What is acne?

Acne is a common skin condition that causes spots.

Some people have a mild form of acne, with only occasional spots or outbreaks. Others have more severe acne, with large areas of the face and body affected.

Acne is more severe in males, but more likely to be ongoing in females. Acne most commonly affects people aged between 16 and 18 years. Acne also affects people whose skin is naturally oilier.

Acne can affect how you feel about your appearance and cause poor self-esteem.

Acne can be mild, moderate or severe. Mild acne appears on the 'T-zone' of your face. Moderate acne can appear on other areas of your body too. Severe acne can cause scarring.

There are different types of acne:

• acne vulgaris
• adult acne

Acne vulgaris

Acne vulgaris generally affects teenagers and lasts for 3 to 5 years. Sometimes it can carry on for longer. It's most common in people aged 16 to 18 years.

Adult acne

Adult acne is also called hormonal acne. This is acne that continues past the age of around 18 to 20 years. It can also start when you are in adulthood.

What are the symptoms of acne?

The symptoms of acne include:

• whiteheads — small white spots under the surface of the skin
• blackheads — small, blocked pores with a black 'plug'
• pimples — inflamed red spots which can have yellow pus in the middle
• nodules — large red bumps under the skin which can be painful

What causes acne?

Acne can be caused by different factors.

Acne is caused by a build-up of dead skin cells and oil. This then forms a pimple or nodule in the skin. Bacteria can then grow in blocked pores, causing inflammation and redness.

Androgen hormones may also make your skin produce more oil. But higher levels of hormones only cause acne in a very small minority of adults, such as people with polycystic ovarian syndrome (PCOS). Hormone levels also increase during puberty in teenagers and young adults.

There are other things that can trigger acne, such as:

• stress
• family history
• diet
• some medicines
• being overweight

Acne is not caused by a lack of hygiene, and food it is not a common cause.

When should I see my doctor?

You should speak with your doctor if you have acne, and it is bothering you.

You should see your doctor if:

• your acne is severe and causing you concern
• your acne does not improve after using the treatment recommended by your pharmacist

Untreated acne can leave you with skin scars. If you think you have acne, it is important to get treatment.

Your doctor may refer you to a dermatologist (a skin specialist) if your acne is severe. They can help you decide which treatment is best for you.

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How is acne diagnosed?

To diagnose acne, your doctor will check your skin for signs of acne. Sometimes, they might order a blood test to check your hormone levels.

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How is acne treated?

There are many different treatments available for acne, including:

• face washes or cleansers
• creams and gels
• medicines and tablets

It's also a good idea to eat a balanced range of foods and drink plenty of water.

The aim of treatment is to:

• reduce the number blackheads and whiteheads
• reduce inflammation, pimples and redness
• prevent scarring
• improve wellbeing and reduce emotional impact

Washing your face

Keeping your skin clean is an important way to treat and prevent acne.

You can use a gentle, soap-free pH balanced face wash. Wash your face with warm water twice a day.

Be careful not to wash your skin too often since this may make your acne worse. If your skin still feels oily after washing, speak to your pharmacist.

If you wear makeup, choose oil-free products. Remove your makeup every night with a cleanser or micellar water.

Try not to pick or squeeze any pimples. Avoid known triggers if possible.

Creams and gels

After washing your face apply a moisturiser or sunscreen.

Your pharmacist can recommend over-the-counter treatments for your acne. These often contain ingredients to help remove oil and unblock your pores. Follow the instructions carefully.

Medicines for acne

Some treatments require a doctor's prescription. These can help with more severe acne, or when your acne doesn't get better with other treatments. These include:

• antibiotics
• anti-androgen medicines, such as the contraceptive pill or spironolactone
• retinoids

It is important to remember that treating acne takes time. It will often take 2 to 3 months of treatment to see an improvement. Even if you don't see your acne getting better right away, keep following the instructions for your treatment.

If your acne doesn't improve after this time, you can ask your pharmacist or doctor about other treatments. You might need to use a combination of more than one treatment.

Other treatments

Other treatments can help with mild acne, such as:

• light microdermabrasion
• chemical peels
• light diathermy

These physical therapies may need to be repeated regularly. They are not suitable for people with severe or active acne.

Some natural ingredients can also help acne, such as:

• alpha hydroxy acid (fruit acid)
• azelaic acid

However, these can also irritate your skin or interfere with other medicines you might be taking. Discuss natural acne treatments with your doctor or pharmacist before using them.

Read more about acne scar treatment.

Can acne be prevented?

If you have acne, there are ways to help:

• prevent new spots appearing
• prevent acne scars from forming

The following will help prevent spots from becoming inflamed or causing scars:

• use sun protection, such as a wide brimmed hat and sunscreen
• remove your makeup before you go to bed
• shampoo your hair regularly, especially if it is oily and rests on your skin
• have a well-balanced, healthy diet and exercise regularly

Things to avoid include:

• oil-based makeup or greasy sunscreen
• washing your face too often or using harsh soaps
• tight clothing over areas where you have acne
• squeezing or picking spots or pimples

What complications can come with acne?

Acne can impact you both physically and mentally.

Acne scars

If left untreated, severe acne can leave life-long scars on your skin. To prevent scars, it is important to take care of your skin and treat your acne.

Treating your acne can stop it from getting infected, which can cause scarring.

Acne and self-esteem

Acne impacts the appearance of your skin. Acne can make you feel self-conscious and affect your self-esteem. This can impact your social life and mental health.

See your doctor if you find yourself:

• worrying about how you look
• avoiding social situations
• feeling down or upset

Your doctor can help you get the best possible treatment, advise you about body image and help you find support.

Resources and support

To learn more about acne, you can visit the A-Z of skin, hosted by the Australasian College of Dermatologists.

You can also visit All About Acne for more information provided by Australian dermatologists.

The Royal Children's Hospital has produced an acne fact sheet for teens.

Visit Health Translations to listen to a podcast about caring for the skin you're in in languages other than English.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.