Acne—How to Treat and Control It

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Got ZITS? You're not alone.

Almost all teens get zits at one time or another. It's called acne. Whether your case is mild or severe, there are things you can do to keep it under control. Read on to find out how.

What causes acne?

During puberty, your skin gets oilier. This can cause pimples. There are many myths about what causes acne, but there are really only 3 main causes.

  • Hormones. You get more of them during puberty. Certain hormones, called androgens, trigger the oil glands on the face, back, shoulders, and upper chest to begin producing more oil. This can cause acne in some people. Some girls get more pimples before and during their periods. This is caused by changes in the levels of hormones.

  • Heredity. Acne can run in families. If your mom or dad had severe acne as a teen, there may be a chance that you'll get it too.

  • Plugged oil ducts. Small whiteheads or blackheads can form when the oil ducts in your skin get plugged with oil and skin cells. They can turn into the hard and bumpy pimples of acne.

What doesn't cause acne?

Don't let people tell you it's your fault. It's not. Acne is not caused by

  • Dirt. That black stuff in a blackhead is not dirt. A chemical reaction in the oil duct turns it black. No matter how much you wash your face, you can still get acne.

  • Contact with people. You can't catch acne from or give acne to another person.

  • Your thoughts. Thinking about sex won't cause acne.

  • Food. Even though soft drinks, chocolate, and greasy foods aren't really good for you, they don't cause acne directly. There is some information suggesting a diet high in sugar and starch may worsen acne, however.

What you can do

  • Don't pop or pinch your zits. All this does is break open the lining of the oil ducts and make them more red and swollen. This can also cause scars.

  • Don't scrub your skin too hard—it irritates the skin. Other things that can irritate the skin are headbands, hats, chin straps, and other protective pads like football players use.

  • Don't use greasy makeup or oily hair products. These can block oil ducts and make acne worse.

  • Do learn how to handle stress. Sometimes stress and anxiety can cause pimples. Try to keep your stress down by getting enough sleep and having time to relax.

  • Do ask your doctor about medicines. If you have to take a prescription medicine, ask your doctor if it can cause pimples. Also ask your doctor what medicines would be best to treat your acne.

Acne and birth control pills

Birth control pills can be useful for treating young women with acne. However, taking birth control pills and other medicines may make both less effective. If you are on the Pill, talk with your doctor about how it might affect your acne.

Types of treatments

The bad news—There's no cure for acne. The good news—It usually clears up as you get older. In the meantime, there are a few things you can do to help keep those zits under control.

Benzoyl peroxide

Benzoyl peroxide wash, lotion, or gel—the most effective acne treatment you can get without a prescription. It helps kill bacteria in the skin, unplug oil ducts, and heal pimples. There are a lot of different brands and different strengths (2.25% up to 10%). The gel may dry out your skin and make it redder than the wash or lotion, so try the wash or lotion first.

How to use benzoyl peroxide

  • Start slowly—only once a day with a 5% wash or lotion. After a week, try using it twice a day (morning and night) if your skin isn't too red or isn't peeling.

  • Don't just dab it on top of your pimples. Apply a thin layer to the entire area where pimples may occur. Avoid the skin around your eyes.

  • If your acne isn't any better after 4 to 6 weeks, try a 10% lotion or gel. Use it once a day at first and then try twice a day if it doesn't irritate your skin.

Stronger treatments

  • Retinoid. If benzoyl peroxide doesn't get your zits under control, your doctor may prescribe a retinoid to be used on the skin (like Retin A, Differin, and other brand names). This comes in a cream or gel and helps unplug oil ducts. It must be used exactly as directed. Try to stay out of the sun (including tanning salons) when taking this medicine. Retinoids can cause your skin to peel and turn red.

  • Antibiotics, in cream, lotion, solution, or gel form, may be used for “inflammatory” acne (when you have red bumps or pus bumps). Antibiotics in pill form may be used if the treatments used on the skin don't help.

  • Isotretinoin (brand names are Accutane, Amnesteem, Sotret, and Claravis) is a very strong medicine taken as a pill. It's only used for severe acne that hasn't responded adequately to other treatments. Because it's such a powerful drug, it must never be taken just before or during pregnancy. There is a danger of severe or even fatal deformities to unborn babies. Patients who take this medicine must be carefully supervised by a doctor knowledgeable about its usage, such as a pediatric dermatologist or other expert in treating acne. Isotretinoin should be used cautiously (and only with careful monitoring by a dermatologist and psychiatrist) in patients with a history of depression. Don't be surprised if your doctor requires a negative pregnancy test, some blood tests, and a signed consent form before prescribing isotretinoin.


The following are things to keep in mind no matter what treatment you use:

  • Be patient. Give each treatment enough time to work. It may take 3 to 6 weeks or longer before you see a change and 12 weeks for maximum improvement.

  • Be faithful. Follow your program every day. Don't stop and start each time your skin changes. Not using it regularly is the most common reason why treatments fail.

  • Follow directions. Not using it correctly can result in treatment failure or troublesome side effects.

  • Only use your medicine. Doctors prescribe medicine specifically for particular patients. What's good for a friend may not be good for you.

  • Don't overdo it. Too much scrubbing makes skin worse. Too much benzoyl peroxide or topical retinoid creams can make your face red and scaly. Too much oral antibiotic may cause side effects.

  • Don't worry about what other people think. It's no fun having acne, and some people may say hurtful things about it. Try not to let it bother you. Most teens get some acne at some point. Also remember that acne is temporary, and there are a lot of treatment options to keep it under control.

The persons whose photographs are depicted in this publication are professional models. They have no relation to the issues discussed. Any characters they are portraying are fictional.

Products are mentioned for informational purposes only and do not imply an endorsement by the American Academy of Pediatrics.

Copyright © 2010, American Academy of Pediatrics. All Rights Reserved.

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