Patient information: Acne (The Basics)
Written by the doctors and editors at UpToDate

What is acne?
— Acne is the medical term for pimples. Pimples happen when pores get clogged with dead skin and oil, and bacteria build up. Then the skin gets inflamed and can turn red or swell (picture 1).

Picture 1.

Is there anything I can do on my own to reduce acne?
— Yes. The way you take care of your skin has a big effect on your acne. Here’s what you should do:

●Wash your face no more than twice a day. Use warm — not hot — water, and do not use harsh soaps. Instead, use a gentle non-soap facial skin cleanser. Do not scrub your face, because that can make acne worse and damage the skin.
●Do not pick or squeeze pimples. This can make acne worse and damage the skin. Plus it can lead to infections.
●Avoid oil-based make-up and skin products. They can make acne worse. If you use a moisturizer for your face, a moisturizer labeled as “non-comedogenic” is often best.

Can I treat my own acne?
— If you have mild acne, you can try non-prescription acne products. You might even try using more than one product at once. That might be more effective than using one single product alone. In rare cases, people have a severe allergic reaction to acne products, so for the first 3 days, try them on just a small area. If you do not improve after 3 months, or if you have moderate or severe acne, ask your doctor or nurse for advice.

How is acne treated?
— Doctors can treat acne using different types of medicines. Sometimes doctors suggest trying more than one medicine at once.

There is no one medicine or combination of medicines that works best for everyone. Instead, people often need to try different medicines until they find what works best for them.

The prescription products include:

– Retinoids are medicines that help keep your pores unclogged. Most retinoids are available in a gel or cream that you put on your skin. Examples include tretinoin (brand name: Retin-A), adapalene (brand name: Differin), and tazarotene (brand name: Tazorac). These medicines can also help improve dark spots on the skin caused by acne.

●Products that help skin shed
– Products such salicylic acid and glycolic acid help remove dead layers of skin. They can reduce acne by helping to unclog pores.

●Antibiotics you put on the skin
– Antibiotics reduce acne by killing the bacteria inside pimples. They also help bring down inflammation. These medicines include erythromycin, clindamycin, dapsone (brand name: Aczone), and others.

●Azelaic acid
– Azelaic acid helps keep pores unclogged and can kill bacteria in pimples. Azelaic acid can also help to improve dark spots on the skin caused by acne.

●Benzoyl peroxide
– Benzoyl peroxide kills bacteria and helps to unclog pores. Benzoyl peroxide is also available without a prescription.

●Antibiotics you take in a pill
– Antibiotic pills work for the same reasons antibiotic gels or lotions work. But they tend to be stronger and can cause unpleasant side effects.

●Birth control pills
– Some of the skin reactions that lead to acne are controlled by hormones. For this reason, birth control pills can sometimes help with acne.

●Isotretinoin pills (sample brand names: Amnesteem, Absorica, Claravis, Sotret)
– One of the retinoid medicines comes in pill form. This medicine, called isotretinoin, is very effective against severe acne. But it can also cause serious side effects and birth defects. Women who want to take isotretinoin must follow very strict safety rules to avoid pregnancy. (This medicine used to be sold under the brand name Accutane, but that brand name is no longer available in the US.)

What if I want to get pregnant?
— If you want to get pregnant, talk to your doctor before you start trying to get pregnant. Many of the medicines used to treat acne are not safe for a growing baby.

Will my diet affect my acne?
— Some studies have found that acne seems to be more common in people who drink a lot of milk. But more research is needed to understand the link between the types of foods people eat and acne.

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