Acne Vulgaris Causes, Symptoms, Treatment & Prevention

Overview

Acne, also called acne vulgaris, is a common, often long-lasting skin condition. It happens when oil (sebum) and dead skin cells clog hair follicles.

Typical features include blackheads or whiteheads, pimples, oily skin, and possible scarring. A plugged follicle can become inflamed, and bacteria that normally live on the skin, now called Cutibacterium acnes (formerly Propionibacterium acnes), can grow inside it.

Some medicines can cause acne or make it worse, including hormone-containing drugs, corticosteroids, and lithium. Certain seizure medicines and isoniazid have also been linked to acne-like breakouts.

Family history matters: you are more likely to get acne if your parents had it. Researchers are still studying the role of diet, and dirt is not a cause.

In both sexes, hormones called androgens rise during puberty and make oil glands larger and more active. That extra sebum is a key part of how acne forms.

Causes of Acne Vulgaris

It’s important to not blame yourself for acne vulgaris. Old familiar tales about greasy french fries, chocolate, or dirty skin causing acne are largely false. Instead, what’s happening is complex.

The oil glands attached to the hair follicles in your skin may be overactive, usually because of hormonal changes. Pores become clogged and inflammation follows.

This happens especially during puberty, which is why many teenagers have acne outbreaks. But acne can happen at any age. Some women also have breakouts just before their period, and certain birth control pills may help manage this; ask your clinician whether they suit you.

Signs and Symptoms Associated With Acne Vulgaris

Acne causes a range of lesions. The most common locations are the face, neck, chest, and back, where most of the oil glands are. The jawline is a common location in adults.

Whiteheads (closed comedones) are plugs that stay below the skin surface. Blackheads (open comedones) are plugs that are open to the air and look dark at the surface.

Papules are small pink to reddish-brown bumps, pustules are pus-filled lesions, and nodules or cysts are deeper, painful lumps. Inflamed skin can look red, warm, and swollen.

Types of Acne Vulgaris

1-Mild Acne

Mild acne vulgaris consists of a few papules, pustules, or comedones.

2- Moderate Acne

Moderate acne has a larger number of lesions.

3- Severe Acne

Severe acne has many comedones, papules, and pustules, and may include painful nodules. It can leave permanent scars, which may look like pits in the skin, or dark or red flat marks where the lesions were.

How Acne Vulgaris Can Be Diagnosed Clinically?

Acne vulgaris is diagnosed by a clinician who looks at your skin and asks about your history. The evaluation usually includes:

a detailed medical history, including how long you have had acne,
a review of medicines you take,
signs or symptoms of excess androgen hormones or other hormone problems.
Comedones (blackheads and whiteheads) are a hallmark of acne. When they are absent, an acne-like rash may point to a different skin condition.
Microcomedones (the earliest stage of blackheads and whiteheads) are too small to see without magnification.

Some features suggest that acne is sensitive to hormones. These include acne that starts or continues in adulthood, flares the week before a period, sits mostly along the jawline and chin, and includes deeper, inflamed lesions.

Treatment of Acne Vulgaris

Your doctor may suggest one treatment or a combination, depending on how severe your acne is. Mild acne can often be treated with over-the-counter creams, gels, and washes containing benzoyl peroxide or salicylic acid.

Benzoyl peroxide kills acne-causing bacteria and is found in many over-the-counter (OTC) washes and gels. Salicylic acid helps break down blackheads and whiteheads and is also common in OTC cleansers.

Retinoids are available over the counter (adapalene, sold as Differin) and by prescription. They help clear whiteheads and blackheads and prevent new clogged pores.

Moderate acne is often treated with oral antibiotics such as doxycycline or minocycline, usually combined with a topical treatment. Doctors limit how long oral antibiotics are used to lower the risk of antibiotic resistance.

Severe acne may be treated with antibiotics and topical medicine. If these don’t work, your doctor may suggest the oral drug isotretinoin (sold under brand names such as Zenatane).

Isotretinoin can cause serious birth defects, so in the U.S. it is only available through the iPLEDGE safety program. People who can become pregnant must use two forms of birth control, starting a month before treatment and continuing for a month after.

It can also affect mood and has other serious side effects, such as severe stomach pain. Ask your doctor about the pros and cons, and report mood changes right away.

Prevention From Acne

You can’t always prevent acne, but these habits can help keep breakouts under control:

Wash your face with a mild cleanser and lukewarm water in the morning, at night, and after heavy exercise
Skip harsh soaps, astringents, and rough scrub pads
Use sunscreen when you go out, since many acne medicines make skin more sensitive to the sun
Don’t squeeze, pinch, or pick pimples, which can cause scars or dark marks
Shampoo regularly, especially if your hair is oily
Use topical retinoids as directed by your dermatologist
Choose oil-free makeup and skin products labeled "noncomedogenic"
Eat a balanced diet with plenty of vegetables and fruits

See a dermatologist if OTC products don’t help after a few months, or if you have painful nodules or scarring.

HP Thoughts: Curious whether kratom does anything for breakouts? Read what we found in our post: Is Kratom Helpful In Treating Pimples?