Source: Office on Women’s Health in the Department of Health and Human Services

Q. What is acne?

A. The most common form of acne is known as acne vulgaris, which means common acne. Most women will experience at least a few acne pimples over the course of their lives. Acne pimples form when oil glands make too much sebum, an oily substance. Sebum is made in much larger amounts during and right after puberty than at other times in a woman’s life. Sebum then blocks pores to form whiteheads, which form under the skin, and blackheads, which are open to the air. Blackheads are black because the air causes a chemical reaction with the oily debris inside, not because they are dirty. Yeast and bacteria in the skin cause whiteheads to become inflamed, making red, sometimes pus-filled pimples.

Because acne forms under the skin, washing away surface oils doesn’t do much to prevent or cure it. It is a myth that women get acne because they don’t wash enough. Gentle washing is important. But, too much washing can irritate the whiteheads and blackheads, causing them to be more infected and making more pimples. Pressure on the skin can make acne worse, by helping block the pores, so chin straps and headbands should be avoided. Hair spray can also block pores. Another myth is that certain foods cause acne. Greasy foods do not cause oily skin. Some medications can cause acne, although this is rare.

For some, acne can be a severe and emotionally difficult illness. As women grow out of adolescence however, acne vulgaris usually gets better. However, some women continue to have acne pimples for many years. Hormonal changes can cause acne after adolescence. For instance, many women experience acne during pregnancy. This usually gets better after the baby is delivered and hormonal levels go back to normal.

Q. Can adults get acne?

A. Yes! Many women are very upset when they first get acne pimples at age 30 or 40. Most adults who develop acne at an older age, rather than just continue to have the acne that they first experienced as teenagers, have a type of acne called acne rosacea, or "rosacea", as it is commonly known.

Acne rosacea causes redness, pimples, and telangiectasias, which look like broken blood vessels. Women with acne rosacea do not have the whiteheads and blackheads seen with common acne. Women with acne rosacea may experience flushing of their face, especially when they are hot, drink alcohol or hot drinks, or eat spicy foods. This flushing causes the face to appear red. Sometimes this redness becomes permanent.

Acne rosacea can usually be treated with antibiotic lotions or gels. The formulas used for these are often different than those used by young women with acne, because the skin of women with acne rosacea tends to be dry, not oily. Sometimes, antibiotic pills need to be taken. All these treatments require a prescription, so consult your health care provider if you think you have acne rosacea.

Q. What is the best treatment for acne?

A. There are many treatments for common acne. Many are mild with few side effects. Others cause dangerous side effects in some women. The trick is to use the mildest treatment that works for you.

Over-the-counter medications containing benzoyl peroxide help prevent whiteheads and blackheads from forming and kill the bacteria that cause pimples. They are good to treat mild acne.

For more severe cases, a health care provider can prescribe antibiotic lotions or gels, as well as retinoic acid, a Vitamin A derivative that helps prevent whiteheads and blackheads from forming. Antibiotic pills are also helpful. Some women break out mainly around their menstrual periods, so taking antibiotic pills right around that time monthly can help. Retinoic acid and antibiotic pills can sensitize skin to the sun, so it’s important to wear sunscreen and avoid the sun while using them.

For severe, scarring acne with large pimples called cysts, isotretinoin (Accutane ®) can be used. This is powerful medication that also causes severe birth defects. For this reason, it should only be used for severe acne when other treatments are not working. It should be prescribed and monitored by a knowledgeable health care provider. Side effects include dry eyes and mouth, and blood test abnormalities. Never take Accutane ® that was prescribed for someone else.

Q. I’ve heard that birth control pills are good for treating acne. Is this true?

A. Some birth control pills can make acne better. This is because the hormones in the pill can balance out the hormones that are causing the oily sebum, which causes acne. If you have other reasons to use the birth control pill, ask your health care provider about choosing a pill, which can also help your acne. Some women have hormonal imbalances in which the birth control pill might be the first choice to treat acne even if they don’t need it to prevent pregnancy. Talk it over with your health care provider.

For More Information…..

You can find out more about acne by contacting the following organizations:

American Academy of Dermatology

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Rosacea Society

Contributions to this FAQ on Acne: Iris Cantor – UCLA Women’s Health Center, a National Center of Excellence in Women’s Health sponsored by the Office on Women’s Health in the Department of Health and Human Services

All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women’s Health in the Department of Health and Human Services; citation of the source is appreciated.