Acne arises from plugged pilosebaceous units where sebum, keratinocytes, and Cutibacterium acnes trigger inflammation. Lesions range from comedones (whiteheads, blackheads) to inflamed papules and nodules. Current management combines topical retinoids and benzoyl peroxide, cautious use of antibiotics, hormonal options, and isotretinoin for severe acne, plus gentle skincare and individualized lifestyle measures.

What acne is and where it starts

Acne is a disorder of the pilosebaceous unit (PSU) - the hair follicle plus its attached sebaceous (oil) gland. PSUs cover most of the body but are densest on the face, chest, and upper back. The sebaceous glands make sebum, an oily substance that normally exits the follicle through a pore. Follicles are lined by keratin-producing skin cells (keratinocytes).

How plugs, bacteria, and inflammation cause pimples

When excess sebum and shed keratinocytes accumulate, they can form a plug that blocks the follicle. That plugged follicle is the basic lesion called a comedo. If the comedo stays below the skin it appears as a closed comedo (whitehead). If it opens to the surface it's an open comedo (blackhead); the dark appearance comes from oxidation of material in the pore, not dirt.

Bacteria normally present on skin - now classified as Cutibacterium acnes (formerly Propionibacterium acnes) - grow in blocked follicles. Their enzymes and byproducts, together with an immune response, trigger inflammation. Inflamed follicles may form red bumps, pustules, or larger nodules and cysts if the follicle wall breaks and spills contents into surrounding skin.

Types of acne lesions

  • Comedones: open (blackheads) and closed (whiteheads).
  • Inflammatory lesions: papules, pustules.
  • Nodules and cysts: deeper, often scarring.

Modern treatment approaches (overview)

Treatment depends on acne type and severity. Mild noninflammatory acne often responds to topical measures. Moderate to severe inflammatory acne commonly needs prescription therapy.

Topical options


  • Topical retinoids (adapalene is available OTC at low strength; tretinoin and stronger retinoids are prescription) normalize follicle cell turnover and help clear and prevent comedones.


  • Benzoyl peroxide reduces surface bacteria and inflammation; it can be combined with topical antibiotics to lower resistance risk.


  • Topical antibiotics reduce bacterial load and inflammation but should not be used alone for long periods because of antibiotic resistance concerns.


Systemic options

  • Oral antibiotics (doxycycline, minocycline) treat inflammation and bacterial overgrowth but are generally limited to short courses and used with topical benzoyl peroxide to reduce resistance.


  • Hormonal treatments (combined oral contraceptives, spironolactone) help many people with hormonally driven acne.


  • Oral isotretinoin treats severe, scarring, or treatment-resistant acne. It is highly effective but teratogenic and requires careful monitoring and pregnancy-prevention programs in the U.S.


Self-care and lifestyle
Use gentle, non-comedogenic skin-care products, cleanse twice daily, and avoid harsh scrubs that irritate skin. Dietary triggers vary by person; some evidence links high-glycemic diets and dairy to worsening acne in susceptible individuals.

If over-the-counter options fail or you have nodules, scarring, or emotional distress, see a dermatologist for tailored therapy and monitoring.

FAQs about Acne Problems

What causes a blackhead vs. a whitehead?
Both are comedones. A whitehead is a closed comedo trapped beneath the skin. A blackhead is an open comedo whose contents darken from oxidation when exposed to air, not from dirt.
Is the acne bacterium the same as it was called before?
Yes - the common acne-associated bacterium was reclassified and is now called Cutibacterium acnes (previously Propionibacterium acnes). It contributes to inflammation inside blocked follicles.
Can I use antibiotics for acne long-term?
Long-term antibiotic monotherapy is discouraged because of resistance risks. Dermatologists usually limit oral antibiotics to short courses and combine them with benzoyl peroxide or topical retinoids to reduce resistance and improve outcomes.
When is oral isotretinoin recommended?
Isotretinoin is used for severe, nodular, or scarring acne or acne that fails multiple other treatments. It is highly effective but carries serious reproductive and other risks and requires close medical monitoring.
Will changing my diet clear my acne?
Dietary effects vary. Some people see improvement when reducing high-glycemic foods or dairy, but evidence is mixed. Dietary changes may help some individuals but are not a guaranteed cure.

News about Acne Problems

How Bad Is Hard Water for Your Skin? We Asked the Pros - Real Simple [Visit Site | Read More]

LED face mask ads banned over acne and rosacea claims - The Independent [Visit Site | Read More]

Claimants handed disability benefits for acne and writer’s cramp - The Telegraph [Visit Site | Read More]

From digestive issues to hormone problems: 4 health conditions acne reveals - Times of India [Visit Site | Read More]

29 Perimenopause Symptoms You May Not Know About - Cleveland Clinic Health Essentials [Visit Site | Read More]

Best acne treatments and skincare products for tackling blemishes and breakouts - British GQ [Visit Site | Read More]

Dr. Jagdish Sakhiya Introduces Simple 4 Step Solution for Acne Problems - Ahmedabad Mirror [Visit Site | Read More]