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.
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