Everything You Need To Know About Acne

Medically Reviewed by Dr. K. on 10th October 2021.

What Is Acne (or Pimple)?

Acne (or pimples) is a chronic, inflammatory skin condition that causes spots and pimples, especially on the face, shoulders, back, neck, chest, and upper arms. A pimple outbreak affects almost everyone at some stage in their lives. It begins as greasy secretions from the skin's sebaceous glands (oil glands) obstruct the hair follicles' tiny openings (plugged pores). Clogs resemble blackheads in which the holes are large: tiny, smooth spots with dark centres. The clogs take the shape of whiteheads, which are thin, flesh-colored bumps if the holes remain small.

Swollen, tender inflammations or pimples, as well as deeper lumps or nodules, may result from all forms of blocked pores. Firm swellings under the skin's surface that become inflamed, tender, and sometimes infected are associated with serious cases of acne (cystic acne).

While acne is still predominantly associated with puberty, adults account for around 20% of all cases. Acne usually appears between the ages of 10 and 13, and it is more prevalent in individuals with dry skin. Acne in teenagers typically lasts five to ten years before clearing up in their early twenties. It affects both sexes, with teenage boys being the most serious cases. Mild to moderate variants are more common in women than men in their 30s and beyond.

The face is the most prominent site for acne lesions, but they can also appear on the abdomen, stomach, back, shoulders, and upper arms.

Acne isn't exacerbated by a bad diet, poor hygiene, or an out-of-control sex drive, contrary to common opinion. The fact of the matter is that certain forms of acne are caused by heredity and hormones. You can't alter your predisposition to this unsightly, often painful, and often embarrassing skin problem by giving up sweets or scrubbing your face 10 times a day.


What Causes Acne?

Acne is caused by a variety of factors that are unknown. While stress can aggravate acne, it does not appear to be the cause.

Hormones. Acne in adolescents is caused by a surge in hormone activity. Both boys and girls develop a lot of androgens, which are male sex hormones like testosterone, during puberty. Testosterone tells the body to develop more sebum, the oil released by the oil glands in the skin.

Bacteria. Excess sebum clogs hair follicle openings, especially on the face, neck, chest, and back. Bacteria thrive in clogged hair follicles. Blackheads or whiteheads, also known as “comedones," form on the skin's surface as a result of this. The clogging will also cause the follicle wall to break due to the strength of the buildup. This causes sebum to spill into surrounding tissues, forming a pustule or papule, which is known as inflammatory acne. Nodules are larger, more tender pustules.

Oral contraceptives can cause acne in some women while suppressing it in others, depending on the type of pill. Acne may be caused by certain injectable contraception and intrauterine birth control systems (IUDs). Some bodybuilders and other competitors use steroids, which may trigger serious outbreaks.

There are several different forms of acne. Acne neonatorum and acne infantum, which often affect boys, may affect newborns and babies. A pimply rash occurs on the forehead, which normally clears up after a few weeks with no long-term consequences. Acne infantum, on the other hand, will last longer, be more serious, and leave scars.

People who had almost no pimples during their adolescent years may experience adult-onset acne as they get older. Despite the fact that androgen levels rise naturally during puberty, some physicians claim that acne flare-ups are caused by how a person's skin reacts to a spike in sebum development or the bacteria that triggers acne. Propionibacterium acnes is a bacteria found in normal hair follicles. They can secrete enzymes that break down sebum and cause inflammation if too many of them accumulate in plugged follicles. Some individuals are inherently more susceptible to this reaction than others. Sebum levels that cause a few pimples in one person can cause widespread outbreaks — or even acute cystic acne — in another.

What are the Symptoms of Acne?

The symptoms of acne are:

  • Pimples are persistent, recurring red spots or swelling on the skin that may become inflamed and fill with pus. They more often occur on the forehead, chest, shoulders, spine, and upper back.
  • Dark spots in the middle of transparent pores (blackheads)
  • Tiny white bumps under the skin and no visible opening (whiteheads)
  • Papules are red swellings or lumps that are noticeably filled with pus.
  • Inflamed, fluid-filled, and often tender nodules or lumps under the skin; these nodules may develop to become an inch wide.

Call Your Doctor About Acne If:

  • You're unhappy or uncomfortable because of your acne.
  • Scars are forming as a result of acne.
  • Dark spots occur as a result of acne.
  • You have extreme acne with nodules under the skin and persistent pimples; a dermatologist can prescribe medication to manage the condition and prevent permanent scarring.
  • If over-the-counter treatments aren't working, you may need medical help.


Referenced on 2.3.2021:

  1. American Academy of Dermatology.
  2. The Merck Manual, Seventeenth Edition.
  3. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
  4. https://www.webmd.com/skin-problems-and-treatments/acne/understanding-acne-basics
  5. https://www.webmd.com/skin-problems-and-treatments/acne/understanding-acne-symptoms

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