Acne is a common skin condition that affects most people at some point. It causes spots, oily skin and sometimes skin that’s hot or painful to touch. No one knows exactly how long acne will last for each person. Many teens find that their acne improves as they get older and that it almost disappears by the time they reach their twenties. Others have acne well into their adult years.
Causes of acne
Acne is most commonly linked to changes in hormone levels during puberty but can start at any age. Certain hormones cause the grease-producing glands next to hair follicles in the skin to produce larger amounts of oil (abnormal sebum). This abnormal sebum changes the activity of a usually harmless skin bacterium called P. acnes, which becomes more aggressive and causes inflammation and pus. The hormones also thicken the inner lining of the hair follicle, causing blockage of the pores. Cleaning the skin does not help to remove this blockage.
Other possible causes
Acne is known to run in families. If both your mother and father had acne, it’s likely that you’ll also have acne. Hormonal changes, such as those that occur during the menstrual cycle or pregnancy, can also lead to episodes of acne in women. There’s no evidence that diet, poor hygiene or sexual activity play a role in acne.
At what age is acne affected?
Acne is very common in teenagers and younger adults. About 95% of people aged 11 to 30 are affected by acne to some extent. Acne is most common in girls from the ages of 14 to 17, and in boys from the ages of 16 to 19. Most people have acne on and off for several years before their symptoms start to improve as they get older. Acne often disappears when a person is in their mid-20s. In some cases, acne can continue into adult life. About 3% of adults have acne over the age of 35.
The following factors may increase your risk for developing acne:
- Hormones. An increase in androgens, which are male sex hormones, may lead to acne. These increase in both boys and girls normally during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy can also cause acne.
- Family history. Researchers believe that you may be more likely to get acne if your parents had acne.
- Medications. Certain medications, such as medications that contain hormones, corticosteroids, and lithium, can cause acne.
- Age. People of all ages can get acne, but it is more common in teens.
The following do not cause acne but may make it worse.
- Diet. Some studies show that eating certain foods may make acne worse. Researchers are continuing to study the role of diet as a cause of acne.
- Stress.
- Pressure from sports helmets, tight clothes, or backpacks.
- Environmental irritants, such as pollution and high humidity.
- Squeezing or picking at blemishes.
- Scrubbing your skin too hard.
Symptoms of acne.
Acne signs vary depending on the severity of your condition:
- Whiteheads (closed plugged pores)
- Blackheads (open plugged pores)
- Small red, tender bumps (papules)
- Pimples (pustules), which are papules with pus at their tips
- Large, solid, painful lumps under the skin (nodules)
- Painful, pus-filled lumps under the skin (cystic lesions)
Acne usually appears on the face, forehead, chest, upper back, and shoulders.
Types of Spot.
There are 6 main types of spots caused by acne:
- blackheads – small black or yellowish bumps that develop on the skin; they’re not filled with dirt, but are black because the inner lining of the hair follicle produces colour
- whiteheads – have a similar appearance to blackheads, but may be firmer and will not empty when squeezed
- papules – small red bumps that may feel tender or sore
- pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus
- nodules – large hard lumps that build up beneath the surface of the skin and can be painful
- cysts – the most severe type of spot caused by acne; they’re large pus-filled lumps that look similar to boils and carry the greatest risk of causing permanent scarring.
Self-help techniques you can try if you have acne.
These self-help techniques may be useful:
- Do not wash affected areas of skin more than twice a day. Frequent washing can irritate the skin and make symptoms worse.
- Wash the affected area with a mild soap or cleanser and lukewarm water. Very hot or cold water can make acne worse.
- Do not try to “clean out” blackheads or squeeze spots. This can make them worse and cause permanent scarring.
- Avoid make-up, skincare and suncare products that are oil-based (sometimes labeled “comedogenic”). Use water-based non-comedogenic products, as they’re less likely to block the pores in your skin.
- Completely remove make-up before going to bed.
- If dry skin is a problem, use a fragrance-free water-based emollient.
- Regular exercise cannot improve your acne, but it can boost your mood and improve your self-esteem. Shower as soon as possible once you finish exercising as sweat can irritate your acne.
- Wash your hair regularly and try to avoid letting your hair fall across your face.
Home treatment for acne.
Some of the most popular home remedies for acne involve natural herbal extracts, many of which traditional medicine practitioners may use. Below, we discuss the best home remedies for acne, what the research says, and lifestyle changes that can help. If an individual is interested in trying certain topical remedies, it is a good idea to talk with a dermatologist before applying the topical remedy directly to the skin, or do a patch test first, which consists of putting a small amount of the topical treatment on the wrist or hand to test for skin reactions. Along with home remedies, specific lifestyle changes can have a powerful effect on keeping the body healthy, making the skin less oily, and reducing acne flare-ups.
1. Tea tree oil
Tea tree oil is a natural antibacterial and anti-inflammatory, which means that it might kill P. acnes, the bacteria that causes acne. Tea tree oil’s anti-inflammatory properties mean that it can also help reduce the swelling and redness of pimples. A 2019 review study looked at the existing evidence for tea tree oil and acne. The researchers found that tea tree oil products can reduce the number of acne sores in people because of tea trees’ antimicrobial capabilities. This same review also noted research showing the total number of acne lesions of study participants was reduced from 23.7 to 10.7 after 8 weeks of using tea tree oil facial products.
How to use tea tree oil
People can apply tea tree extract to their acne in creams, gels, or essential oils. However, a 2016 review article points out that tea tree oil can cause allergic reactions in some individuals, and suggests people use tea tree oil products under 5%Trusted Source concentration to avoid skin irritation. Although research suggests that essential oils may have some health benefits, it is important to remember that the Food and Drug Administration (FDA) does not monitor or regulate the purity or quality of these. A person should talk with a healthcare professional before using essential oils, and they should be sure to research the quality of a brand’s products. A person should always do a patch test before trying a new essential oil.
2. Jojoba oil
Jojoba oil is a natural, waxy substance extracted from the seeds of the jojoba shrub.
The waxy substances in jojoba oil may help repair damaged skin, which may also help speed up wound healing, including acne lesions.
Some of the compounds in jojoba oil might help reduce skin inflammation, which may reduce redness and swell around pimples, whiteheads, and other inflamed lesions.
In a 2012 study, researchers gave 133 people clay face masks that contained jojoba oil. After 6 weeks of using the masks two to three times per week, people reported a 54% improvement in acne.
How to use jojoba oil
Try mixing jojoba essential oil with a gel, cream, or clay face mask and apply it to acne. Otherwise, place a few drops of jojoba oil on a cotton pad and rub this gently over acne sores.
3. Aloe vera
Aloe vera is a natural antibacterial and anti-inflammatory, meaning it may reduce the appearance of acne and prevent acne breakouts. Aloe vera contains sugar molecules, amino acids, and zinc, making it an excellent skin moisturizer and protectant. It is especially suitable for people who get dry skin from other anti-acne products. In a 2021 studyTrusted Source, researchers determined that the number of bumps, lesions, and dry skin lowered when using aloe vera combined with ultrasound and soft mask applications.
How to use aloe vera gel
An individual should clean acne sores and then apply a thin layer of cream or gel twice daily after cleansing with soap.
4. Honey
For thousands of years, honey has treated skin conditions because it contains many antioxidants that can help to clear clogged pores. However, while there is evidence that honey has specific antimicrobial effects, a 2016 reviewTrusted Source did not find strong evidence for honey’s effect on acne specifically.
How to use honey
Using a clean finger or cotton pad, rub a little honey into pimples. Otherwise, add honey to a face or body mask.
5. Zinc
With its anti-inflammatory properties, zinc is often touted as a method to reduce acne lesions and redness. According to a 2021 articleTrusted Source, research is conflicting on zinc’s effectiveness. However, a person can expect better results when applying the supplement directly to the skin. The reason is that when taken orally, some of the supplement gets broken down in the digestion process and may lose efficacy along the way.
How to use zinc
People can apply zinc topically onto the skin or take it via supplement form.
6. Green tea
Green tea contains high concentrations of a group of polyphenol antioxidants called catechins. Some people with acne have too much sebum, or natural body oils, in their pores and not enough antioxidants. Antioxidants help the body break down chemicals and waste products that can damage healthy cells. Green tea also contains compounds that may help to:
- reduce the skin’s sebum production
- reduce P. acnes
- reduce inflammation
How to use green tea
An individual can either drink green tea or put green tea extract on their skin, though researchers say current evidence is limited. However, one 2017 studyTrusted Source found a 79–89%Trusted Source reduction in whiteheads and blackheads after using a polyphenol green tea extract for 8 weeks. People can find green tea in most food stores. Green tea extract is more challenging to find but available from some health stores or online.
7. Echinacea
Echinacea, also known as purple coneflower, may contain compounds that help destroy viruses and bacteria, including P. acnes. Many people believe that echinacea can boost the immune system and reduce inflammation to fight off or prevent infections, including colds and flu. While there is some evidence that echinacea can help stop the spread of P. acnes and reverse inflammation caused by bacteria, current research is minimal.
How to use echinacea
People can apply echinacea creams to areas with acne lesions or take echinacea supplements. Echinacea products are available from health stores or online as creams or supplements.
8. Rosemary
Rosemary extract, or Rosmarinus officinalis, contains chemicals and compounds with antioxidant, antibacterial, and anti-inflammatory properties. Further research is needed to measure its effectiveness.However, a 2016 research article suggested that rosemary extract can reduce inflammation from the acne-causing bacteria P. acnes.
9. Purified bee venom
Although it’s not wildly available, purified bee venom contains antibacterial properties. In a 2016 studyTrusted Source, people who applied a gel containing purified bee venom to their face for 6 weeks saw a reduction of mild to moderate acne lesions. Though more research is needed, purified bee venom may be a beneficial future ingredient in acne medication.
10. Coconut oil
Like some other natural remedies listed, coconut oil contains anti-inflammatory and antibacterial compounds. These properties mean that coconut oil may help eradicate acne-causing bacteria and reduce the redness and swelling of pimples. Due to its soothing and moisturizing effectsTrusted Source, coconut oil may help speed up the healing of open acne sores. However, focused research on coconut oil as an acne deterrent is lacking.
How to use coconut oil
Try rubbing pure, virgin coconut oil directly into the area with acne. Look for coconut oil in the natural foods section of grocery stores or online.
11. Avoid touching pimples
It can be very tempting, but touching acne sores will irritate the skin, may make the pimple worse, and can spread pimples to other areas. Touching, rubbing, squeezing, or popping acne sores can also introduce more bacteria into the lesion, causing further infection. Squishing a pimple can push bacteria and debris further into the skin, so the spot may come back worse than it was before. Talk with a doctor about large sores or those deep under the skin to find out how to treat them safely.
12. Choosing the right cleanser
Many regular soaps have an acidity, or pH, that is too high and can irritate the skin, making acne worse. Choose mild cleansers, rinses, and washes to reduce the risk of acne flare-ups and let sores heal.
13. Using oil-free skin care
Oil-based or greasy products can block pores, increasing the risk of clogged and growing acne sores. Look for skin care products and cosmetics labeled as “oil-free” or “noncomedogenic,” which contain ingredients that allow pores to breathe.
14. Staying hydrated
When the skin is dry, it can become irritated or damaged, which can make acne worse. Staying hydrated also ensures new skin cells develop correctly as sores heal. There is no standard daily recommended water intake because each person’s water needs vary depending on age, how active they are, temperature, and any medical conditions. Making a concentrated effort to drink more water during the day is a good starting point.
15. Reducing stress
The American Academy of Dermatology lists stress as a possible cause of acne flare-ups. Stress causes levels of the hormone androgen to increase. Androgen stimulates hair follicles and oil glands in pores, increasing the risk of acne. Tips for managing stress include:
- talking with family, friends, a doctor, or other supportive people
- getting enough sleep
- eating a healthful, balanced diet
- exercising regularly
- limiting alcohol and caffeine consumption
- practicing deep breathing, yoga, mindfulness, or meditation
Seek medical advice if.
If self-care remedies don’t clear your acne, see your primary care doctor. He or she can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor who specializes in the skin (dermatologist or pediatric dermatologist). For many women, acne can persist for decades, with flares common a week before menstruation. This type of acne tends to clear up without treatment in women who use contraceptives. In older adults, a sudden onset of severe acne may signal an underlying disease requiring medical attention. The Food and Drug Administration (FDA) warns that some popular nonprescription acne lotions, cleansers, and other skin products can cause a serious reaction. This type of reaction is quite rare, so don’t confuse it with any redness, irritation, or itchiness that occurs in areas where you’ve applied medications or products. Seek emergency medical help if after using a skin product you experience:
- Faintness
- Difficulty breathing
- Swelling of the eyes, face, lips or tongue
- Tightness of the throat
Acne can persist into adulthood, but it usually improves significantly in one’s mid-20s. For some people, it can continue into their 30s, 40s, or even beyond. However, the severity and frequency of outbreaks typically decrease with age. It’s important to note that every person’s skin is unique and the timing and severity of acne can vary greatly from person to person. If good hygiene doesn’t help with breakouts, you can try an over-the-counter acne cream or gel. Be sure you follow the directions carefully and does not use it more than recommended. If your acne still doesn’t improve after several weeks, you may need some extra help from the family doctor or a dermatologist. A doctor can recommend the best treatment for you and also give lots of useful tips on dealing with acne.