acne, also known as nodular acne, is characterized by tender and inflamed nodules in the skin. Individuals with severe acne often describe painful and inflamed "underground pimples" and abscesses that leave acne scars.
Acne can occur as single lesions, small clusters, or scattered in different body areas.
In the face, it is not uncommon to get pimples on the chin and around the mouth, cheeks, forehead, and nose. Pimples in the scalp can also occur, which can be folliculitis (hair follicle inflammation). You can read more about this here. As for the rest of the body, pimples can commonly appear on the back, neck, and chest. Pimples may also occur in the genital area and on the buttocks, but it can also be due to ingrown hairs related to shaving or folliculitis.
Folliculitis usually does not cause significant discomfort. However, a deep folliculitis, called a furuncle, can develop into an abscess (pus-filled boil) and cause pain. If multiple furuncles merge and cause systemic symptoms, it is called a carbuncle.
Persistent and inflamed folliculitis can lead tos carring of the hair follicle and surrounding skin. This is particularly problematic on the scalp.
Fortunately, there are now many ways to treat acne. Many people first try over-the-counter skincare creams, which can be purchased online or at a pharmacy. For some, this may be sufficient, but for many, medical treatment is necessary. A dermatologist can treat acne with creams and/or oral medications.
In most cases, a dermatologist will initially try to treat acne with creams containing active ingredients that aim to open and cleanse the pores and/or reduce inflammation in the skin. The creams need to be applied to the entire affected areas daily or every other day for several weeks before improvement can be seen.
The most common approach is for the dermatologist to prescribe antibiotics for a shorter period or a stronger course of oral medication for acne over a longer period.
Do not wash your face more than twice a day, and use lukewarm water and mild soap. It is not recommended to squeeze pimples as it can damage the skin and lead to scarring. Avoid oily skincare products. If you use sunscreen or moisturizer, choose one that is suitable for oily skin and labeled as "non-comedogenic," meaning it does not cause the development of blackheads. First, try over-the-counter products (gels, toners, or day creams) that you can purchase at the pharmacy. The active ingredients in these products may include benzoyl peroxide, glycolic acid, or salicylic acid.
Folliculitis closely resembles acne. Unlike acne, which originates from sebaceous glands, folliculitis is related to inflammation of the hair follicles. Folliculitis is characterized by a central hair strand. Link
