What causes acne?

There are three main causes of acne.

1. Overproduction of your skin's natural oil (sebum)
2. Clogged pores from dirt and debris of dead skin cells
3. Infection from bacteria in the oil (sebaceous) glands

What makes acne worse?

• Not washing your face gently twice a day
• Pinching pimples or scrubbing skin
• An unhealthy diet (junk food, greasy foods)
• Things that rub on the skin (headbands, hats, etc.)
• Certain cosmetics, creams or hair products containing oil
• Some medications, including birth control pills with higher doses of the hormone progesterone
• Hormones produced naturally during puberty
• For girls, increased hormones just before menstrual periods
• For boys, increased levels of testosterone
• Emotional stress and nervous tension

How can you avoid or treat acne?

Cleansing is an important part of avoiding and treating acne. To help prevent the oil buildup that can contribute to acne, wash your face twice a day with a mild soap or cleanser and warm water. 

Don't scrub your face hard with a washcloth – acne can't be scrubbed away, and scrubbing may actually make it worse by irritating the skin and pores. Try cleansing your face as gently as you can.

•  Use a mild cleanser, such as Cetaphil, or an acne cleanser – such as Aveeno Clear Complexion Foaming Cleanser, Neutrogena Acne Wash or PanOxyl Benzoyl Peroxide 4% Acne Creamy Wash.
• Exfoliating, which removes the layer of dead skin cells on the surface, is also important for healthy skin. After washing your face with a gentle cleanser, exfoliate with facial scrub one to two times a week. This can help reduce dead skin cells and debris that can clog pores and cause more acne.
• To avoid further clogging of your pores, use only cosmetics, lotions and sunscreens that are oil-free. To avoid overly dry skin, use an oil-free lotion. To avoid sunburn, use oil-free sunscreen. And remember to beware of hair products and gels because they tend to be very oily and can get on your skin. Use pore strips to remove clogs in pores, which lead to acne.
• Look for product labels that say "non-comedogenic," which means they won't clog pores. Hypoallergenic” is also good.

What kind of medicine works for acne?

Benzoyl peroxide is an ingredient that can be found in many over-the-counter (not prescribed by a doctor) acne medications. It kills bacteria that worsen acne, unplugs oil ducts and helps to heal acne pimples. 

When using benzoyl peroxide:

• Start conservatively, with 2.5% gel or lotion once a day (such as after you wash your face to go to bed).
• After one week, increase use to twice a day if you are not using another medication and the once-a-day application isn't helping.

If your acne isn't better after four to six weeks, try a 5% or 10% kind of benzoyl peroxide. 

Benzoyl peroxide is available over-the-counter (without a doctor's prescription). You may want to ask the pharmacist to direct you to the type that used to be available by prescription only.

What if acne doesn't go away?

If acne doesn't go away with cleansing and over-the-counter products, make an appointment to see your doctor. He or she may recommend that you see a dermatologist (skin specialist) or prescribe a medication to treat acne.

Youth reviewer: Bernice Kwan

Reviewed by: Nancy Brown, Ph.D.

Last reviewed: July 2019