Acne: What Causes it and How to Medically Treat it?

Acne is a skin condition that causes the development of whiteheads, blackheads, or pimples on the skin’s surface. Our skin has very tiny holes called pores and when these pores are blocked by oil (sebum), dirt, dead skin cells, and bacteria, one may develop acne.

The severity of acne can range from being mild like a few seasonal zits, or it could be moderate such as inflammatory pimples, or it could be severe in the form of cysts and nodules. No matter the severity of the acne, multiple factors play into why someone can have acne.

Luckily, there are now many effective medical treatments for acne. These treatments typically work to prevent acne from even forming in several different ways plus help reduce acne scarring. 

So let’s dive into the causes of acne and explore the most effective acne treatments!

What Causes Acne? 

Multiple factors cause acne.

Puberty

The first and most common is when our sebaceous glands (oil glands) become active at puberty. Oil or sebum is the natural substance our skin uses as a lubricant and a protective shield. However, when the hormonal balance is altered, or someone is hitting puberty, the tiny pores become clogged due to the excess buildup of oil underneath.  

The buildup of oil underneath the skin surface is due to any of the two reasons:

The accumulation of dead skin cells in pores
Bacteria buildup in pores

Bacteria are generally present over the surface of our skin because they are released by sebaceous glands. However, when they are accumulated, they start multiplying. This causes neighboring tissues to become inflamed. 

Inheritable

Almost all of us have some acne at some point in our life, but some get it earlier than others. In this case, they may have obtained this from their parents. However, the inherited acne condition is not typically as severe as what their parents experienced.

Diet

All over the world, doctors and dermatologists prohibit teens from the overconsumption of fast foods, overly processed foods, and foods with lots of sugar (pizza, chocolates, fried food, etc.) These junk foods don’t cause acne; however, they can worsen acne. Everything in moderation!

Dirt

People with oily skin may develop acne because of excessive sweating after exercise. The bacteria in the sweat start multiplying, and if one doesn’t take a shower after a workout, there is a 90% chance that the individual will develop acne. So important to wash your face at least twice a day!

Drugs

Drugs containing steroids may cause or worsen acne. Some specific medications have harmful chemicals, bromides, and iodides. These chemicals may also result in acne. So be mindful of what medications you are taking and take note of any effects they have on the skin.

Nicotine/Smoking

Smoking not only accelerates aging but can also cause acne. Some studies have found that women who smoke are more likely to get acne than others. A case study shows that the more a woman smokes, the more severe the acne gets. So put down the cigarettes and vapes, please!

Stress/Pressure

Hard to stay away from the stress and pressure of the modern-day world. Thankfully, stress doesn't cause acne (or we’d all be NOT okay!) but stress may worsen existing acne. According to research in 2018, stress and social pressure intensify the severity of acne. Make sure you are de-stressing when life allows you to or schedule relaxation time, not only your skin will thank you but your whole body will!

Environment

Some industrial employees have a considerable amount of exposure to skin irritants and industrial chemicals compared to employees that work desk jobs. These industrial chemicals may cause severe acne. So what are you doing to protect your skin every day from harsh environmental aggressors?

Apart from these, acne can also occur for the following reasons:

Hormonal imbalance during pregnancy

Overuse of cosmetics and their side effects
High humidity and excessive perspiration
Polycystic ovary syndrome (formation of multiple cysts in the ovary in women of childbearing age, cause various skin conditions)

Treatment of Acne

There are many treatments for acne out there which all usually fall into two categories, which are:

Medical treatments include anything your take orally or apply topically that is prescribed by a board-certified dermatologist.
Cosmetic treatments include services or products that don’t require prescriptions but have been clinically proven to help reduce acne.

To properly treat acne, one must know the type of acne they have. So seeking an expert opinion from a board-certified dermatologist is essential to your acne journey as they can support you in prescribing or recommending the best acne treatments suited for you and your skin.  

Medical Treatments for Moderate & Severe Acne

You have severe acne if you have painful nodules and many pores on your face, chest, and back. Moderate and severe acne often need prescription medications to be properly treated. The most effective prescription medicines are: 

Topical Retinoids
Topical Antibiotics

Azelaic acid
Antibiotic tablets
Accutane

These treatments will vary for each patient. Typically, these treatments take 2-3 months sometimes longer before they give results. 

Whichever treatment your dermatologist recommends, it’s essential to be patient and consistent with the medications!

Topical Retinoids

Topical retinoids work as an exfoliating agent. They remove dead skin cells, which prevent them from accumulating within the pores. 

The topical retinoids used to treat acne are Tretinoin and adapalene. They are readily available in gel and cream forms and their application is super feasible:

Apply gel/cream about 20 minutes after you wash your face at night
Apply on all the acne-affected areas
Apply sparingly, these topicals are high in concentration

You must wear sunscreen daily during this course of treatment

Retinoids are not recommended during pregnancy. As they can cause birth congenital disabilities defects. 

Side effects of Retinoids include: 

Mild irritation
Stinging of the skin
Skin dryness

Although these side effects cannot be totally avoided however it is helpful to start with the lowest concentration or mix with your moisturizer to lessen side effects. Retinoids are typically prescribed for six weeks, and after six weeks, you may be required to use this medication as needed.

Topical Antibiotics

Topical antibiotics help in the prevention of bacteria. These antibiotics kill bacteria on the skin’s surface and avoid their accumulation in its pores. 

The topical antibiotics are available in both lotion and gel form. The application must be once or twice a day. The treatment is usually for six weeks as well, however, can be extended to no more than eight weeks. 

After eight weeks, topical antibiotics can make the bacteria resistant to the medicine which can cause your acne to worsen. 

Side effects of topical antibiotics are

Mild irritation and burning of the skin.

Peeling of the skin. 
Redness of the skin.

Benzoyl Peroxide

Treatment with benzoyl peroxide involves killing bacteria present on the skin surface. Benzoyl peroxide is an antiseptic usually available as a cream or gel. 

Besides reducing the number of bacteria, benzoyl peroxide also reduces blackheads, whiteheads, is anti-inflammatory, and is easy to use:

Apply the gel or cream 20 minutes after you wash your face 
Apply on all the acne-affected areas
Apply sparingly

After application, avoid exposure to sunlight or UV rays and wear sunscreen

This treatment is also recommended as a six-week course.

The side effects of Benzoyl peroxide include

Mild redness, itching, and burning
Peeling of the skin 
Dry and rough skin

Benzoyl peroxide has bleaching properties. Avoid getting it on your clothes and especially your hair. 

Cosmetic Treatments For Acne

These treatments include:

Photodynamic Therapy: This is the most effective yet feasible and time-saving therapy. In this treatment, light is applied to the acne area to reduce the symptoms of acne. 

OMNILUX CLEAR is an FDA-cleared, dermatologist-recommended red and blue light therapy mask with clinically-proven results for acne. It reduces active acne, redness, and inflammation while reducing the appearance of acne scars and clearing breakouts faster!

Comedone Extractor: A small pen-like instrument used to clean out blackheads and whiteheads. Although the process looks easy, it’s best to leave these tools to licensed aestheticians to prevent scarring.

Chemical Peels: These treatments involve the application of a chemical solution to the affected area. The solution peels off the skin and allows new skin to generate. I love a good peel!

These types of treatments are not forever solutions but do help keep acne under control while on certain prescribed medicines. Always consult with your dermatologist before scheduling a cosmetic treatment when on prescriptions for acne.

Best Acne-Fighting Products 

EltaMD Foaming Cleanser: A gentle enzyme and amino acid cleanser that loosens makeup, oil, and other impurities on the skin and in the pores. The thick, rich foam gently lifts those impurities and rinses them away, leaving your skin feeling clean and balanced. Great for all skin types!

SkinCeuticals LHA Cleanser: Features a blend of salicylic acids to address breakouts and visible signs of aging. It delivers even exfoliation to unclog congested pores while removing excess oils and makeup. It’s paraben-, soap-, synthetic-fragrance-, dye- and alcohol-free. Suitable for oily, combination, and aging skin types!

SkinCeuticals Blemish Age + Defense: Reduces excess sebum production plus improves the appearance of blotchiness, blemishes, and uneven skin tone. It works to decongest clogged pores and helps diminish visible signs of aging. Ideal for acne-prone, oily, combination, and aging skin types!

Skinbetter AlphaRet Clearing Serum: Improves the clearness of your skin, pore size, radiance, and overall tone and texture with little-to-no dryness or flaking. Your skin will be smoother, healthier, and more even-looking!

EltaMD Skin Recovery System: This system is powered by proprietary AAComplex Technology, which helps to repair a damaged skin barrier, calms skin, and helps to minimize the risk of irritation. Each product also contains antioxidants to help defend against free radical damage.

Toner - A gentle essence toner with a malachite extract that helps to detox the skin. It delivers essential nutrients while improving the skin’s ability to absorb and maintain moisture.
Serum - Contains twice the concentration of the AAComplex Technology and should be applied before the Light Moisturizer.
Light Moisturizer - Helps repair damaged skin barrier, calms skin, and helps minimize the risk of irritation. Formulated with antioxidants to defend against free radical damage. Offers lightweight moisture and hydration. Is oil-free and pH-balanced.

Final Thoughts

Acne can be a stressful problem but it is treatable and you aren’t alone! Be patient with your skin it may take a few weeks or months, depending on the severity of your acne. My last few points of advice are: