Acne: Causes, Symptoms, and Treatment

What Is Acne?

Acne is a common skin condition that develops when hair follicles become clogged with oil and dead skin cells. It can present as blackheads, whiteheads, pimples, or cysts, and most often affects the face, chest, shoulders, and back. Acne is most common in teenagers but can affect people of all ages, including adults.

How Common Is Acne?

Acne is one of the most widespread skin conditions worldwide. Around 85% of people between the ages of 12 and 24 experience acne to some degree. In Australia, acne is one of the most frequent reasons people seek advice from a GP or dermatologist.

What Causes Acne?

Several factors contribute to the development of acne:

  • Excess oil production: Overactive sebaceous (oil) glands.

  • Clogged pores: Build-up of dead skin cells.

  • Bacteria: Propionibacterium acnes (now called Cutibacterium acnes) thrives in blocked pores and causes inflammation.

  • Hormones: Fluctuations during puberty, menstrual cycles, pregnancy, or from certain medications.

  • Lifestyle factors: Diet, stress, and skincare products may worsen symptoms in some individuals.

Symptoms and Types of Acne

The signs of acne vary in severity:

  • Mild: Blackheads and whiteheads.

  • Moderate: Papules (red bumps) and pustules (pimples with pus).

  • Severe: Nodules and cystic acne, which are deeper, painful, and more likely to scar.

Acne may also lead to post-inflammatory hyperpigmentation (dark marks) or long-term scarring if not treated.

How Is Acne Diagnosed?

Diagnosis is usually made during a physical skin examination by a GP or dermatologist. Blood tests or hormone tests may be ordered if acne is persistent or thought to be linked with hormonal conditions such as polycystic ovary syndrome (PCOS).

Treatment Options

Effective treatments are available, depending on severity:

  • Mild acne:

    • Over-the-counter creams or gels with benzoyl peroxide or salicylic acid.

    • Gentle, non-comedogenic skincare routines.

  • Moderate acne:

    • Prescription topical retinoids or antibiotics.

    • Combination treatments (topical + oral medicines).

  • Severe or persistent acne:

    • Oral antibiotics or hormonal treatments (such as the oral contraceptive pill in women).

    • Isotretinoin (a powerful oral retinoid), prescribed under specialist care.

What To Do If You Are Concerned

  • See your GP: If acne is painful, persistent, or affecting your confidence, your GP can discuss treatments tailored to your needs.

  • Act early: Early treatment reduces the risk of scarring.

  • Consider a referral: Dermatologists can provide advanced treatment if first-line options are not effective.

What Not To Do Until You Have a Diagnosis

  • Do not pick or squeeze pimples, as this can worsen inflammation and scarring.

  • Avoid harsh scrubbing or strong alcohol-based cleansers, which may irritate the skin further.

  • Do not rely solely on social media or unproven remedies. Some “natural” treatments can actually make acne worse.

Outlook

Acne is a treatable condition, and most people improve significantly with the right approach. While it can cause emotional stress and impact self-esteem, modern treatments are effective and can prevent long-term complications such as scarring.

References

  • Zaenglein AL, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 2023.

  • World Health Organization. Skin conditions overview.

  • Australian College of Dermatologists. Acne: Factsheet for patients.

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