What Causes Acne?
And more importantly, how do I get rid of it?

All types of acne — blackheads, whiteheads, pimples, and cysts — develop when pores in our skin become clogged. The culprit is sebum [see-bum], an oil in our skin. Our bodies make more sebum when our hormones surge. This is why teens get acne. This is why women often breakout before their periods. Since hormones fluctuate in the years leading up to menopause, many women in their 40s and 50s get acne.

Why do people get different types of acne?
What happens inside the clogged pore determines the type of acne we see.

A blackhead appears when sebum and dead skin cells clog the pore. While the pore is clogged, its surface remains open. This lets us look into the pore and see a black color. Your dermatologist may call a blackhead an “open comedo” (co-me-dough).

A whitehead forms when the excess oil and dead skin cells clog the pore and block the opening of the pore. Because the pore closes, dermatologists call this type of acne a “closed comedo.”

Where we get acne


face and chest

upper back  

Acne develops where we have the most sebaceous glands. These glands make sebum and are found in the greatest number on our face, neck, chest, back, shoulders, and upper arms.

The excess oil does more than clog pores. Bacteria that normally live on our skin, P. acnes, thrive in this excess oil. Immersed in excess oil, the bacteria can rapidly increase in number. As the bacteria multiply in a clogged pore, the pore becomes inflamed. Inflammation is what causes a pimple to look red, hot, and swollen.

When inflammation reaches deep into the skin, an acne cyst forms. This is the most severe type of acne. Cysts can be very painful. People often see permanent scarring after this type of acne heals.

acne on back

This 14-year-old boy has acne and acne scars on his upper back and shoulders. Getting the acne under control can prevent more scarring.

(Photo used with permission of the American Academy of Dermatology
National Library of Dermatologic Teaching Slides)

Getting Rid of Acne
Thanks to advances in medicine, today, virtually every case of acne can be controlled. Many people with mild acne can see clear skin with good skin care and acne products available without a prescription. However, this won’t control everyone’s acne. Sometimes acne control requires a dermatologist’s help. Even severe acne can be successfully controlled with treatment from a dermatologist.

While treating acne may seem unimportant, research shows treatment has value. Treating acne can prevent additional breakouts and scars. It can improve a person’s quality of life. People living with acne can suffer from low self-esteem, anxiety, and depression. Acne can even discourage people from pursuing life's dreams. When acne is under control, a person’s confidence grows. Anxiety and depression diminish.

More Information
Acne Can Change the Way You See the World
Acne Treatment
Skin Care for Acne-prone Skin

Leyden JJ. “A review of the use of combination therapies for the treatment of acne vulgaris.” Journal of the American Academy of Dermatology September 2003; 49: S200-10.

Zaenglein AL, Graber, EM, Thiboutot DM, et al. “Acne Vulgaris and Acneiform Eruptions.” In: Wolff K, et al. editors. Fitzpatrick’s Dermatology in General Medicine. United States. McGraw Hill Medical; 2008. p. 690-3.

All content solely developed by the American Academy of Dermatology

blackheads and pimples
Squeezing, popping, and picking at acne can lead to infection and scarring. To learn what dermatologists recommend, visit:

What Can Help Clear Acne (slideshow)


(Photo used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides)





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Page last updated 4/14/10

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