Acne is one of the most common skin conditions worldwide, affecting teenagers and adults alike. During Acne Awareness Month, it’s important to highlight that acne is not simply caused by ‘dirty skin’ or poor hygiene, it is a complex medical condition influenced by hormones, genetics, inflammation and lifestyle factors.
The good news is that acne is treatable, and early management can help prevent long-term scarring and improve confidence and wellbeing.
What Is Acne?
Acne occurs when hair follicles become blocked with oil (sebum), dead skin cells, and bacteria. This can lead to:
- Blackheads
- Whiteheads
- Red inflamed spots
- Painful cysts
- Deep nodules
- Acne scarring
Acne most commonly affects the face, chest, back and shoulders.
While acne is often associated with teenagers, many adults continue to experience breakouts well into their 20s, 30s, and into their 40’s with women reporting hormonal acne flare ups as a peri menopause symptom.
Why Do People Get Acne?
There is no single cause of acne, several factors work together.
Hormonal Changes
Hormones play a major role in acne development. During puberty, increased androgen hormones stimulate the oil glands, causing excess sebum production. Hormonal fluctuations can also trigger acne in adults, particularly:
- Around menstrual cycles
- During pregnancy
- Around menopause
- In conditions such as PCOS (Polycystic Ovary Syndrome)
Genetics
If your parents had acne, you are more likely to develop it too. Genetics can influence:
- Oil production
- Skin inflammation
- Acne severity
- Likelihood of scarring
Excess Oil Production
Some people naturally produce more sebum, which can clog pores and encourage bacterial growth.
Bacteria and Inflammation
A bacterium called Cutibacterium acnes naturally lives on the skin. When pores become blocked, bacteria can multiply and trigger inflammation, leading to painful spots and cysts.
Lifestyle Factors
Although lifestyle alone does not cause acne, certain factors may worsen it:
- Stress
- Poor sleep
- High glycaemic diets
- Excess dairy intake in some individuals
- Heavy or pore-clogging skincare products
- Picking or squeezing spots
Can Acne Be Prevented?
Not all acne can be prevented, especially when hormones and genetics are involved. However, there are steps that may help reduce flare-ups and support healthier skin.
Use Gentle Skincare
Avoid harsh scrubs and over-cleansing, which can irritate the skin and worsen inflammation.
A simple routine usually works best:
- Gentle cleanser
- Non-comedogenic moisturiser
- Daily SPF
Avoid Picking Spots
Squeezing spots increases inflammation and significantly raises the risk of permanent scarring and pigmentation.
Choose Non-Comedogenic Products
Look for makeup and skincare labelled:
- Oil-free
- Non-comedogenic
- Fragrance-free
Manage Stress
Stress can influence hormone levels and inflammation, potentially worsening acne flare-ups.
Maintain a Healthy Lifestyle
A balanced diet, regular exercise, hydration and adequate sleep all contribute to overall skin health.
Acne Treatments: What Actually Works?
Treatment depends on the severity and type of acne. Mild acne may respond well to topical products, while more severe acne often requires prescription medication.
Topical Treatments – These are applied directly to the skin and may include retinoids, benzoyl peroxide, adapalene , clascoterone or azelaic acid.
Topical Antibiotics – Sometimes prescribed for inflammatory acne, often alongside other treatments.
Oral spironolactone – For moderate to severe hormonal acne.
Oral Antibiotics – Used short-term to reduce inflammation and bacterial overgrowth.
Hormonal Treatments – Some women benefit from hormonal therapies such as the oral contraceptive.
Isotretinoin: (Roaccutane ) What You Need to Know
One of the most effective treatments for severe or persistent acne is isotretinoin (also known by the trade name Roaccutane).
Isotretinoin works by:
- Dramatically reducing oil production
- Decreasing inflammation
- Preventing clogged pores
- Reducing acne-causing bacteria
It can be life-changing for people with:
- Severe acne
- Scarring acne
- Acne resistant to other treatments
Isotretinoin is a prescription-only medication that requires close medical supervision because it can cause side effects. Regular follow-up appointments and blood tests are usually required throughout the course. Despite the need for monitoring, isotretinoin remains one of the most effective long-term treatments available for severe acne.
When Should You See a Dermatologist?
You should consider seeing a dermatologist if:
- Acne is painful or cystic
- Over-the-counter products are not helping
- You are developing scars
- Acne is affecting your confidence or mental wellbeing
- You experience persistent adult acne
Early treatment can help prevent permanent scarring and improve outcomes.
Acne Is Treatable
Acne can affect self-esteem, confidence, and quality of life at any age. During Acne Awareness Month, it’s important to remember that acne is a genuine medical condition.
With the right skincare, lifestyle support and medical treatment, most people can achieve significant improvement in their skin.
If you are struggling with acne or acne scarring, make an appointment with Oxona Dermatologists who can help you find a personalised treatment plan that works for your skin.