Acne: Causes, Care, and When to See a Dermatologist

Acne results from clogged follicles, sebum, inflammation, and bacteria. Gentle cleansing, non-comedogenic moisturizers, sunscreen, and OTC treatments (benzoyl peroxide, salicylic acid, adapalene) help many people. Dermatologists can prescribe topical retinoids, antibiotics, hormonal options, or isotretinoin and offer procedures for scars. Early, tailored treatment reduces scarring risk.

What is acne?

Acne is a common inflammatory skin condition that most people experience at some point. It is particularly common in teens - affecting up to about 85% of adolescents - but many adults have persistent or late-onset acne.

What causes acne?

Acne develops when hair follicles (pores) become clogged by a mix of dead skin cells and sebum (skin oil). Three linked processes drive acne: increased sebum production, follicular hyperkeratinization (blocked follicles), and inflammation triggered in part by Cutibacterium acnes. Hormones and genetics play major roles. Certain factors can aggravate acne, including some medications, high-glycemic diets, dairy in some people, heavy or comedogenic cosmetics, stress, and friction or sweating.

Conditions that can look like acne

Several skin disorders mimic acne and need different care. Common look-alikes include:

• Rosacea

• Perioral dermatitis

• Keratosis pilaris

• Folliculitis

Basic acne care: cleansers, moisturizers, sunscreens

Start with gentle, non-abrasive cleansing once or twice daily. Avoid harsh scrubs or overwashing, which can irritate skin and worsen inflammation.

Choose non-comedogenic (won't clog pores) moisturizers to reduce dryness and tolerance issues when using active treatments. Look for ingredients like ceramides or hyaluronic acid.

Use a broad-spectrum, oil-free sunscreen (SPF 30 or higher). Physical (mineral) sunscreens with zinc oxide or titanium dioxide are often well tolerated under acne treatments.

Over-the-counter treatments

Effective OTC options include benzoyl peroxide (antibacterial, anti-inflammatory), salicylic acid (exfoliant that helps unclog pores), and topical adapalene 0.1% (a retinoid that normalizes follicular turnover). Introduce actives one at a time and use moisturizers to manage dryness.

Prescription and procedural options

If OTC care is insufficient, dermatologists offer topical retinoids, topical or oral antibiotics (used short-term and usually combined with benzoyl peroxide to limit resistance), hormonal therapies for people with menstrual-related acne (combined oral contraceptives or spironolactone), and oral isotretinoin for severe or scarring acne. Procedural treatments for persistent lesions or scars include chemical peels, laser and light therapies, microneedling, subcision, and fillers. Treatment choice depends on acne type, severity, patient goals, and safety considerations.

Scars and prevention

Treating active acne early and appropriately reduces the risk of scarring. When scars form, options vary by scar type: atrophic scars (depressed) respond to resurfacing procedures and fillers, while hypertrophic or keloid scars may need other approaches. A dermatologist can recommend the best plan.

When to see a dermatologist

See a dermatologist if acne is moderate to severe, is causing nodules or cysts, leaves scarring, or does not improve with consistent OTC care. Professional care can prevent permanent skin changes and tailor treatment to your needs.