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Acne is a skin condition that causes pimples to develop.  Acne is the most common skin disorder in North America, affecting an estimated 85% of adolescents.

Effective acne treatments are available to treat existing pimples and prevent new ones from developing.  In addition, cosmetic treatments can help to reduce scarring and changes in skin color caused by acne.

How Does Acne Develop?

There are 4 basic events involved in the development of acne lesions.

  1. Hair follicles become blocked with an overabundance of normal skin cells.  These cells combine with sebum (oily substance that lubricate the hair and skin), creating a plug in the follicle.
  2. The glands that produce sebum, known as sebaceous glands, enlarge during adolescence and sebum production increases. Numerous sebaceous glands are found on the face, neck, chest, upper back and upper arms. 
  3. The increase in sebum production allows for the overgrowth of a bacterium call Propionibacterim acnes that normally lives on the skin.
  4. Inflammation occurs as a result of bacterial overgrowth or other factors.  This can lead to the rupture of the follicle and the formation of a red or tender pimple.


  • Hormonal changes – hormonal changes during adolescence cause the sebaceous glands to become enlarge, and sebum production increases.
  • Less often, women’s hormone levels are affected by an underlying medical problem known as polycystic ovarian syndrome (PCOS)
  • External factors – oil-based cosmetics and greases in hair products may contribute to the development of acne/worsen skin lesions.  Water-based or “non-comedongenic” products are less likely to worsen acne.
  • Diet – the role of diet in acne is controversial.  Some studies have found associations between cow’s milk and increased risk of acne, perhaps because of hormones that occur naturally in milk.  However, there is no strong evidence that milk, high-fat foods, or chocolate increase the risk of acne
  • Stress – Psychological stress can probably worsen acne.  In several studies of students, acne severity appeared to worsen during times of increased stress.


There is no single best treatment for acne, and combinations of treatments are sometimes recommended.  Since acne lesions take 8 weeks to mature, you should use a treatment for a minimum of two to three months before deciding if the treatment is effective.

Acne skin care

Skin Hygiene – wash your face at least twice daily using a gentle non-soap facial skin cleanser.  Vigorous scrubbing can worsen acne and damage the skin surface

Moisturizers – use of a moisturizer minimizes dryness and skin peeling, which are common side effects of some acne treatments

Sun Protection – some acne treatments increase the skin’s sensitivity to sunlight (retinoids, doxycycline).  To minimize skin damage from the sun, avoid excessive sun exposure and use a sunscreen with SPF 30 or higher that is broad spectrum before sun exposure.

Topical Medical Treatments

  • Retinoids – topical retinoid mediations are often recommended for noninflammatory acne.  Examples include tretinoin (Retin-A, Atralin), adapalene (Differin, Epiduo) and tazorotene (tazarac, Fabior).  Skin irritation can be reduced by using every other day or less, then increase as tolerated over time.  Sunscreen is recommended when in use.
  • Benzoyl peroxide – it may be combined with topical retinoid or antibiotics. 
  • Topical antibiotics – control the growth of acne bacteria and reduce inflammation.  Topical antibiotics includes clindamycin, erythromycin, sulfacetamide and dapsone.

Oral Medications

  • Oral Antibiotics – work to slow the growth of acne-producing bacteria.  Doxycycline and minocycline are the most commonly prescribed oral antibiotics for acne.
  • Hormonal therapy – hormone estrogen can help to offset the effect of androgens (hormones responsible for acne development).  Spironolactone is a medication that can be used to treat acne in women.  Spironolactone reduces the effects of androgens.