Acne treatment

Acne is a disorder of the body’s pilosebaceous units. Each unit consists of a sebaceous gland and a canal or follicle, which is lined with cells called keratinocytes and which contains a fine hair. Most numerous in the skin of the face, upper back, and chest, sebaceous glands manufacture an oily substance called sebum, which is released onto the skin’s surface through the follicle’s opening, or pore.

All the constituents of the narrow follicle—the hair, sebum, and keratinocytes—may form a plug that prevents the sebum from reaching the surface of the skin through the pore. The plug allows a strain of bacterium, called Propionibacterium acnes, to multiply in the plugged follicle. As bacteria build up, white blood cells accumulate, causing inflammation. The wall of the plugged follicle eventually breaks down, and the bacteria form a pimple at the skin’s surface.

Acne treatment

Many people with acne seek treatment from dermatologists (doctors who specialize in skin disorders). Over-the-counter and prescription medi- cations are helpful in treating existing pimples, as well as preventing new ones from forming. Doctors may prescribe a combination of oral and topical medications that reduce inflammation and clumping of cells in the follicles, or that kill bacteria. These medications come in a variety of forms: antibiotics or benzoyl peroxide to kill bacteria, or retinoids (chemically related to vitamin A) to unblock pores. Niacinamide (nicotinamide) cream reduces inflamma- tion, though it is available only by prescription in the United States. Early treatment is important to prevent scarring. Pimples should be left alone to heal— squeezing and picking can cause scarring.


Because the underlying cause of acne is unknown, there are currently no preventive measures, although many medications are successful in preventing new pimples. In addition, proper care of the skin may help prevent outbreaks. Skin should be cleaned gently with a mild cleanser. Strong detergent soaps and rough scrubbing often worsen rather than improve acne.