Acne and Pimples: Causes, Risk Factors and All the Current Treatments Available [2025]

Acne is a common skin condition, and it can happen anywhere on the skin. The most common sites include face and neck, shoulders, back and chest.
Acne can present in various ways.

Blackheads appear black due to the presence of hair follicle and are small black or yellow bumps that occur on the skin. These are not filled with dirt or pus.

Whiteheads look like blackheads and could be firmer. If these are squeezed, nothing usually comes out.

Papules are small red bumps that can be sore and tender.

Pustules are similar to papules with a white tip in the centre due to the presence of pus.

Nodules are large hard lumps that occur under the skin and can be painful.

Cysts are the most severe type of acne spots. These may appear similar to boils and are large pus-filled lumps. Cystic acne can lead to permanent scarring.

The exact cause of acne is not fully known, and it is commonly linked to hormonal changes during puberty, positive family history, and hormonal changes during menstrual cycle or pregnancy.

The hormonal changes can produce larger amounts of oil in the skin called sebum next to hair follicles, and this can lead to some bacteria in the skin to cause inflammation and pus.

The hormones also thicken the inner lining of the hair follicles, leading to blockage of the skin pores. This type of blockage cannot be removed by cleaning the skin.

Acne is most common in girls from the ages of 14 to 17, and in boys from the ages of 16 to 19. Acne often goes away when people reach their mid-20s. In some cases, acne can continue into adult life, and a small proportion of people can have acne over the age of 35.

There is no conclusive evidence to suggest that acne is caused by bad hygiene, diet or sexual activity. However, it is best to avoid any possible triggers or aggravating factors if known to play a role in causing acne.

Frequent face washing can irritate the skin further so it should be avoided. Lukewarm water rather than very hot or cold water should be used. It is best to use non-comedogenic facial products that are water-based rather than oil-based comedogenic products.

Acne spots or blackheads should not be squeezed or popped as this can cause scarring and infection.

There are various acne treatments that can be used to treat acne. These include benzoyl peroxide, Clearasil, Adapalene or Differin, Duac Gel and Zineryt.

Tretinoin, Clindamycin Gel or Dapsone Gel are among other treatments of acne.

Most of these treatments are available over the counter without a prescription. The general rule is to start with a mild treatment such as benzoyl peroxide and move on to a stronger treatment like tretinoin if necessary.

Epiduo Gel is a combination of Adapalene and benzoyl peroxide, and it can be an effective combination to treat more resistant acne. This is only available on prescription from a doctor.

Acnatac is another prescription only topical gel that can work well for acne, and it contains an antibiotic called clindamycin plus tretinoin.

If topical treatments do not work, the next step is to try an oral antibiotic such as lymecycline or doxycycline which generally work very well.

The last option is Accutane or Isotretinoin, and this is reserved for very severe acne that does not respond to conventional treatments. It is only prescribed by a dermatologist.

The other treatment options for acne are photodynamic therapy, comedone extractor to remove whiteheads and blackheads, or chemical peels.

If standard over the counter treatments do not work, it is advisable to see a doctor or dermatologist in person for further assessment.

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#acne vulgaris

#spots

#pimples

#skin pimples

#pustules and papules

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