Acne Basics

What is acne? 

Acne is a condition resulting from the action of hormones, mainly testosterone, combined with the overproduction of sebum (oil) which combines with dead skin to clog pores. Clogged pores cause a natural increase in bacteria called Propionibacterium acnes (P.acnes) causing inflamed papules or pustules (pimples or “zits”).

Common myths about acne

  • Acne is caused by dirt/ poor hygiene: False
  • Acne is caused by diet: chocolate, fatty foods, etc.: False
  • Acne is caused by stress: False

Factors that can cause acne to worsen

  • Changing hormone levels at puberty and premenstrual
  • Oil from skin products or environment. Always choose products that say “oil-free” or “noncomedogenic”, meaning it won’t cause clogged pores or comedones (blackheads)
  • Pressure from sports helmets or equipment
  • Squeezing, picking, or “popping” pimples. This it not recommended, it may cause permanent scarring
  • Hard scrubbing. Do not scrub the skin too vigorously -- this will clog pores and cause irritation.

Common treatments for clearing and preventing breakouts

Topical retinoids are topical vitamin A derivatives useful at unplugging and preventing comedones (blackheads) and whiteheads. Some examples of topical retinoids are: Retin-A (tretinoin), Differin (adapalene), and Tazorac (tazarotene).  Generally to be used at night.

Additonal treatments:

Benzyol peroxide as wash or "leave on" topical product to reduce bacteria

Other topical antibiotics to reduce baceria

Additional treatments:

Oral antibiotics such as doxycycline or minocycline may be used for limited time

Other treatments

Oral retinoids, such as isotretinoin, can be used to treat severe cystic or drug resistant acne. Treatment generally lasts 5-8 months and requires monthly lab tests, monthly office visits, and strict contraception. About 60-80% of those treated with oral isotretinoin become clear and remain clear. In some cases, a second course may be needed.

For female patients: hormonal therapy to help control menstral flares, in the form of oral contraceptives are sometimes helpful. Yaz and OrthoTriCyclen have FDA approval for treatment of acne. 

For adult female patients: anti-androgen (testosterone blocking) therapy such as Aldactone (spironolactone) can sometimes be helpful 

Photodynamic Therapy (PDT): light treatment with the application of aminolevulinic acid (ALA) assists in minimizing pores and oil glands and killing bacteria. This is used as an alternative to antibiotics or topical therapy but is not covered by insurance.

Your Recommended Daily Regimen


Every Morning

Every Night

Every Other Night





 Other topical








© 2012 Akron Dermatology. Last updated February 10, 2012.

Akron Dermatology

566 White Pond Drive
Suite E
Akron, Ohio  44320

Phone: (330) 535-7100



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Additional Resources

Acne Handout (link to AAD)
AcneNet (link to AAD)
Treatment Summary
Medications: Topical
Risks & Complications
Self Care
En Espanol
Acne (link to NIH)
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