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Almost all teens get acne. It happens when an oily substance called sebum clogs pores.

Pimples usually pop up on the face, neck, back, chest, and shoulders. Acne isn't a serious health risk, though severe acne can cause permanent scars. Acne can also damage self-esteem.

What Does Acne Look Like?

Acne can appear as one of the following:

Whiteheads: White dots that are pores impacted with oil and skin covered by skin layers.

Blackheads: Black bumps that are impacted pores in which material pushes out through the follicles. The black color is not from dirt. It may be from bacteria, dead skin cells, and matter that react with oxygen.

Papules, pustules or nodules: More serious lesions appearing red and swollen due to inflammation or infection of the tissue around the clogged follicles, which are often painful and feel hard.

Cysts: Deep, pus-filled pimples.

Why Do Some People Get Acne and Others Don't?

It is not clear why some people are more prone to acne than others.

The exact cause of acne is not known, but hormones called androgens can play a role. Androgens increase in both boys and girls during puberty. Androgens make the skin's oil glands get larger and make more sebum. Androgens also can increase because of hormonal changes related to pregnancy or starting or stopping birth control pills.

Genetics may also matter. If your parents had acne, you may have inherited that tendency.

Some medications (for example, epilepsy medication, prednisone, androgens taken as medicine, and lithium) can cause acne.

Cosmetics that have a greasy consistency may also clog pores. Water-based products are less likely to cause acne than oil-based makeup.

Other things that can make acne worse include:

  • Friction caused by leaning on or rubbing the skin; harsh scrubbing
  • Picking or squeezing blemishes
  • Pressure from bike helmets, backpacks, or tight collars
  • Changing hormone levels in adolescent girls and adult women two to seven days before the start of the menstrual period
  • Stress

How Is Acne Treated?

Dermatologists (doctors who specialize in skin problems) often treat acne, particularly in severe cases. Family or general practitioners, pediatricians, or internists can treat milder forms of acne.

Treatments may include:

Nonprescription ("over the counter") topical treatments: "Topical" means that you put these products on your skin. They're not pills. These include salicylic acid, benzoyl peroxide, and sulfur. These treatments are available in many forms including gels, lotions, creams, soaps, and pads. When these products are used regularly, they are moderately effective in treating acne. It may take 4-8 weeks for skin to improve. 

Prescription topical treatments: These include benzoyl peroxide, antibiotics, tretinoin, tazarotene, adapalene, dapsone, and azelaic acid.

Prescription oral drug treatments: For people with moderate to severe acne, doctors often prescribe oral antibiotics (pills) in addition to topical medication. Oral antibiotics are thought to help control acne by curbing the growth of bacteria, thereby decreasing inflammation. They are usually taken daily for four to six months and then tapered and discontinued as acne improves. The most potent oral drug, isotretinoin, is usually taken once or twice a day for 16 to 20 weeks. It is believed to reduce the size of the oil glands so that much less oil is produced and to help prevent clogged pores. That curbs the growth of acne-causing bacteria. Because of the risk of birth defects, women of childbearing age must not be pregnant and must not become pregnant while taking isotretinoin.

acne you can't see

Acne: You Don't Know the Half of It

We all know the side of acne you can see. But what about the acne you can't see?

dermatologists talk

Dermatologists Talk

"Even if your skin looks clear, there could be acne forming underneath your skin. We call this Unseen Acne."

- Dr. Lisa Chipps,
Beverly Hills Dermatologist

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