Acne: Causes, Evidence-Based Treatments, and When to See a Dermatologist
Acne vulgaris is a common inflammatory skin condition involving clogged hair follicles, excess oil production, inflammation and the skin bacterium Cutibacterium acnes. It can affect teenagers and adults and may occur on the face, chest, shoulders and back.
Types of acne
- Blackheads and whiteheads
- Inflamed papules and pustules
- Deeper nodules or cyst-like lesions
What contributes to acne?
Hormones, genetics, oil production, follicular plugging and inflammation all play roles. Certain medicines and skin or hair products can also worsen acne. Acne is not caused by poor hygiene.
Evidence-based topical treatment
Current American Academy of Dermatology guidelines support treatments including benzoyl peroxide, topical retinoids, azelaic acid, salicylic acid, clascoterone and topical antibiotics in appropriate combinations.
Topical antibiotics are generally combined with benzoyl peroxide rather than used alone to reduce antibiotic resistance.
Oral treatment
Moderate-to-severe inflammatory acne may require oral treatment. Options can include doxycycline or other appropriate antibiotics, hormonal therapies such as combined oral contraceptives or spironolactone for selected patients, and isotretinoin for severe, scarring or treatment-resistant acne.
Do not rely on “acne cures”
Supplements, detox products and commercial programs should not be presented as proven cures for acne. Evidence for many home remedies is limited, and concentrated essential oils can irritate skin.
Diet and acne
Diet is not the sole cause of acne. Some evidence suggests that high-glycemic dietary patterns or certain foods may influence acne in some people, but dietary change should complement—not replace—appropriate skin treatment.
Skin-care basics
- Use a gentle cleanser rather than aggressive scrubbing.
- Choose non-comedogenic moisturizers and sunscreen.
- Avoid picking or squeezing lesions, which can increase scarring.
- Give treatments time to work; meaningful improvement often takes several weeks.
When to see a dermatologist
Seek professional care for painful nodules, scarring, persistent acne despite over-the-counter treatment, significant emotional distress, or acne associated with other hormonal symptoms.
Editorial sources
This article provides general education and does not replace individualized dermatology care.
