How to Manage Acne: Causes, Treatments, and Practical Steps

Acne results from clogged follicles, excess sebum, bacteria, hormones, and other factors. Gentle cleansing, non-comedogenic products, and OTC treatments (benzoyl peroxide, salicylic acid, topical retinoids) help many people. For moderate to severe cases, a clinician can offer prescription topicals, oral antibiotics, hormonal options, or isotretinoin. Diet adjustments and stress reduction may help but usually aren't sufficient alone.

Why acne happens

Acne develops when hair follicles (pores) become clogged with oil (sebum) and dead skin cells, which can lead to inflammation and pimples. Hormones - especially androgens - increase sebum production, so acne commonly appears during puberty, menstrual cycles, and other hormonal changes. Genetics, certain medications, friction or pressure on the skin, and the skin bacteria Cutibacterium acnes all play roles.

Diet and allergy are often discussed in relation to acne. Current evidence links high-glycemic diets (refined carbs and sugary foods) and possibly dairy to worsening acne in some people. True food allergies rarely cause acne; elimination diets should be tried carefully and ideally with medical guidance.

Stress does not directly cause acne, but it can make existing acne worse by altering hormones and inflammation pathways.

Practical first steps you can take

• Use a gentle cleanser twice daily. Avoid scrubbing, which can irritate skin and worsen inflammation.

• Choose non-comedogenic, oil-free makeup and sunscreen.

• Try over-the-counter products: benzoyl peroxide and salicylic acid reduce bacteria and unclog pores. Topical retinoids (adapalene is available OTC in many countries) help normalize skin cell turnover.

• Do not pick or squeeze pimples - that increases the risk of scarring.

When to see a clinician

See a primary care clinician or dermatologist if acne is moderate-to-severe, painful, leaving marks, or not responding to OTC treatments after 6-12 weeks. A clinician can assess cause and recommend prescription options.

Medical treatments commonly used

• Topical therapies: prescription retinoids, benzoyl peroxide, and combination formulations. These are first-line for many cases.

• Oral antibiotics: for moderate inflammatory acne, usually for a limited time to reduce resistance risk.

• Hormonal therapy: combined oral contraceptives or spironolactone can help when androgens drive acne in people assigned female at birth.

• Oral isotretinoin: a highly effective option for severe or treatment-resistant acne; it requires specialist supervision because of potential side effects.

Lifestyle factors and realistic expectations

Improving diet (lowering high-glycemic foods and reducing skim milk for some people) and managing stress can help but rarely eliminate acne on their own. Many people need a combination of lifestyle changes and medical treatment. Clear results often take several weeks to months, so consistent care and follow-up matter.

If scarring or persistent inflammation develops, see a dermatologist early - treatments exist that reduce long-term scarring and improve outcomes.