Acne, one of the most common skin disorders, peaks in adolescence and early adulthood, affecting around 85% of people between the ages of 12 and 24. Though it is often thought of as a teenage problem, acne can occur in people of any age, though it grows less common as time goes on. Still, over 25% of women and 12% of men in their 40s report having acne.
“It’s a common misconception to think of acne as a teenage disease, ” says Yale Medicine dermatologist Christopher Bunick, MD, PhD. “One of the most common reasons adult women between the ages 20 of 40, for example, come to the dermatology clinic is for acne. Clinical trial data revealed that approximately 50% of women in their 20s, 33% of women in their 30s, and 25% of women in their 40s suffer from acne. The good news is there are many treatment options available to help.”
Acne is a category of skin complaints that includes pimples, blackheads, and whiteheads, which can appear on the face, back, and chest. Pimples that contain pus are known as pustules. Those without pus are called papules. Blackheads and whiteheads are together known as comedones.
Adolescent Acne Vulgaris: An Overview Of Therapeutic Options
Severe cases of acne can cause cysts and nodules to form under the skin and can result in scarring, which can be permanent.
Acne develops when hair follicles—the small, tube-shaped cavities near the surface of the skin from which tiny hairs grow—get clogged with oils, dead skin cells, and bacteria.
The oil comes from the sebaceous glands that are connected to the hair follicles under the skin surface. They secrete sebum, an oily substance that travels up the follicle to the surface, where it moisturizes the skin and hair.
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Sebaceous glands get their cues to produce sebum from hormones called androgens (one of which is testosterone). When puberty hits, the body increases the production of androgens, which can stimulate the sebaceous glands to produce excess sebum. The excess sebum, along with dead skin cells (which are formed as part of the normal skin cells cycle) clogs hair follicles. Other conditions that cause hormonal changes can trigger acne such as pregnancy, the menstrual cycle (including menopause), and certain medical disorders. Medications that affect hormonal levels, such as oral contraceptives for some women, can also cause acne to flare up.
The plugged hair follicles can form blackheads and whiteheads. If they become inflamed, red, raised pimples develop on the skin, or nodules or cysts may form under the skin.
Scientists are still working out why acne affects some people, but not others. In addition to fluctuations in the levels of androgens, other factors have been associated with acne:
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Acne most frequently occurs on the face, neck, shoulders, chest, and upper back. A person with this condition may notice any or all of the following:
While acne is mainly thought of as a skin problem that “only” affects one’s appearance, it often leads to social and mental health issues. People who have acne or the scarring that sometimes follows may be self-conscious, and because of this, may avoid social activities.
Doctors will usually begin by asking about your medical history. In particular, they may ask whether you have a family history of acne, take any medications that can affect hormone levels, or use skin care products that may clog hair follicles. Your doctor will also ask about your symptoms and when they began.
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A physical exam is essential for diagnosis of acne. Your doctor will look at affected areas of skin to determine the type and severity of acne.
Though a diagnosis of acne can usually be made on the basis of a medical history and physical exam, blood tests are sometimes helpful to measure the levels of hormones (such as testosterone) associated with acne.
Nearly everyone has experienced acne at some point in their lives, and for most, the outlook is excellent. In general, acne peaks during the teen years and usually clears up on its own in early adulthood. But some people continue to experience acne into adulthood.
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In moderate and severe cases, scarring can occur. Fortunately, many treatment options are available that can effectively alleviate symptoms and minimize or remove acne scars.
“Yale Medicine dermatologists work closely with each patient to tailor an acne care regimen optimized for their particular situation. No two patients are exactly alike, and here at Yale Medicine we strive to take the various factors outlined above, such as gender, age, type of acne, scarring, pigmentation, location of acne—face, chest, back, buttocks, etc.—and other medical conditions into account when we treat patients, ” says Dr. Bunick. “This holistic approach to treating acne enhances the doctor–patient relationship and leads to better treatment outcomes for our patients.”Author: Reviewed and updated by Dr Amanda Oakley Dermatologist, Hamilton, New Zealand; Vanessa Ngan, Staff Writer; and Clare Morrison, Copy Writer; June 2014.Skin of colour update: Dr Chelsea Jones, Dermatology Research Fellow, The Skin Hospital Westmead NSW, Australia; Dr Monisha Gupta, Dermatologist, Conjoint University of NSW and Western Sydney University, Sydney, NSW, Australia. July 2021
Acne vulgaris is the common form of acne, characterised by a mixed eruption of inflammatory and non-inflammatory skin lesions (see all the acne types).
Severe Acne Vulgaris
Nearly all of us have acne at some time or another. Acne affects both sexes and all races. Although acne mainly affects adolescents, it can affect a wide age range.
Acne most often affects the face, but it may spread to involve the neck, chest and back, and sometimes even more extensively over the body.
Individual lesions are centred on the pilosebaceous unit, ie the hair follicle and its associated oil gland. Several types of acne spots occur, often at the same time. They may be inflammatory papules, pustules and nodules; or non-inflamed comedones and pseudocysts.
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Individual acne lesions usually last less than 2 weeks but the deeper papules and nodules may persist for months. Many acne patients also have oily skin (seborrhoea ).
All characteristic lesions of acne vulgaris can occur in skin of colour, but it usually presents with less discernible redness and more postinflammatory hyperpigmentation (pigmented macules) which persists long after the acne lesion has gone. Post-inflammatory hyperpigmentation is often the major reason for seeking medical attention, causing significant psychological effects.
Pomade acne occurs more commonly in people with skin of colour due to cultural practices with hair styling products in African American and Hispanic populations. The use of greasy hair products leads to follicular plugging and comedones along the hairline.
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Some dermatologists assess the severity of a patient's acne more precisely by using a grading scale. The inflammatory lesions are compared with a set of standard photographs to determine the grade, which may be 1 (very mild) to 12 (exceptionally severe) for example.
In clinical trials evaluating acne treatment, the numbers of non-inflamed and inflamed lesions are carefully counted at regular intervals. It is remarkably difficult to count consistently.
Treatment for acne depends on the patient's age and sex, the extent and the severity of the acne, how long it has been present, and response to previous treatments.
Acne Vulgaris: Causes, Symptoms, And Effective Treatments
DermNet does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.Acne vulgaris, the medical term for common acne, can severely impact your self-perception and confidence, whether it’s a severe or mild outbreak. Covering it up with make-up or using the wrong types of treatments can make it worse. Because each case is unique and effective treatments vary, it’s important to get counseling from a dermatology specialist to determine the best acne treatment for your skin. At Dermatology Associates, we provide the highest quality of medical dermatology with personalized treatment plans, personable support, and state-of-the-art equipment. Whether your case is mild or severe, teenage acne or adult acne, we can help you clear up acne breakouts and manage future outbreaks. Schedule an acne appointment today and get the clear skin you’ve always wanted!
Acne can be separated into two types, inflammatory acne and non-inflammatory acne, though each type appears differently depending on how it’s formed and the affected body areas. Non-inflammatory acne is usually less severe and does not cause swelling or discomfort, while Inflammatory acne is typically more severe and can cause acne scars.
While acne is directly caused by an excess of oil, dead skin, and bacteria, different factors can cause or worsen acne, especially the production or sensitivity to the bacteria. This can include any of the following.
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There’s no magical cure for acne, no matter how much we may want it. In fact, acne treatment often comes down to trial and error of a combination of treatments to discover the right solution for your unique skin. Having the input of a skincare specialist can help you quickly determine what is and is not working for you. Common treatments include the following.
Discovering what triggers acne outbreaks for your body can be a long process but well worth it. In general, avoid skincare and make-up products that can cause clogged pores. Instead, look for labels that say “non-comedogenic” or “oil-free.” Watching what you eat and staying hydrated is also important. Regular exercise can also help combat stress, leading to
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