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Am Fam Physician. 2000;61(2):366

See related article on acne.

What is acne?

Acne causes skin blemishes called “pimples”. If acne is bad, pimples can be large and painful.

What causes acne?

Acne often begins in your teenage years, when your skin makes too much oil. You're more likely to have pimples on your face, chest and back. These areas contain many oil glands.

If your skin has too much oil and your pores become blocked, bacteria (germs) grow more easily. The bacteria cause red, swollen pimples.

Some medicines can also cause pimples. If you're worried about what a medicine might do to your skin, talk to your doctor.

Dirty skin and foods like chocolate, pizza or soda do not cause pimples. Masturbating or thinking about sex does not cause pimples either.

What can I do about my pimples?

Wash your face twice a day with a mild soap and warm water. Don't scrub your skin or use harsh soap. Washing too hard can make your pimples worse.

Don't pick or squeeze your pimples. This can also make them worse.

Don't use oil-based make-up, hair products or suntan lotions. If you wear make-up, use products that are water-based or that have the word “non-comedogenic” on the label. This means that they don't cause acne or make it worse.

Over-the-counter medicines for pimples can be helpful. Acne medicine might irritate your skin or make it too dry. If your skin doesn't get better after you have used a medicine for a few weeks, see your family doctor.

What can my doctor do about acne?

Instead of an over-the-counter medicine, you might need prescription medicines like stronger benzoyl peroxide, topical antibiotics and products related to vitamin A. With any medicine, it will take 4 to 6 weeks for your skin to get better. Some medicines may seem to make your acne a little worse before it gets better.

If you have oily skin, the gel or liquid medicines may be the best for you. They tend to dry your skin out. If you have dry skin, a cream medicine may be better for you.

Benzoyl peroxide can stain your clothing or bed sheets, so put it on in the morning after you get dressed. If you need to use it twice a day, put it on again right after your evening meal.

If you use the benzoyl peroxide and erythromycin combination (brand name: Benzamycin), you have to mix the two products together yourself. Keep the mixture in your refrigerator so it doesn't spoil.

Some products related to vitamin A (brand names: Retin-A, Avista, Differin and Tazorac) make your skin more sensitive to sunlight. Put on these medicines in the evening. You only need a pea-sized amount for your face.

Your doctor will want to see you about a month after you start using the medicine. At this time, your doctor may add to or change your medicines. Finding the treatment that works best for you may take some time.

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