Acne

Isotretinoin Treatment for Severe Acne Cases

Overview

Definition

Acne is a common condition where small bumps form on the skin. The bumps are called blackheads, whiteheads, pimples, pustules, and cysts. They are most common on the face, neck, back, chest, and shoulders.

Causes

Acne is caused when pores in the skin are clogged with oil (called sebum) and dead skin cells.

Pimple
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Blackheads are clogs that reach the skin's surface. Whiteheads are clogs that stay beneath the surface of the skin.

Bacteria can also become trapped in pores and cause an infection. This may cause small red bumps, pimples, and cysts.

Risk Factors

Acne is most common in teenagers. However, adults and children can have it too. Things that may raise the risk are:

  • Changes in hormone levels due to:
    • Puberty
    • Pregnancy
    • The time before a menstrual period
    • Polycystic ovarian syndrome (PCOS)
  • Emotional stress
  • Certain skin products
  • Sweating
  • Certain drugs such as:
    • Anabolic steroids
    • Drugs to treat epilepsy
    • Lithium
    • EGRF inhibitors—to treat cancer
  • Family history

SymptomsandDiagnosis

Symptoms

Acne symptoms vary from person to person. They can range from mild to severe. Symptoms may be:

  • Excess oil in the skin
  • Blackheads—small black dots
  • Whiteheads—small, white, raised bumps
  • Papules—small, pink bumps that may be tender
  • Pimples—inflamed, pus-filled bumps that may have a red base
  • Nodules—large, painful, solid lumps deep in the skin
  • Cysts—deep, inflamed, pus-filled lumps that can cause pain and scarring

Diagnosis

The doctor can make a diagnosis based on a physical exam. People with severe acne may need to see a skin doctor.

Treatments

Treatment

Treatment goals are to reduce the acne and treat infection. A combination of treatments works best. Options are:

Medications

Acne may be treated with:

  • Medicines to reduce oil and bacteria in pores, such as
    • Over-the-counter cleansers, creams, lotions, and gels
    • Prescription antibiotic or retinoid ointments
    • Antibiotics pills
  • Medicines to control certain hormone levels
  • Oral retinoids to reduce the size of oil glands—for severe cystic acne.

Procedures

Procedures to treat acne may be:

  • Corticosteroid injections—mostly for large, cystic acne lesions
  • Acne surgery
  • Chemical peels—to loosen blackheads and reduce papules
  • Dermabrasion—to treat deep acne scars
  • Scar excision—to improve the appearance of acne scars
  • Collagen fillers—to make acne scars look smoother
  • Light and laser therapies

Skin Care

Good skin care can help reduce irritation of acne. This includes gentle washing and using skin products that do not clog the pores.

Prevention

It can be hard to prevent acne. For some, reducing emotional stress may help.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Pimples; Blackheads; Whiteheads; Acne Vulgaris)

RESOURCES

American Skin Association https://www.americanskin.org 

American Academy of Dermatology https://www.aad.org 

CANADIAN RESOURCES

Canadian Dermatology Association https://www.dermatology.ca 

Dermatologists.ca http://dermatologists.ca 

References

Acne. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acne. Accessed February 17, 2021.

Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/health-topics/acne. Accessed February 17, 2021.

Acne: overview. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/acne-and-rosacea/acne. Accessed February 17, 2021.

Habeshian KA, Cohen BA. Current issues in the treatment of acne vulgaris. Pediatrics. 2020;145(Suppl 2):S225-S230.