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What is acne?

Acne is a very common skin condition. It causes spots and painful bumps on the skin. It's most noticeable on the face, but can also appear on the back, shoulders and buttocks. Severe acne can cause scarring.

Acne usually starts in puberty, but it affects adults too.

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What are the symptoms of acne?

There are different kinds of spots:

  • blackheads are small, blocked pores
  • whiteheads are small, hard bumps with a white centre
  • pustules are spots with a lot of pus visible
  • nodules are hard, painful lumps under the skin

Inflammatory acne is when the skin is also red and swollen.

An example of acne
An example of a whitehead, which are small, hard bumps with a white centre.

Sometimes acne can keep appearing along the lower cheeks, jawline and neck. The spots can be quite painful and take a long time to heal. The acne can worsen for women before they have their period.

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What causes acne?

Acne happens when hair follicles get blocked with sebum, an oily substance that helps protect the skin. When dead skin cells mix with the blockage, spots can form. Bacteria in the skin multiply, which can cause pain and swelling (inflammation) beneath the blockages.

During puberty, changes in levels of the hormone testosterone can cause changes in the sebum produced. This happens in both boys and girls.

Acne can also be caused by:

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When should I see my doctor?

You can see your doctor if the acne doesn’t go away with treatments from your pharmacist or if it is bothering you a lot. Acne is a medical condition, so it’s a good idea to have it treated by a medical professional rather than a beauty therapist.

Your doctor can assess how bad your acne is and discuss the options with you. Don't be afraid to tell your doctor how your acne affects your life and how it makes you feel.

If your acne is very bad, your doctor may refer you to a dermatologist.

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How is acne treated?

Acne will usually go away on its own, but it can take many years. There are treatments that can help clear acne more quickly.

Over-the-counter treatments can help with mild acne. Ask a pharmacist for advice on which treatment could help and how long you will have to use it. You should not expect to see results for several weeks, even a couple of months.

If over-the-counter treatments don't help after 6 to 8 weeks, treatments are available on prescription.

Treatment options

  • Retinoids: This is treatment from vitamin A that unblocks pores and prevents new blockages. Either swallowed or applied directly to the skin.
  • Antibiotics: These reduce the bacteria that cause acne and reduce inflammation. Either swallowed or applied directly to the skin.
  • The low dose contraceptive pill: regulates the hormones that cause acne in some women.
  • Isotretinoin tablets (Roaccutane): A medication used for severe acne.
  • Microdermabrasion, light or laser therapies may help with mild acne.

The Australasian College of Dermatologists recommend that oral antibiotics for acne should be avoided where possible. If prescribed, combine with a topical antiseptic, which may reduce antibiotic resistance. For more information, speak to your doctor or visit the Choosing Wisely Australia website.

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Can acne be prevented?

If you have acne there are a number of things you can do to help to manage the condition. Here is some self-help information:

  • Do not squeeze spots and try not to touch them because this can lead to an infection or scarring.
  • Cleanse with a mild 'soap free' liquid face cleanser that’s acid and/or pH balanced and free of abrasives and alcohol.
  • When washing your face, you should clean it gently rather than scrubbing the skin. Pat your skin dry rather than rubbing it.
  • If you wear make-up, removing it before going to bed will also help to keep the skin glands unblocked. Choose a product that is suitable for acne-prone skin. Don’t go to sleep without taking your make-up off.
  • If you use hair products such as gels, sprays and waxes, you should make sure they don’t come into contact with your face, especially your forehead. You may also find keeping your hair away from your forehead can help improve spots on your forehead. Washing your hair more regularly also helps improve spots.
  • Use makeup and/or sunscreen only during the day and a moisturiser at night. Apply makeup, moisturisers and sunscreens after or on top of your morning or evening acne treatments.
  • Sunbeds and sun bathing increase the risks of skin damage that can cause melanoma and other skin cancers and should be avoided.
  • When shaving, moisten hairs for a few minutes first to soften them. Use a shaving cream designed for sensitive skin and make sure the razor is sharp. Don’t try to shave off pimples and use light pressure only.

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Complications of acne

Sometimes acne can cause low self-esteem. It can make people feel down and prevent them from taking part in social or sporting activities.

Severe acne can lead to scarring. Medications that control acne can help avoid this.

Sometimes acne in girls may be caused by polycystic ovarian syndrome or other disorders with the hormones. These will need to be treated by a doctor.

Resources and support

For more information, visit the All About Acne website.

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Last reviewed: October 2019

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