What you need to know
about acne

Who gets acne?


Severe recalcitrant nodular acne

Most teenagers, as many as 90%, will experience acne. But acne is not restricted to teenagers; it affects people of all ages and races.

Acne can remain a problem well into adulthood. In fact, as many as 40% of people treated for acne are older than age 25.

The causes of
acne

People have theories about what causes acne.
Many of them are simply not true.

Severe recalcitrant nodular acne
Severe recalcitrant nodular acne

Hormones play a role

During the early teenage years, the body begins to make more hormones. Some of these hormones, called androgens, cause oil glands in the skin to get bigger and make more oil, or sebum.

Severe recalcitrant nodular acne

Bacterial buildup

When pores become blocked with a combination of too much sebum and dead skin cells, bacteria start to build up. This causes the redness, swelling, and infection that we associate with acne lesions, which can range from mild to severe and cause scarring.

Severe recalcitrant nodular acne

Classifying acne

Acne is a continuous process and causes the eruption of new lesions over time. Acne is usually classified (mild, moderate, or severe) by the primary lesions present and the severity of those lesions.

Different types of
acne

Just as all people are not the same, acne itself is not the same in all people. The 2 main types of acne are noninflammatory and inflammatory.

Noninflammatory acne
Closed comedones (whiteheads) Open comedones (blackheads)

Noninflammatory acne

Noninflammatory acne consists of comedones. When pores are closed, these comedones are called whiteheads. Whiteheads stay below the surface of the skin, and the tops of the plugs are white. Open comedones are called blackheads.

Blackheads:

  • Occur when the pores open to the surface and the sebum inside turns brown or black
  • Are not dirt and can’t be washed away
  • Can last a long time
Inflammatory acne
Severe recalcitrant nodular acne

Inflammatory acne

A blackhead or whitehead can release its contents and heal, or it can rupture and cause inflammatory acne. Inflammatory acne causes the skin to look red and swollen. Ruptures can happen on their own or as a result of picking or touching the skin, which is why skin with acne should be left untouched. Inflammatory acne lesions are much more serious forms of acne and may be defined as

  • Papules
  • Pustules
  • Cysts
  • Nodules
Severe nodular acne
Severe recalcitrant nodular acne

Severe nodular acne

People with severe nodular acne, the type that may damage skin, usually have intense erythema (abnormal redness), inflammation, nodules (lumps), cysts (growths filled with fluid), and scars.

In more serious cases of acne, cysts and nodules may burst and damage nearby skin. There are many different treatments for acne, and your dermatology health care provider can help you decide which is best for you.


Ask your dermatology health care provider about treatment options that may be appropriate for you.

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Understanding Acne

Consequences of Acne >

Learn about physical and emotional consequences of severe acne and scarring

Treatment Options

Treatment Options >

Learn about acne treatments that can make a difference in your appearance.

Frequently Asked Questions

Frequently Asked
Questions >

Get the answers to questions you may have about acne and scarring.

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