by Scholten A
(Pimples; Blackheads; Whiteheads; Acne Vulgaris)


Acne is a common condition where small bumps form on the skin. The bumps are called blackheads, whiteheads, pimples, pustules, and cysts. They are most common on the face, neck, back, chest, and shoulders.


Acne is caused when pores in the skin are clogged with oil (called sebum) and dead skin cells.

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Blackheads are clogs that reach the skin's surface. Whiteheads are clogs that stay beneath the surface of the skin.

Bacteria can also become trapped in pores and cause an infection. This may cause small red bumps, pimples, and cysts.

Risk Factors

Acne is most common in teenagers. However, adults and children can have it too. Things that may raise the risk are:

  • Changes in hormone levels due to:
  • Emotional stress
  • Certain skin products
  • Sweating
  • Certain drugs such as:
    • Anabolic steroids
    • Drugs to treat epilepsy
    • Lithium
    • EGRF inhibitors—to treat cancer
  • Family history


Acne symptoms vary from person to person. They can range from mild to severe. Symptoms may be:

  • Excess oil in the skin
  • Blackheads—small black dots
  • Whiteheads—small, white, raised bumps
  • Papules—small, pink bumps that may be tender
  • Pimples—inflamed, pus-filled bumps that may have a red base
  • Nodules—large, painful, solid lumps deep in the skin
  • Cysts—deep, inflamed, pus-filled lumps that can cause pain and scarring


The doctor can make a diagnosis based on a physical exam. People with severe acne may need to see a skin doctor.


Treatment goals are to reduce the acne and treat infection. A combination of treatments works best. Options are:


Acne may be treated with:

  • Medicines to reduce oil and bacteria in pores, such as
    • Over-the-counter cleansers, creams, lotions, and gels
    • Prescription antibiotic or retinoid ointments
    • Antibiotics pills
  • Medicines to control certain hormone levels
  • Oral retinoids to reduce the size of oil glands—for severe cystic acne.


Procedures to treat acne may be:

  • Corticosteroid injections—mostly for large, cystic acne lesions
  • Acne surgery
  • Chemical peels—to loosen blackheads and reduce papules
  • Dermabrasion—to treat deep acne scars
  • Scar excision—to improve the appearance of acne scars
  • Collagen fillers—to make acne scars look smoother
  • Light and laser therapies

Skin Care

Good skin care can help reduce irritation of acne. This includes gentle washing and using skin products that do not clog the pores.


It can be hard to prevent acne. For some, reducing emotional stress may help.


American Skin Association 

American Academy of Dermatology 


Canadian Dermatology Association 


Acne. EBSCO DynaMed website. Available at: Accessed February 17, 2021.

Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: Accessed February 17, 2021.

Acne: overview. American Academy of Dermatology website. Available at: Accessed February 17, 2021.

Habeshian KA, Cohen BA. Current issues in the treatment of acne vulgaris. Pediatrics. 2020;145(Suppl 2):S225-S230.

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