Acne is one of the most common condition of young patients come with to my clinic.

Acne is a skin condition Occurring due to blocking of the hair follicles with oil and dead skin cells. This results in the formation of whiteheads, blackheads, red pimples, pustular pimples and sometimes cysts and nodules. It usually affects the body parts rich oil glands like the face, forehead, chest, upper back and shoulders.
Acne is most common among teenagers and young adults, though it affects people of all ages.
Besides causing aesthetic disfigurement, acne can be a major reason for psychological distress too. Depending on its severity, it can cause anxiety, reduced self-esteem, and, in extreme cases, depression, or thoughts of suicide.
The earlier the treatment is started, the lower are the chances of complications.

What causes acne?

Acne is a chronic inflammatory disease affecting the pilosebaceous units.

Four main factors causing acne are:

  1. Excess oil production
  2. Clogging of hair follicles by oil and dead skin cells
  3. Bacteria
  4. Excess activity of androgen hormones

Acne typically appears on the areas which have maximum number of oil (sebaceous) glands like your face, forehead, chest, upper back and shoulders.

Hair follicles are connected to oil glands.

The follicle wall bulges forming a whitehead. If the opening of the hair follicle is big enough, the plugged sebum gets oxidised and turns black in colour, causing a blackhead.

Pimples are raised red spots with a white centre that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce larger cyst-like lumps beneath the surface of your skin.

Are there any risk factors that can predispose to acne breakouts?

Yes, definitely! Some of the conditions that can increase the chances of you getting acne are:

Family history - A definite role of genes has been shown in various research studies. So if your parents had acne, your chances to develop it too increase.

Age - acne is most common in teenagers.

Hormonal changes

Certain medications

Friction or pressure on your skin - due to telephones, cellphones, helmets, tight collars and backpacks, may also precipitate acne.

Stress - Stress make acne worse

How to identify that I have acne?

Whiteheads (closed plugged pores)

Blackheads (open plugged pores)

Small red, painful bumps (papules)

Pimples (pustules), which are bumps with pus at their tips

Large, painful lumps in the deeper part of the skin (nodules)

Pus-filled, painful lumps in the deeper part of the skin (cystic lesions)

What are the areas where I can develop acne?

Acne arise from the oil glands, so the areas rich in oil glands have a tendency to develop acne lesions. These include, your face, forehead, chest, upper back and shoulders.

What factors can worsen my acne?

The occurrence, recurrence and severity of acne can be influenced by your hormones, what food you eat, your stress level as well as certain medications.

These factors can trigger or aggravate acne:


  1. Androgens are hormones that increase during puberty and cause the sebaceous glands to enlarge and make more sebum.
  2. Hormonal changes associated with pregnancy.


  1. Dairy products and carbohydrate rich foods such as bread, bagels and chips have been shown to increase acne lesions.
  2. Foods with high glycemic index like sweets, chocolates, ice creams also worsen your acne.


Certain medications

  1. Drugs containing corticosteroids, testosterone or lithium can worsen your acne.
How can I get rid of acne?

Getting your acne treated is very important, not only because it is causing social embarrassment and cosmetic disfigurement, also because acne have a risk of scarring the skin. And once the skin is scarred, it can not be healed completely.
If you are suffering from acne issues, it is highly recommended that you consult a qualified dermatologist for its management as soon as possible. There are wide variety of treatment options available to treat acne. Your dermatologist will assess the severity of acne, and recommend the treatment accordingly.

A combination of different treatment modalities always gives you the best results.

The various treatment options include -

  1. Benzoyl peroxide
  2. Topical and oral antibiotics
  3. Topical and oral retinoids
  4. Hormonal therapy
  5. Chemical peels
  6. Microdermabrasion
  7. Photo facial
  8. Carbon facial
  9. Laser skin resurfacing for acne scars
What are the complications of acne?

If you are not taking treatment for your acne, then be ready to develop its complications as well!

Yes, complications due to acne most commonly occur when a person ignores acne as a normal physiological phenomenon thinking it will subside on its own with age and the skin will become perfect again. It does not happen that way. No mater how mild acne you have, you will develop its complications if you are not treating it early and actively.

The two most dreaded after effects of acne include -

  1. Pigmentation
  2. Acne scars
What are acne scars?

Acne scars are irregularities in the skin surface that are seen as holes or depressions. They can be of various types ranging from mild superficial rolling scars to deep box scars and ice pick scars.
Some people may also develop raised scars which are either hypertrophic scars or keloids.

How can I get rid of acne scars?

Acne scars can be improved by a combination of different therapeutic modalities like chemical peels, microdermabrasion, ablative and non-ablative laser skin resurfacing, dermal fillers, and surgical scar revision.

What kind of face wash should I use if I have acne?

People suffering from acne benefit from using face washes containing active ingredients like alpha hydroxy acids (AHA) and beta hydroxy acids (BHA). The most commonly used active agents are glycolic acid 1%, salicylic acid 1-2%, and benzoyl peroxide 4%.

The face should be washed at least twice a day, and if the skin is super oily, one may use the face wash up to four times a day.

Which is the best moisturiser for acne prone skin?

Yes, you read it right!
Although acne occur more commonly in oily skin, still moisturiser should be used on acne prone skin as well. There are many scientific studies showing benefit of a moisturiser in acne treatment.

An ideal moisturiser for acne prone skin should be non-comedogenic. So it should not be too greasy and occlusive. It should be gel based and easily absorbable.

Which is an ideal sunscreen for acne prone skin?

People with acne and especially those who are on some form of treatment for acne, do tend to have photo sensitivity, hence, using a sunscreen is very important.

For an acne prone skin, physical sunscreens with a minimum SPF of 30 are best suited, as they are broad spectrum and also do not react with the skin.

What precautions should I follow with respect to my diet?

The association between diet and acne is well established. Dairy products, carbohydrate rich foods, and foods with high glycemic index, have been shown to aggravate acne. So you should restrict or preferably avoid the intake of such food products.

What additional precautions should I follow?

You may follow the below mentioned precautions in case you develop acne -

  1. Avoid popping the acne lesions. It is a big NO NO! Popping of acne increases the risk of complications, so you should avoid picking the acne.
  2. Avoid using make up as much as possible. Any form of make up does cause clogging of pores, so make up usage should be limited to only when extremely necessary. More important, do not forget to remove your make up before sleeping.
  3. Do not leave oil in your hair and scalp overnight. While you sleep, there are chances that the oil gets transferred to your pillow over which your face is rubbing, and this clog the pores worsening the acne.
  4. If you have dandruff in the scalp, kindly get that treated too as dandruff increases the acne both on face as well as on body.
  5. Avoid vigorous scrubbing of the face. You may gently exfoliate your skin weekly once.

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