Acne: What Causes It, How Is It Treated?

What causes acne?

There is no single cause for acne. The basic mechanisms are increased activity of the sebaceous glands, cell accumulation and blockage at the opening of the hair follicle, changes associated with Cutibacterium acnes, and inflammation. Genetic predisposition, hormonal factors, certain medications, and cosmetic products can also affect the condition.

Therefore, it is not correct to view acne solely as a "skin cleansing problem." Washing too frequently and aggressively can also irritate the skin, making the treatment process more difficult.

What does acne look like?

Acne doesn't look the same in everyone. Multiple types of lesions can be present in the same person.

• Comedones: These are lesions commonly known as blackheads and whiteheads.
• Papules and pustules: These are classic acne lesions that appear red, raised, and sometimes inflamed.
• Nodules and deep lesions: These may be larger, more painful, and deeper located. They carry a higher risk of scarring.

Acne doesn't have to be limited to the face. The back, shoulders, and chest can also frequently be affected.

Are adolescent acne and adult acne the same?

The underlying disease mechanism is similar; however, the distribution, triggers, and treatment plan may vary.

During adolescence, comedonal and inflammatory lesions may be more common on the forehead, nose, and cheeks. In adult women, lesions may be more prominent on the chin, jawline, and lower face; evaluation of hormonal factors may be important in some patients.

In adulthood, new onset acne or acne accompanied by symptoms such as menstrual irregularities or increased hair growth may require further evaluation.

Does acne leave scars?

Yes. Especially deep, inflammatory, and long-term uncontrolled acne can leave permanent scars.

Two different problems can occur after acne:

Color changes: Red or brown spots.

True acne scars: Depressions or, more rarely, raised areas on the skin.

Therefore, the goal of acne treatment is not just to clear existing pimples. Reducing the formation of new lesions and the risk of future scarring are also important aims of treatment.

Treating acne scars may require a separate dermocosmetic evaluation from treating active acne.

Is acne contagious?

No. Acne is not contagious. It is not contracted through contact with another person.

Although bacterial factors play a role in the development of acne, this does not mean that acne is contagious from person to person like an infection.

Should pimples be squeezed?

Usually not.

Squeezing or picking at pimples can increase inflammation, prolong healing time, and especially increase the risk of permanent scarring.

The habit of repeatedly squeezing pimples can become a significant problem for some patients.

Is there a link between diet and acne?

The relationship between diet and acne isn't as simple as "one single food causes acne.".

Current scientific data suggest a modest but significant association between high glycemic index and high glycemic load diets and acne. Studies on the relationship with dairy products are more heterogeneous; the effect may vary from population to population and from person to person.

Therefore, instead of giving all patients very strict lists of restrictions, a more appropriate approach is to recommend a balanced diet and to assess individual triggers.

How long does acne treatment take?

Acne treatment is generally not a process that lasts only a few days.

It may take weeks for topical treatments to show noticeable effects. Dryness, sensitivity, or temporary irritation may occur in the first few days. Therefore, premature discontinuation of treatment is a common problem.

When developing a treatment plan, the goal is not only to clear active acne but also to prevent the formation of new lesions and reduce the risk of recurrence.