Skin Education

Skin Conditions

Understanding Acne: Causes, Types, and Treatment Options

Medically reviewed by Anna Heck, PA-C, MPAS, CAQ-Derm · 5 min read

Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually. Despite its prevalence, it remains one of the most misunderstood — and most undertreated — conditions in dermatology.

What Causes Acne?

Acne develops when hair follicles become clogged with oil (sebum) and dead skin cells. Several factors contribute:

  • Excess sebum production — often triggered by hormones
  • Clogged pores — dead skin cells that don't shed properly
  • Bacteria — *Cutibacterium acnes* (formerly *P. acnes*) thrives in clogged follicles and triggers inflammation
  • Inflammation — the immune response to bacteria causes the redness, swelling, and pain associated with acne

Types of Acne

Understanding the type of acne you have is the first step to effective treatment:

Non-inflammatory (comedones) - Whiteheads: closed clogged pores - Blackheads: open clogged pores (the dark color is oxidized melanin, not dirt)

Inflammatory - Papules: small red bumps - Pustules: papules with visible pus at the tip - Nodules: large, solid, painful lumps deep in the skin - Cysts: large, painful, pus-filled lesions that can cause scarring

What Doesn't Cause Acne

Several common myths persist:

  • Chocolate and greasy food — the evidence here is weak. Diet may play a role for some people (particularly dairy and high-glycemic foods), but it's not the primary driver for most.
  • Dirty skin — over-washing can actually make acne worse by irritating the skin and stripping moisture
  • Not washing your face enough — acne is driven by biology, not hygiene

Treatment Options

Treatment depends on the severity and type of acne:

Mild acne - Over-the-counter retinoids (adapalene), benzoyl peroxide, or salicylic acid - Consistent skincare routine

Moderate acne - Topical prescription retinoids or antibiotics - Combination products

Severe or cystic acne - Oral antibiotics (short-term) - Oral contraceptives (for hormonal acne in women) - Isotretinoin (Accutane) — the most effective option for severe cases - Cortisone injections for fast relief of painful cysts

When to See a Dermatology Professional

If over-the-counter products haven't improved your acne after 8–12 weeks, or if you're developing cysts or nodules that may scar, it's time to see a dermatology professional. Many patients spend years treating acne ineffectively before getting a proper diagnosis and prescription-strength treatment.

OnSpot dermatology professionals treat acne at our offices and mobile clinics throughout Florida. A 15-minute visit can get you on the right treatment plan.

Ready for a Skin Exam?

Education is the first step. Schedule your annual skin cancer screening with a OnSpot dermatology professional — in your community or at one of our offices.

Find an Appointment Call (941) 444-0011