The Complete Dermatologist-reviewed Guide to Acne
What Is Acne?
Acne is a chronic inflammatory skin condition that occurs when pores become clogged with oil, dead skin cells, and bacteria. While extremely common–affecting up to 85% of people at some point–its severity, causes, and best treatments vary widely from person to person.
Acne is not just a teenage problem. Many adults in their 20s, 30s, and 40s continue to experience persistent breakouts.
Why Acne Happens: The Root Causes
Excess Oil Production (Sebum): Hormones stimulate oil glands. When they ramp up, pores clog more easily.
Dead Skin Cell Buildup: If dead skin cells don’t shed efficiently, they combine with oil and block pores.
Bacterial Overgrowth – Cutibacterium acnes: This bacteria lives on everyone’s skin, but trapped inside a pore, it triggers inflammation.
Hormones & Acne: Hormonal fluctuations–puberty, menstrual cycles, pregnancy, and stress–are major contributors. These can be more common in individuals with conditions such as PCOS.Â
Lifestyle Triggers: Certain habits can worsen acne, including:
- High-glycemic diets
- Heavy or comedogenic skincare products
- Poor makeup removal
- Sweaty environments
- Stress
In Summary: Acne is a skin condition caused by clogged pores, inflammation, and hormonal activity. It can range from mild whiteheads to severe cystic acne and is treatable with personalized dermatology care.
Types of Acne
Understanding the type of acne is essential for choosing the right treatment.
Non-Inflammatory Acne
- Whiteheads (closed comedones): small, firm, closed white bumps on skin
- Blackheads (open comedones): dark because the inside material has oxidized after being exposed to air
Inflammatory Acne
- Papules: solid, raised bumps that do not contain visible fluid
- Pustules: small, inflamed bumps filled with pus
- Nodules: severe, painful, red, hard lumps under the skin
- Cysts: severe, painful, pus-filled under the skin
Hormonal Acne
Hormonal acne is caused by hormonal fluctuations causing overproduction of sebum, which clogs pores leading to pimples. It can affect both men and women, but is most common in women. It affects almost 80% of the US population at some point in their lives.
Fungal Acne
Fungal acne is when hair follicles are infected with a fungus named Malassezia yeast. It can appear as small, itchy, red bumps, sometimes turning into whiteheads. Although fungal acne is big on social media, it is actually quite rare.
In Summary: There are several types of acne, ranging from surface-level clogged pores to deep, painful cysts. Each type responds differently to treatment. At Utah Valley Dermatology, we treat all types of acne.
How Acne Looks at Different Ages
Acne can often appear in different ways, throughout the stages of life.Â
- Teens: Teenage acne is commonly widespread across the face, chest, and back.
- Adults: More common in women, it often shows on the jawline, chin, and around the mouth.
- Pregnancy/Postpartum: Acne during this time can often be more severe, appearing as nodules or cysts.
- Men vs Women: Men often produce more testosterone than women, which can result in a higher production of sebum (oil). Facial hair can exacerbate acne. Women experience these acne struggles as well, but often interrupted and fluctuate with hormone cycles and birth control pills.
How Dermatology Providers Diagnose Acne
Your dermatology provider considers:
- Skin type (oily, dry, sensitive, combination)
- Acne type and severity
- Medical history
- Hormonal factors
- Previous treatments tried
- Scarring or pigmentation risk
Treatments for Acne
Topical Treatments
- Topical retinoids (tretinoin, adapalene): Unclogs pores, regulates cell turnover, prevents future breakouts
- Benzoyl peroxide: Kills acne-causing bacteria and reduces inflammation
- Topical antibiotics: Used in combination with benzoyl peroxide to prevent resistance
- Azelaic acid: Targets acne and treats pigmentation and redness
- Salicylic acid: Helps exfoliate and keeps pores clear
Oral Medications
- Oral antibiotics: Short-term use for inflammatory acne
- Hormonal therapy: Birth control pills, spironolactoneÂ
- Isotretinoin (Accutane): The most effective treatment for severe or scarring acne
In-Office Procedures Offered at Utah Valley Dermatology
- Acne surgery: Acne extractions performed by a licensed master aesthetician
- Microneedling: Reduces appearance of acne scars and assists in collagen production
- Chemical peels: Improves skin texture, reduces comedones, brightens post-acne mark
- Excision: For deep cysts
At Utah Valley Dermatology, we have onsite dermatology providers and master aestheticians to help you with your acne needs.
In Summary: Mild acne often responds to topical treatments, while moderate or severe acne may require oral medications or in-office procedures. Most patients need a combination approach for the best results.
Accutane (Isotretinoin) Explained:
What Is Accutane?
Accutane, also known by its generic name isotretinoin, is a powerful medication primarily used to treat severe acne that has not responded to other treatments. Originally developed in the 1980s, it has become a cornerstone in dermatology for its effectiveness in reducing and often eliminating severe, cystic acne as well as acne that is distressing to the patient.
How Does Accutane Work?
Accutane works by decreasing the amount of oil released by oil glands in your skin and helping your skin renew itself more quickly. It interacts with nucleic acid receptors in the skin, which suppresses sebum production, the oily substance produced by sebaceous glands. By reducing sebum production, this medication helps to prevent clogged pores and the formation of acne.
It is highly effective in treating severe, cystic acne that has not responded to other treatments. Many patients experience significant improvement and permanent clearance of acne after completing a course of Accutane.
What Are the Potential Side Effects of Accutane?
Common side effects include dry skin, chapped lips, dry eyes, and nosebleeds. Some patients may also experience mild muscle and joint pain. These side effects are generally manageable with proper skincare and hydration.
Learn more about Accutane here.
Treating Acne Scars
Acne treatment often also includles addressing discoloration and scarring.
Why Does Scarring Happen?
Acne scars are often caused by the skin irregularly healing after inflammation of acne, and from picking at the skin.
Types of Acne Scars:
- Ice pick
- Boxcar
- Rolling
- Hypertrophic/keloid
Modern Scar Treatments:
- Microneedling
- Laser resurfacing
- Chemical reconstruction (TCA Crosshatch)
- Subcision
- Radiofrequency treatments
Lifestyle Factors That Actually Matter
- Diet
- Stress
- Sleep
- exercise/sweat
- Makeup & skincare routine
- picking/popping risks
What Makes Acne Worse (Myths vs Facts)
Myths:
- Acne is caused by dirty skin
- Eating chocolate causes acne
- Popping pimples helps them heal
- Makeup always makes acne worse
- Sun exposure clears acne
- Sunscreen can cause acne
Facts:Â
- Genetics and hormones play a role in acne.
- Using the wrong skincare products can cause acne.
When to See a Dermatology Provider
Patients should seek professional care when:
- Acne becomes painful or cystic.
- Acne is leaving scars.
- Over-the-counter treatments aren’t helping after 3 months.
- Acne affects quality of life.
Understanding Utah's Unique Skin Challenges
Living in Utah provides several skin challenges that can directly impact acne:
- Dry, high-altitude climate: Utah’s low humidity increases dry skin, which can worsen oil imbalance and clogging.
- Significant sun exposure: Outdoor lifestyles and activity often increase pigmentation and inflammation.
- Seasonal swings: Cold winters and hot summers can cause breakouts to flare.
Because we treat thousands of Utah patients each year, our dermatology providers understand how these local factors influence acne – and how to tailor treatment to your skin in this environment.
FAQ About Acne
- Does diet cause acne?
- No, diet does not directly affect acne.
- Is acne genetic?
- Yes, acne has genetic components.
- What products should teens use?
- Teens should use gentler products, unless directed by a dermatology provider.
- What’s the best acne treatment for sensitive skin?
- Salicylic acid can be a gentle treatment for acne.
- Why is acne worse in Utah?
- The dry climate can cause overproduction of oil in the skin.
- Can adults get acne suddenly?
- Yes, this is often because of hormonal changes.
- How long does Accutane take to work?
- It depends on the dose, but changes can normally be seen within the first 2 months.
- What causes hormonal acne?
- Hormonal acne is caused by hormonal changes, which increase oil production in the skin.
Why Choose Utah Valley Dermatology for Acne Treatment
At Utah Valley Dermatology, our board-certified dermatologists and experienced dermatology providers help patients throughout Utah County and surrounding areas with their Utah-specific acne expertise. Our personalized treatment plans include advanced acne and scarring treatments that actually work.
Schedule an appointment with Utah Valley Dermatology today to get clear answers and personalized care for your skin.
Article Reviewed by Cameron Dower, PA-C