What is acne?

Acne is the term used to describe the skin irritation, bumps and pustules that typically appear on the face, back, shoulders, chest and neck of both men and women, during and after puberty. Acne occurs when a hair follicle becomes blocked and oil (sebum) that would normally be secreted on to the skin stays under the surface. A bottleneck forms in the follicle, bacterium begins to grow, and a microcomedone is created.

A microcomedone is normally referred to as a “pimple” or “zit” and typically results in a white head or black head. White heads are small white slightly raised spots on the skin. They are created when the sebum from the hair follicle stays below the surface. A black head forms when the pore opens up to the surface and the skin pigment in the sebum turns brown or black. Given time and gentle skin care, a whitehead or blackhead will eventually fade on its own. If the skin is picked or scratched in that area, a more serious form of acne may develop in the form of a papule or pustule.

Types of Acne:

  • Whitehead
  • Blackhead
  • Papule
  • Pustule
  • Nodule
  • Cyst
  • Milia (“baby acne”)

Acne Symptoms

The symptoms of acne include visible whiteheads, blackheads, small colorless raised bumps on the skin, as well as red raised areas. These appear on the sites typically known for acne production including the face, chest, neck and back of both women and men.

Acne is classified in two groups, non-inflamed and inflamed.

Non-inflamed acne is characterized by whiteheads, blackheads, very tiny whiteheads known as milia (common on infants known as “baby acne”) and raised bumps on the skin creating an uneven surface.

Inflamed acne causes redness, inflammation and swelling leading to pustules, papules, and in severe cases, even cysts. Symptoms of inflamed acne can be uncomfortable including oozing of the lesions and possible scab formation.

Acne Causes

Acne is caused by blocked hair follicles. When skin cells and sebum (oil) are trapped in the blocked pore instead of being sloughed away, the trapped cells, oil and resulting bacteria growth cause the follicle to enlarge, creating a bump, also called a whitehead or blackhead. If the follicle wall ruptures and this material reaches the deeper layers of skin, inflammation occurs resulting in pustules, which are raised bumps seen on areas of the skin like the face, back, and shoulders.


Acne occurs more frequently during puberty and in adolescence because hormone release from the adrenal glands, ovaries and testes are at an all-time high. Hormones stimulate the glands to produce more sebum (oil) and as a result, the skin is more prone to breakouts.

Acne Treatment

There are a variety of methods to treat acne, like topical solutions and prescription medicines.

Over the counter products may be used to help prevent breakouts and clear up mild acne. Their primary goal is to dry up oil, promote sloughing of dead skin cells and kill bacteria. For mild acne use soaps and creams that contain a main ingredient of one or more of the following: benzoyl peroxide, sulfur, resorcinol and salicylic acid. Proactive is a popular name-brand OTC acne treatment.

Topical prescription medication may be needed to keep acne at bay and clear up acne that doesn’t respond to mild cleansers and OTC products. A physician or dermatologist may prescribe a topical retinoid or topical microbial for moderate to severe acne.

Topical Retinoids are derivative of vitamin A. Retinoids work by unclogging pores to prevent whiteheads and blackheads. Retinoids may cause skin irritation and increase sun sensitivity so it is important to follow directions carefully. An added benefit of retinoids is that they help reduce fine lines and wrinkles.

Retinoids include:

  • Adapalene (Brand name Differin)
  • Tazarotene (Brand name Tazorac, Avage and Zorac)
  • Tretinoin

Topical Antimicrobials are a type of topical medication that inhibits the growth of propionibacterium acnes (p. acnes), the bacteria located in the pores that feeds on the oil in the sebaceous glands. It can be used alone or in conjunction with other medications.

Antimicrobials include:

  • Azelaic acid
  • Benzoyl peroxide
  • Clindamycin
  • Erythromycin
  • Sodium sulfacetamide

Oral prescription medication may be prescribed to adults who suffer from severe and persistent acne. Oral prescriptions are designed for long term care. They work by reducing inflammation and like topical antimicrobials, lessen the production of p. acnes.

Oral prescriptions include:

  • Erythromycin
  • Tetracycline and derivatives
  • Derivatives of tetracycline: doxycycline and minocycline

Oral contraceptives, or birth control, have also known to be affective in clearing up acne in women. They work by suppressing overactive sebaceous glands.

Acne Holistic Treatment

Many people who suffer from acne but either cannot afford prescription medication nor want to risk the side effects may try these alternate treatments for acne recommended by doctors, nutritionists and even Chinese herbalists.

Herbal medicine

  • Black current seed oil or evening primrose oil
  • Lavender or chamomile tea (for stress-induced acne)
  • Chinese herbs including conidium seed and honeysuckle flower


  • Zinc (reduces inflammation)
  • Vitamin A (reduces sebum)
  • Vitamin E (antioxidant)
  • Vitamin B-6 (metabolizes hormones)


Some nutritionists believe eating a diet high in beta carotene including carrots, cantaloupe, pumpkin and other yellow/orange fruits and vegetables are helpful in preventing acne.

Acne Prevention

Aside from hormonal stimulation and pore blockage, there is no real known cause for the development of acne; therefore there is no surefire prevention method but you can take a few precautions to keep it at bay.

  • If you find a skin regimen that works, stick with it.
  • Wash acne prone areas with a gentle oil-free cleanser twice a day.
  • Avoid heavy foundation makeup by trading it in for powder foundation. If you must use cream foundation, choose water-based instead of an oil-based product.
  • Remove makeup before going to bed.

A healthy diet will also help maintain clear skin, especially by drinking plenty of water daily and consuming the recommended servings of fresh fruits and vegetables.

Acne Resources –

American Academy of Dermatology –