Section One

Common Health Problems

Acne

“Zits are the pits! I was hoping that by the time I got to college, my pimples would be gone. They weren’t. I went to a dermatologist and did what he said. It’s easier to look in the mirror now.”
– Sally J., Valparaiso University

Acne is a common skin condition. It occurs most often in teenagers and young adults, but can persist into adulthood.

illustration of the three stages of a pimple

Signs & Symptoms

The following occur on the face, neck, back, and/or shoulders:

  • Whiteheads and/or blackheads.
  • Red and painful pimples.
  • Deeper lumps (cysts or nodules).

Causes & Risk Factors

Acne results when oil ducts below the skin get clogged. Factors that help cause acne include:

  • Hormone changes during adolescence.
  • Changes in hormone levels before a female’s menstrual period or during pregnancy.
  • Rich moisturizing lotions or oily makeup.
  • Emotional stress.
  • Nutritional supplements that have iodine.
  • Some anticonvulsive medications (for seizures) and lithium (used to treat some forms of depression).
  • Illegal (anabolic) steroids (used for muscle-building).

Foods and beverages, such as chocolate, nuts, greasy foods, and cola do not cause acne. If you find that eating certain foods make your acne worse, avoid them.

Treatment

Mild acne can be treated with self-care (see below). When this is not enough, a health care provider can prescribe one or more of the following:

  • A topical cream medicine (retinoid) that contains an altered form of Vitamin A, such as Retin-A. {Note: Retin-A makes your skin more sensitive to the sun.}
  • A topical cream, lotion, or wipe with an antibiotic, such as clindamycin or erythromycin.
  • A topical gel with dapsone. A brand name is Aczone Gel 5%.
  • An antibiotic pill, such as minocycline or tetracycline. {Note: These medicines can make birth control pills less effective and make your skin more sensitive to the sun.}
  • For some females, a specific birth control pill.
  • Isotretinoin. Brand names are Accutane Amnesteem, Claravis, and Sotret. This is usually prescribed for severe acne. {Note: Discuss this medicine with your health care provider. Females should not get pregnant while they take this medicine and for at least 1 month after stopping it, as it can cause severe birth defects. There is some evidence that pregnant females should avoid contact with sperm from males who take isotretinoin. Also, this medicine may cause depression, psychosis, and rarely, suicidal thoughts, suicide attempts, and suicide.}

Are you taking the medicine isotretinoin and are you planning suicide, making suicidal gestures, or do you have repeated thoughts of suicide or death?

if yes, get immediate care
if no, proceed to next question

Is your acne very bad and do you have signs of an infection, such as a fever and swelling at the acne site?

if yes, see provider
if no, proceed to next question

Do you have any of these problems?

  • The acne results in scarring.
  • The pimples are big and painful or widespread.
  • The acne causes a lot of emotional embarrassment.
if yes, call provider
if no, proceed to next question

Have you tried self-care and it doesn’t help or does it make your skin worse?

if yes,call provider
if no, use self care

Self-Care

photo of smiling student with healthy skin
  • Gently wash your skin, where the acne appears, twice a day. Use a mild soap and clean washcloth. Work the soap into your skin gently for 1 to 2 minutes. Rinse well. Don’t scrub.
  • Wash after you exercise or sweat.
  • Wash your hair at least every other day.
  • For males: To soften your beard, wrap a warm towel around your face before you shave. Shave along the natural grain of the beard.
  • Leave your skin alone! Don’t squeeze, scratch, or poke at pimples. They can get infected and leave scars.
  • Use an over-the-counter lotion or cream that has benzoyl peroxide. (Some people are allergic to benzoyl peroxide. Try a little on your arm first to make sure it doesn’t hurt your skin.) Follow the directions as listed.
  • Don’t spend too much time in the sun, especially if you take antibiotics for acne. Don’t use sun lamps.
  • Use only oil-free and water-based makeup. Don’t use greasy or oil-based creams, lotions, or makeup.
  • If you take an antibiotic for acne treatment and get signs of a vaginal yeast infection, use “Self-Care For a Vaginal Yeast Infection.”

For more information, contact:

American Academy of Dermatology  |  888.462.DERM (462.3376)  |  www.aad.org