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痤疮 - 症状与病因 - 妙佑医疗国际
痤疮 - 症状与病因 - 妙佑医疗国际
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患者护理和健康信息
疾病与状况
痤疮
预约门诊
症状与病因诊断与治疗医生与科室
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概述痤疮是一种皮肤病，当油脂和死皮细胞堵塞毛囊时就会滋生痤疮。痤疮会导致白头粉刺、黑头粉刺或丘疹。痤疮最常见于青少年，但也可能累及所有年龄段的人群。
虽然可以找到有效的治疗方案，但痤疮也可能难以治愈。丘疹和肿块恢复缓慢，而且常常此起彼伏。
根据严重程度的不同，痤疮可能引起情绪困扰以及在皮肤上留疤。越早开始治疗，出现此类问题的风险也就越低。产品与服务书籍：《妙佑医疗国际家庭健康手册》第 5 版书籍：《妙佑医疗国际家庭疗法指南》妙佑医疗国际商店的护肤品种类简报：妙佑医疗国际卫生来信 — 数字版显示妙佑医疗国际的更多产品
症状
囊肿性痤疮
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囊肿性痤疮
囊肿性痤疮
囊肿性痤疮是最严重的一种痤疮，在油脂和死皮细胞堆积在毛囊深处时发生。由此导致的皮肤破裂可能会形成疖子样的炎症。
痤疮症状因病情严重程度而异：
白头（闭合性的毛孔堵塞）
黑头（开放性的毛孔堵塞）
有疼痛感的红色小肿块（丘疹）
粉刺（脓疱），是顶部有脓液的丘疹
皮肤下较大、坚硬、有疼痛感的肿块（结节）
皮肤下疼痛、充满脓液的肿块（囊性病变）
痤疮通常出现在面部、前额、胸部、背部上部和肩部。
何时就诊如果自我护理疗法不能清除痤疮，请前往初级保健医生处就诊。医生可能开具药效更强的药物。如果痤疮仍然存在或较为严重，您可能应该只寻求皮肤方面的专科医生（皮肤科医生或小儿皮肤科医生）的治疗。
很多女性的痤疮可能持续数十年，并且常常在经期前一周暴发。对于使用避孕药的女性，这种类型的痤疮往往不经治疗即可消除。
如果年龄较大的成人突然发生严重痤疮，这可能会提示基础疾病，这种情况需要就医。
美国食品药品监督管理局（FDA）警告表示，一些流行的非处方痤疮洗剂、清洁剂和其他皮肤产品可能引起严重的反应。这种反应相当罕见，所以不要将其与任何发红、刺激或瘙痒混淆，后者发生在您涂抹药物或产品的区域。
如果使用护肤品后出现以下情况，请寻求紧急医疗帮助：
昏厥
呼吸困难
眼睛、面部、嘴唇或舌头肿胀
咽喉绷紧
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病因
痤疮的发展过程
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痤疮的发展过程
痤疮的发展过程
当油脂（一种润滑头发和皮肤的油性物质）和死皮细胞堵塞毛囊时，就会出现痤疮。细菌可能引发炎症和感染，从而造成更严重的痤疮。
引起痤疮的四个主要因素：
油脂分泌过多
油脂和死皮细胞堵塞毛囊
细菌
发炎
痤疮一般发生在面部、前额、胸部、上背部和肩部，因为这些部位的皮肤油脂（皮脂）腺最多。毛囊与油腺相连。
囊壁可能鼓起，产生白头。堵塞物也可能露出表面并变黑，形成黑头。黑头看起来可能像塞在毛孔中的污垢。但实际上，毛孔中充满了细菌和油，当毛孔暴露在空气中时，就会变成棕色。
丘疹是毛囊堵塞发炎或被细菌感染后形成的中心为白色的凸起红斑。毛囊深处的堵塞和炎症会使皮肤表面下产生囊样肿块。皮肤上的其他毛孔（汗腺的开口）通常不会长痤疮。
某些因素可能触发或加重痤疮：
激素变化。雄激素是青春期男孩和女孩体内增加的激素，会导致皮脂腺增大，产生更多的皮脂。中年期间激素的变化，特别是女性，也会导致爆发。
某些药物。例如含有皮质类固醇、睾酮或锂的药物。
饮食。研究表明，食用某些食物——包括富含碳水化合物的食物，如面包、贝果和薯片——可能会使痤疮恶化。需要进一步的研究来确定痤疮患者遵循特定的饮食限制是否有益。
压力。压力不会引起痤疮，但如果已经有了痤疮，压力可能会使其加重。
痤疮误区这些因素对痤疮的影响不大：
巧克力和油腻食物。吃巧克力或油腻食物对痤疮几乎没有影响。
卫生情况。痤疮不是由皮肤不洁引起。事实上，用力擦洗皮肤或用刺激性强的肥皂或化学物质清洗会刺激皮肤，并可能使痤疮恶化。
化妆品。化妆品不一定会使痤疮加重，如果使用不会堵塞毛孔的无油化妆品（无致痘成分）并经常卸妆，尤其没有影响。非油性化妆品不会影响痤疮药物的疗效。
并发症肤色较深者比肤色较浅者更容易出现这些痤疮并发症：
瘢痕。痤疮治愈后，麻面皮肤（痤疮瘢痕）和厚瘢痕（瘢痕疙瘩）可能长期残留。
皮肤变化。痤疮清除后，受影响的皮肤可能比痤疮出现前更暗（色素增加）或更淡（色素减退）。
风险因素痤疮的风险因素包括：
年龄。所有年龄段的人都可能出现痤疮，但青少年中最为常见。
激素变化。此类变化常见于青春期或怀孕期间。
家族史。痤疮与遗传因素有关。如果您的父母双方都有痤疮，您也可能会出现痤疮。
脂性或油性物质。当皮肤接触油性或脂性乳液或乳霜时，您可能会出现痤疮。
摩擦或压迫皮肤。这可能是由电话、手机、头盔、紧身衣领和背包等物品所致。
来自妙佑医疗国际员工
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Oct. 08, 2022
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显示参考文献
AskMayoExpert. Acne. Mayo Clinic; 2019.
American Academy of Dermatology. Guidelines of care for the management of acne vulgaris. https://doi.org/10.1016/j.jaad.2015.12.037.
Alpha hydroxyl acids (AHAs). Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed July 9, 2020.
Rakel D, ed. Acne vulgaris and acne rosacea. In: Integrative Medicine. 4th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Sept. 5, 2017.
Dinulos JGH. Acne, rosacea, and related disorders. Habif's Clinical Dermatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 6, 2020.
Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/acne. Accessed July 9, 2020.
Graber E. Treatment of acne vulgaris. https://www.uptodate.com/contents/search. Accessed July 9, 2020.
Thiboutot D, et al. Pathogenesis, clinical manifestations and diagnosis of acne vulgaris. https://www.uptodate.com/contents/search. Accessed July 9, 2020.
Kermott CA, et al., eds. Acne. In: Mayo Clinic Book of Home Remedies. 2nd ed. Time; 2017.
Maymone M, et al. Common skin disorders in pediatric skin of color. Journal of Pediatric Health Care. 2019; doi:10.1016/j.pedhc.2019.04.019.
Matthes BM, et al. Intralesional corticosteroid injection. https://www.uptodate.com/contents/search. Accessed July 8, 2020.
Gibson LE (expert opinion). Mayo Clinic. July 20, 2020.
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Acne - Symptoms and causes - Mayo Clinic
Acne - Symptoms and causes - Mayo Clinic
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Patient Care & Health Information
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Acne
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OverviewAcne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It causes whiteheads, blackheads or pimples. Acne is most common among teenagers, though it affects people of all ages.
Effective acne treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.
Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems.Products & ServicesA Book: Mayo Clinic Book of Home RemediesA Book: Mayo Clinic Family Health Book, 5th EditionAssortment of Skin Care Products from Mayo Clinic StoreNewsletter: Mayo Clinic Health Letter — Digital EditionShow more products from Mayo Clinic
Symptoms
Cystic acne
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Cystic acne
Cystic acne
Cystic acne — the most severe form of acne — occurs when oil and dead skin cells build up deep within hair follicles. The resulting rupture within your skin may form boil-like inflammation.
Acne signs vary depending on the severity of your condition:
Whiteheads (closed plugged pores)
Blackheads (open plugged pores)
Small red, tender bumps (papules)
Pimples (pustules), which are papules with pus at their tips
Large, solid, painful lumps under the skin (nodules)
Painful, pus-filled lumps under the skin (cystic lesions)
Acne usually appears on the face, forehead, chest, upper back and shoulders.
When to see a doctorIf self-care remedies don't clear your acne, see your primary care doctor. He or she can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor who specializes in the skin (dermatologist or pediatric dermatologist).
For many women, acne can persist for decades, with flares common a week before menstruation. This type of acne tends to clear up without treatment in women who use contraceptives.
In older adults, a sudden onset of severe acne may signal an underlying disease requiring medical attention.
The Food and Drug Administration (FDA) warns that some popular nonprescription acne lotions, cleansers and other skin products can cause a serious reaction. This type of reaction is quite rare, so don't confuse it with any redness, irritation or itchiness that occurs in areas where you've applied medications or products.
Seek emergency medical help if after using a skin product you experience:
Faintness
Difficulty breathing
Swelling of the eyes, face, lips or tongue
Tightness of the throat
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Causes
How acne develops
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How acne develops
How acne develops
Acne develops when sebum — an oily substance that lubricates your hair and skin — and dead skin cells plug hair follicles. Bacteria can trigger inflammation and infection resulting in more severe acne.
Four main factors cause acne:
Excess oil (sebum) production
Hair follicles clogged by oil and dead skin cells
Bacteria
Inflammation
Acne typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands.
The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it's exposed to the air.
Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne.
Certain things may trigger or worsen acne:
Hormonal changes. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, particularly in women, can lead to breakouts too.
Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium.
Diet. Studies indicate that consuming certain foods — including carbohydrate-rich foods, such as bread, bagels and chips — may worsen acne. Further study is needed to examine whether people with acne would benefit from following specific dietary restrictions.
Stress. Stress doesn't cause acne, but if you have acne already, stress may make it worse.
Acne mythsThese factors have little effect on acne:
Chocolate and greasy foods. Eating chocolate or greasy food has little to no effect on acne.
Hygiene. Acne isn't caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.
Cosmetics. Cosmetics don't necessarily worsen acne, especially if you use oil-free makeup that doesn't clog pores (noncomedogenics) and remove makeup regularly. Nonoily cosmetics don't interfere with the effectiveness of acne drugs.
ComplicationsPeople with darker skin types are more likely than are people with lighter skin to experience these acne complications:
Scars. Pitted skin (acne scars) and thick scars (keloids) can remain long-term after acne has healed.
Skin changes. After acne has cleared, the affected skin may be darker (hyperpigmented) or lighter (hypopigmented) than before the condition occurred.
Risk factorsRisk factors for acne include:
Age. People of all ages can get acne, but it's most common in teenagers.
Hormonal changes. Such changes are common during puberty or pregnancy.
Family history. Genetics plays a role in acne. If both of your parents had acne, you're likely to develop it too.
Greasy or oily substances. You may develop acne where your skin comes into contact with oil or oily lotions and creams.
Friction or pressure on your skin. This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks.
By Mayo Clinic Staff
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Diagnosis & treatment
Oct. 08, 2022
Show references
AskMayoExpert. Acne. Mayo Clinic; 2019.
American Academy of Dermatology. Guidelines of care for the management of acne vulgaris. https://doi.org/10.1016/j.jaad.2015.12.037.
Alpha hydroxyl acids (AHAs). Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed July 9, 2020.
Rakel D, ed. Acne vulgaris and acne rosacea. In: Integrative Medicine. 4th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Sept. 5, 2017.
Dinulos JGH. Acne, rosacea, and related disorders. Habif's Clinical Dermatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 6, 2020.
Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/acne. Accessed July 9, 2020.
Graber E. Treatment of acne vulgaris. https://www.uptodate.com/contents/search. Accessed July 9, 2020.
Thiboutot D, et al. Pathogenesis, clinical manifestations and diagnosis of acne vulgaris. https://www.uptodate.com/contents/search. Accessed July 9, 2020.
Kermott CA, et al., eds. Acne. In: Mayo Clinic Book of Home Remedies. 2nd ed. Time; 2017.
Maymone M, et al. Common skin disorders in pediatric skin of color. Journal of Pediatric Health Care. 2019; doi:10.1016/j.pedhc.2019.04.019.
Matthes BM, et al. Intralesional corticosteroid injection. https://www.uptodate.com/contents/search. Accessed July 8, 2020.
Gibson LE (expert opinion). Mayo Clinic. July 20, 2020.
Related
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Common acne
Cystic acne
How acne develops
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acne_百度百科
_百度百科 网页新闻贴吧知道网盘图片视频地图文库资讯采购百科百度首页登录注册进入词条全站搜索帮助首页秒懂百科特色百科知识专题加入百科百科团队权威合作下载百科APP个人中心收藏查看我的收藏0有用+10acne播报上传视频英文，n.<医>痤疮，粉刺；青春美丽痘 [1]；俗称粉刺，青春期发病。有丘疹、黑头粉刺、脓疱、结节或囊肿等多种皮损并伴皮脂溢出的一种皮肤病。外文名acne别 名青春美丽痘；粉剌西医学名acne中医学名痤疮，粉刺；所属科室五官科 - 皮肤科目录1简介2临床表现3病因4治疗▪护理▪分级治疗5诊断简介播报编辑有丘疹、黑头粉刺、脓疱、结节或囊肿等多种皮损并伴皮脂溢出的一种皮肤病。俗称粉刺。青春期发病。女性患者月经期加重。治疗采用综合措施，少吃高脂肪及糖类食物，外用硫磺洗剂；外用维甲酸制剂或内用维生素A有溶角质作用，可去黑头粉刺；外用抗菌药物，如过氧化苯甲酰、1%～4%红霉素、1%～2%洁霉素等。临床表现播报编辑皮损好发于面部及上胸背部。痤疮的非炎症性皮损表现为开放性和闭合性粉刺。闭合性粉刺（又称白头）的典型皮损是约1毫米大小的肤色丘疹，无明显毛囊开口。开放性粉刺（又称黑头）表现为圆顶状丘疹伴显著扩张的毛囊开口。粉刺进一步发展会演变成各种炎症性皮损，表现为炎性丘疹、脓疱、结节和囊肿。炎性丘疹呈红色，直径1～5毫米不等；脓疱大小一致，其中充满了白色脓液；结节直径大于5毫米，触之有硬结和疼痛感；囊肿的位置更深，充满了脓液和血液的混合物。这些皮损还可融合形成大的炎性斑块和窦道等。炎症性皮损消退后常常遗留色素沉着、持久性红斑、凹陷性或肥厚性瘢痕。临床上根据痤疮皮损性质和严重程度将痤疮分为3度、4级：1级（轻度）：仅有粉刺；2级（中度）：除粉刺外，还有一些炎性丘疹；3级（中度）：除粉刺外，还有较多的炎性丘疹或脓疱；4级（重度）：除有粉刺、炎性丘疹及脓疱外，还有结节、囊肿或瘢痕。病因播报编辑痤疮的发生主要与皮脂分泌过多、毛囊皮脂腺导管堵塞、细菌感染和炎症反应等因素密切相关。进入青春期后人体内雄激素特别是睾酮的水平迅速升高，促进皮脂腺发育并产生大量皮脂。同时毛囊皮脂腺导管的角化异常造成导管堵塞，皮脂排出障碍，形成角质栓即微粉刺。毛囊中多种微生物尤其是痤疮丙酸杆菌大量繁殖，痤疮丙酸杆菌产生的脂酶分解皮脂生成游离脂肪酸，同时趋化炎症细胞和介质，最终诱导并加重炎症反应。治疗播报编辑护理每日一到两次温水洗脸，清洁皮肤，忌用手挤压或搔抓皮损。忌用油脂类、粉类化妆品和含有糖皮质激素的软膏及霜剂。分级治疗（1）1级 一般采用局部治疗，首选外用维A酸类制剂。（2）2级 联合外用维A酸类及过氧化苯甲酰或抗生素，必要时联合口服抗生素。（3）3级 常常需要联合治疗，口服抗生素联合外用过氧化苯甲酰和/或维A酸类药物为首选。有指征的女性患者也可考虑抗雄激素治疗。（4）4级 口服异维A酸是最有效的治疗方法，可作为一线治疗。对于炎性丘疹和脓疱较多者，也可先系统应用抗生素联合外用过氧化苯甲酰，待皮损明显改善后再改用口服异维A酸序贯治疗。诊断播报编辑根据青少年发病、皮损分布于颜面和胸背部、主要表现为白头、黑头粉刺、炎性丘疹、脓疱等多形性皮损等特点，临床易于诊断，通常无需做其他检查。有时需要与酒渣鼻、颜面播散性粟粒性狼疮、皮脂腺瘤等鉴别。新手上路成长任务编辑入门编辑规则本人编辑我有疑问内容质疑在线客服官方贴吧意见反馈投诉建议举报不良信息未通过词条申诉投诉侵权信息封禁查询与解封©2024 Baidu 使用百度前必读 | 百科协议 | 隐私政策 | 百度百科合作平台 | 京ICP证030173号 京公网安备110000020000寻常型痤疮 - 皮肤科疾病 - MSD诊疗手册专业版
寻常型痤疮 - 皮肤科疾病 - MSD诊疗手册专业版
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兽医手册（仅有英文版）
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皮肤科疾病
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痤疮及相关疾病
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寻常型痤疮
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本章节的其他主题
寻常型痤疮
化脓性汗腺炎
口周皮炎
玫瑰痤疮，酒渣鼻
寻常型痤疮
（痤疮）
作者：
Jonette E. Keri
, MD, PhD, University of Miami, Miller School of Medicine
医学审查 2月 2022
看法 进行患者培训
病理生理
病因
症状和体征
诊断
预后
治疗
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炎症性痤疮伴色素沉着过度
有大粉刺的痤疮
有耳廓粉刺的痤疮
皮肤病变（脓疱）
痤疮（粉刺和脓疱）
有多个脓疱的痤疮
影响身体的痤疮
形成脓肿的痤疮
囊肿性痤疮
颜面聚合性痤疮 (融合性痤疮)
暴发性痤疮
面部脓皮病（酒糟鼻）
面部脓皮病（妊娠相关）
不同药物治疗痤疮的机制
表格 (2)
痤疮的严重程度分级
痤疮的药物治疗
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由于毛囊阻塞和皮脂腺单位（毛囊及其附属的皮脂腺）的炎症，寻常痤疮主要表现为粉刺、丘疹、结节和（或）囊肿。痤疮好发于面部和上部躯干。多发在青春期。诊断根据临床。需根据痤疮的严重程度来制定相应的方案，治疗包括一系列不同的外用和系统药物，主要通过减少皮脂腺分泌，减少粉刺形成，控制炎症和抗菌，以及调节上皮角化来改善皮损。 痤疮是美国最常见的皮肤疾病，几乎80％的人群在其一生中不同程度地患过痤疮。 寻常型痤疮的病理生理学 痤疮发生于4个主要因素的相互作用： 过剩的皮脂分泌 毛囊被皮脂和角质形成细胞堵塞 卵泡的定植 Cutibacterium acnes （以前 Propionibacterium acnes), 正常人体厌氧菌 多种炎症介质的释放 痤疮可分为下列几种类型： 非炎性：主要为粉刺 炎性痤疮：主要表现为丘疹、脓疱、结节和囊肿。 非炎性痤疮 粉刺由脂栓阻塞毛孔所致。根据开口于皮肤的毛囊口是扩张还是闭合状态，粉刺又可分为开放性粉刺和闭合性粉刺。角栓很容易从开放粉刺挤出，但难以从闭合粉刺中拔出。闭合粉刺是炎性痤疮的前身。 炎症性痤疮 丘疹和脓疱当痤疮丙酸杆菌 C. acnes在闭合性粉刺中增殖，皮脂被分解成游离脂肪酸，后者刺激毛囊上皮并诱发炎症反应（先是中性粒细胞聚集，继而淋巴细胞聚集），进一步破坏上皮，于是临床上便形成了。当发生炎症的毛囊破裂（通常为物理摩擦或用力擦洗所致），粉刺样内容物进入真皮，进一步诱发局部炎症，临床上便形成了丘疹。如果炎症剧烈，便会产生化脓性脓疱。 结节和囊肿 是炎症性痤疮的其他表现。结节是更深在的皮疹，可能累及超过一个毛囊，而囊肿是较大的具有波动感的结节。 寻常痤疮的病因 此类疾病 最常见病因是 青春期 在青春期，此时体内骤增的雄激素可刺激皮脂腺分泌以及毛囊上皮过度角化。 其他可能的触发因素包括： 怀孕或月经周期可伴随有激素水平的变化。 可致毛孔堵塞的化妆品、清洁剂、洗剂和衣物 高湿度和出汗 痤疮加重与面部清洁不足、手淫以及性别之间的关联尚未得到证实。一些研究表明，这可能与奶制品和高血糖饮食有关。由于日光的抗炎作用，痤疮在夏季会有所缓解。高胰岛素血症亦可能与痤疮的发病有关，但仍需进一步研究。 某些药物（如糖皮质激素、锂、苯妥英钠、异烟肼）可加重粉刺或诱发痤疮样疹。 寻常痤疮的症状和体征 痤疮皮疹和疤痕会给患者带来不容忽视的负面情绪。结节和囊肿可伴疼痛。不同阶段的皮损常常共存。 粉刺分为白头和黑头粉刺。白头粉刺（闭合性粉刺）表现为肉色或白色的丘疹，直径1～3mm；黑头粉刺（开放性粉刺）与其大小形态类似，但中央呈黑色。 痤疮的表现 有大粉刺的痤疮 © Springer Science+Business Media 有耳廓粉刺的痤疮 © Springer Science+Business Media 皮肤病变（脓疱） 脓疱是隆起的，通常是带有脓液的黄色顶部病变。 这个长痘痘的人脸上会出现散落的脓疱。 图片由医学博士Thomas Habif提供。 痤疮（粉刺和脓疱） 痤疮通常表现为粉刺（白头或黑头），也表现为丘疹（蓝色箭头）和脓疱（黑色箭头）。 图片由医学博士Thomas Habif提供。 有多个脓疱的痤疮 丘疹和痂也可见。 © Springer Science+Business Media 影响身体的痤疮 存在丘疹和粉刺。 © Springer Science+Business Media 丘疹和脓疱表现为2～5mm大小的红色皮损。丘疹相对比较深在。脓疱的部位要浅些。 结节较丘疹更大、更深，触之更坚实。形态与炎性 表皮样囊肿 皮肤囊肿 表皮包涵体囊肿是最常见的皮肤囊肿。粟丘疹是小的表皮包涵囊肿。毛发囊肿通常在头皮，可能是家族性。 良性皮肤囊肿 根据囊肿壁或衬里和解剖位置的组织学特征进行分类。触诊可触及质地坚实的、可移动的、无触痛的球状囊肿；囊肿通常大小不一，直径可达5cm。有几种良性皮肤囊肿：... Common.TooltipReadMore 类似，但实际上痤疮结节缺乏真正的囊壁结构。 囊肿是化脓的结节。极少的囊肿会形成深在脓肿。长期的囊肿型痤疮会导致疤痕的形成，表现多样，如小而深的凹陷（冰锥形瘢痕）、较大的凹陷、表浅的凹陷，增生性瘢痕及 瘢痕疙瘩 瘢痕疙瘩 瘢痕疙瘩是发生于创伤部位（例如，伤口、手术切口和躯干部痤疮）的平滑的成纤维组织过度增生，偶尔是自发性的。 瘢痕疙瘩最常见于深色人种。好发于躯干上部，特别是上背部、中胸部和三角肌部位。不同于增生性瘢痕，瘢痕疙瘩组织通常扩展超出最初创伤的范围。也可自发地发生。... Common.TooltipReadMore 。 聚合性痤疮是寻常型痤疮最严重的一种表现，多发于男性。患者出现脓肿、窦道、瘘管，以及增生性或萎缩性瘢痕。胸、背部常严重受累，手臂、腹部、臀部亦可累及，严重病例皮损可累及头皮。 暴发性痤疮是一种急性、发热性、溃疡性痤疮，特征表现为突发的融合性脓肿所致的出血性坏死。出现白细胞增多、关节肿痛等系统症状。 面部脓皮病 （亦称为“暴发性酒渣鼻”）常突发于年轻女性的面中部，可能是暴发性痤疮的同型。皮损表现为分布在下颌、面颊和前额的红斑性斑块、脓疱。 丘疹和结节可能发展并融合。 寻常痤疮的诊断 评估诱发因素（如激素水平、物理机械因素或药物相关等） 明确严重程度分级（轻度、中度、重度） 评估心理社会状态 根据临床表现即可诊断痤疮。 鉴别诊断包括 玫瑰痤疮 症状和体征 玫瑰痤疮是一种慢性炎症性皮肤病，特征表现为面部潮红、毛细血管扩张、红斑、丘疹、脓疱等，严重病例甚至可出现鼻赘。根据特征性的临床表现和病史即可诊断。 治疗根据严重程度而定，包括外用甲硝唑、外用/口服抗生素，外用伊维菌素，很少用异维A酸，严重鼻赘可予外科治疗。... Common.TooltipReadMore （不会出现粉刺）、激素诱发性痤疮（不会出现粉刺，脓疱形态较均一）、 口周皮炎 口周皮炎 口周皮炎是一种红斑性、丘疹脓疱性面部皮肤病，皮疹与 痤疮 、 酒渣鼻 相似，但前者典型地从口周起病。 通过外观即可诊断。治疗包括避免病因，局部外用或者有时口服抗生素。 多种因素均可引起口周皮炎，包括外用糖皮质激素和（或）暴露于水和牙膏中的氟化物，但口周炎的确切病因仍不清楚。尽管叫“皮炎”，但它并非真... Common.TooltipReadMore （通常分布于口周和眼周），以及痤疮样药疹 ( Professional.see table 药物反应类型和常见诱发药物 药物反应类型和常见诱发药物 )。根据皮损的数量和类型，痤疮可分为轻度、中度和重度痤疮；标准分级系统之一详见表 痤疮的严重程度分类 痤疮的严重程度分级 。 表格 寻常痤疮的预后 各种类型的痤疮20岁以后往往能自然减轻，个别患者，特别是妇女可迁延至40岁以上；由于生育原因，治疗选择受限。许多成人患者偶然也发生非炎症性及轻度炎症性痤疮。非炎性痤疮和轻度痤疮往往愈后不留瘢痕。中至重度炎症性痤疮痊愈后易留有瘢痕。痤疮对患者产生的影响并非仅仅身体上，也会对患者产生巨大精神压力，青少年往往以此为借口逃避复杂的人际交往。对于一些严重病例，需加强患者心理咨询，其父母也需加以重视。 治疗寻常痤疮 粉刺：外用维A酸 轻度炎症性痤疮：单独外用维A酸，或者联合抗生素或（和）过氧化苯甲酰 中度痤疮：口服抗生素联合轻度痤疮所用的局部治疗 重度痤疮：口服异维A酸 囊肿性痤疮：皮损内使用曲安奈德 控制痤疮病情、减少疤痕形成、进行心理干预对于痤疮治疗是十分重要的。 痤疮治疗囊括了一系列的外用和系统用药，作用靶点包括降低皮脂腺分泌、抑制粉刺形成、抗炎、抗菌以及改善上皮角化过度（ Professional.see figure 不同药物治疗痤疮的机制 不同药物治疗痤疮的机制 )。 一般根据痤疮的严重程度来选择相应的治疗，方案总结见表 治疗痤疮的药物 痤疮的药物治疗 。另见美国皮肤病学会制定的2016年寻常痤疮治疗护理指南。 皮损处应该每天清洗一到两次，但过度清洁、使用抗菌皂以及搓洗，只会适得其反。 对于难治性青春期痤疮，可以考虑降低血糖饮食和适量牛奶摄入，但这些措施在治疗痤疮方面的有效性仍存在争议 (1 治疗参考文献 由于毛囊阻塞和皮脂腺单位（毛囊及其附属的皮脂腺）的炎症，寻常痤疮主要表现为粉刺、丘疹、结节和（或）囊肿。痤疮好发于面部和上部躯干。多发在青春期。诊断根据临床。需根据痤疮的严重程度来制定相应的方案，治疗包括一系列不同的外用和系统药物，主要通过减少皮脂腺分泌，减少粉刺形成，控制炎症和抗菌，以及调节上皮角... Common.TooltipReadMore )。 去皮剂（如硫磺、水杨酸、乙醇酸、对苯二酚）是有效的辅助治疗剂。 口服避孕药能效治疗炎性和非炎性痤疮；螺内酯（起始剂量50mg po qd，数月后如果需要可加量到100mg~150mg [最大剂量200mg] po qd）是另一种抗雄激素药物，在治疗女性痤疮时偶有疗效。 各种光疗法，使用和不使用外用光敏剂，可有效治疗痤疮，尤其是炎性痤疮。 治疗应包括宣教和给患者制定切实可行的治疗方案。治疗失败通常是因为患者依从性不够，或随访时间尚不足。专科医生的会诊亦十分必要。 不同药物治疗痤疮的机制 表格 轻度痤疮 轻微痤疮治疗须持续6周，或直到皮损消退。为巩固疗效，维持治疗也十分必要。 对于粉刺型痤疮，一般单药治疗 足矣。治疗粉刺，最主要的就是在耐受的前提下每天外用维A酸制剂；对此不能耐受的患者，可换用阿达帕林凝胶、他扎罗汀霜/凝胶、壬二酸霜、乙醇酸或水杨酸等。副作用包括红斑、灼烧感、刺痛和脱屑。阿达帕林和他扎罗汀都是维A酸类药物，与维A酸一样，都有轻微的刺激和光敏性。壬二酸有粉刺溶解和抗菌作用，机制不明，与维A酸类药物有协同作用。 双药联合治疗 （例如，如维甲酸联合过氧化苯甲酰或外用抗生素，或后两者联合）用于治疗轻度丘疹脓疱性（炎症）痤疮。外用抗生素通常是红霉素或克林霉素。抗生素制剂联合过氧化苯甲酰外用可以减少耐药性的发生。 乙醇酸可以代替维甲酸或除维甲酸外使用，但不再普遍使用。 除了可引起干燥和刺激（以及罕见的对过氧化苯甲酰的过敏反应），这些治疗并无严重的不良反应。 对外用治疗无反应的患者，用粉刺提取器物理性地剔除 粉刺亦是不错的选择。粉刺剔除术可由医师、护士或医师助手完成。粉刺提取器的一端类似于刀片或刺刀，可刺破闭合性粉刺，另一端施压于患处，挤出粉刺内容物。 当皮损泛发，外用治疗无法控制时，可考虑予以口服抗生素（如四环素、米诺环素、多西环素、红霉素等）。 Clascoterone 是第一个治疗痤疮的外用雄激素受体抑制剂。它可用于12岁及以上的患者。1%克拉司酮乳膏每天使用2次。不良反应包括发红、脱屑或干燥、瘙痒；虽然根据其机制预测了高钾血症和下丘脑-垂体-肾上腺轴抑制，但这些影响在临床上尚未发现(3 治疗参考文献 由于毛囊阻塞和皮脂腺单位（毛囊及其附属的皮脂腺）的炎症，寻常痤疮主要表现为粉刺、丘疹、结节和（或）囊肿。痤疮好发于面部和上部躯干。多发在青春期。诊断根据临床。需根据痤疮的严重程度来制定相应的方案，治疗包括一系列不同的外用和系统药物，主要通过减少皮脂腺分泌，减少粉刺形成，控制炎症和抗菌，以及调节上皮角... Common.TooltipReadMore ）。 中度痤疮 口服抗生素全身治疗 是治疗中度痤疮的最佳方式。对痤疮有效的抗生素有四环素、米诺环素、强力霉素和萨瑞环素，最好连续使用≥12周。 局部治疗轻度痤疮 通常与口服抗生素同时进行。 多西环素和米诺环素是一线药物；两者都可以与食物一起服用。 四环素也是一种很好的首选药物，但它不能与食物同服，且疗效可能低于多西环素和米诺环素。 多西环素和米诺环素的使用剂量为50~100mg po bid。多西环素可引起光敏，长期使用米诺环素可引起更多不良反应，包括药物诱发性狼疮和色素沉着。 四环素应在两餐之间口服，使用剂量为250~500mg bid。 病情控制后，为减少抗生素耐药的发生（通常2~3个月），应尽可能减少剂量以维持病情控制状态。Sarecycline 是一种新型四环素抗生素。剂量以体重为基础：33 至 54 公斤，每天一次口服 60 毫克； 55 至 84 公斤，100 毫克口服，每天一次； 85～136公斤，150毫克，每日一次。 若局部治疗维持在病情控制良好的状态，可停用抗生素。 红霉素和阿奇霉素是其他的选择，但它们可能会导致胃肠道不良反应，也更常发生抗生素耐药。一些医生还使用甲氧苄氨嘧啶/磺胺甲恶唑，但可能会产生耐药性，并且这种组合可能引起罕见的药物不良反应。 长期使用抗生素可能引起鼻部和面中部的革兰氏阴性菌脓疱性毛囊炎。这种并不常见的二重感染治疗起来比较棘手，最好在停用口服抗生素后续服异维A酸。氨苄西林亦是治疗革兰氏阴性菌毛囊炎的选择之一。长期使用抗生素的女性，易继发念珠菌性阴道炎；若局部和系统用药均不能治愈阴道炎，须停用治疗痤疮的抗生素。 对口服抗生素无效的女性患者，可以考虑予以口服抗雄激素治疗（口服避孕药和/或安体舒通）。 重度痤疮 对于抗生素治疗无效的中度痤疮和炎症严重的痤疮，口服异维A酸是最佳选择。剂量通常为1mg/（kg•d），可增加至2mg/（kg•d），疗程16～20周。若该剂量下出现严重的副反应，则减量至0.5mg/（kg•d）。停止用药后，痤疮仍会继续改善。 许多患者不需要第二疗程；如若需要，须在停药4个月后再开始第二疗程的用药，但严重情况下可以更早复用。如果初始剂量较低（0.5 mg/kg），则更需要再次治疗。使用这种剂量（在欧洲非常流行），不良反应较少发生，但通常需要延长治疗时间。累积剂量获得研究支持; 120至150mg/kg的总剂量导致较低的复发率，一些专家建议累积剂量更高，为220mg/kg (4 治疗参考文献 由于毛囊阻塞和皮脂腺单位（毛囊及其附属的皮脂腺）的炎症，寻常痤疮主要表现为粉刺、丘疹、结节和（或）囊肿。痤疮好发于面部和上部躯干。多发在青春期。诊断根据临床。需根据痤疮的严重程度来制定相应的方案，治疗包括一系列不同的外用和系统药物，主要通过减少皮脂腺分泌，减少粉刺形成，控制炎症和抗菌，以及调节上皮角... Common.TooltipReadMore )。 异维A酸治疗痤疮效果极佳，但临床运用受限于其副作用，包括睑结膜和生殖器黏膜的干燥、口唇干裂、关节痛、抑郁、血脂升高等，孕期用药还有导致胎儿畸形的风险。外用凡士林产生的水合作用可以缓解黏膜和皮肤的干燥。关节痛（主要是大关节或下背部）经常发生。不少文献均认为口服异维A酸可增加抑郁和自杀的风险，但这仍是小概率事件。新发或恶化的炎症性肠病（克罗恩病和溃疡性结肠炎）的风险是否增加仍不明确（5 治疗参考文献 由于毛囊阻塞和皮脂腺单位（毛囊及其附属的皮脂腺）的炎症，寻常痤疮主要表现为粉刺、丘疹、结节和（或）囊肿。痤疮好发于面部和上部躯干。多发在青春期。诊断根据临床。需根据痤疮的严重程度来制定相应的方案，治疗包括一系列不同的外用和系统药物，主要通过减少皮脂腺分泌，减少粉刺形成，控制炎症和抗菌，以及调节上皮角... Common.TooltipReadMore ）。 治疗前应检测全血细胞计数、肝功能、甘油三酯和胆固醇水平。治疗4周后须重新评估上述指标，若未发现异常，直至治疗结束无需再重复检查。甘油三酯很少升高到需要停药的水平。肝功能很少受到影响。 由于异维A酸具有致畸性，须告知育龄期妇女在用药前1月、用药期间以及停药后1个月均须使用两种避孕措施以防止怀孕。 治疗前直到治疗后1个月，每月均须行妊娠测试。 囊肿性痤疮 皮损内注射0.1 mL浓度为2.5mg/mL（浓度为10mg/mL的悬液需先进行稀释）的曲安奈德悬浊液适用于渴望迅速改善皮损并减少瘢痕形成的囊肿性痤疮患者。可能会出现局部萎缩，但多为暂时性的。对于孤立的、湿软的皮损，切开引流效果佳，但会留有永久性瘢痕。 其他类型痤疮 面部脓皮病须用口服糖皮质激素和异维A酸治疗。 暴发性痤疮常需口服糖皮质激素和系统使用抗生素进行治疗。 如果很严重且全身性抗生素无效，则合并性痤疮可用口服异维jia酸和全身性皮质类固醇治疗。 由内分泌异常引发的痤疮（例如，多囊性卵巢综合征，女性的男性化肾上腺肿瘤），需使用抗雄激素治疗。螺内酯，具有一定的抗雄激素作用，治疗痤疮的剂量一般为口服50～150mg（最大剂量200mg）一次/天。环丙孕酮在欧洲运用广泛。 当其他措施均无效时，可尝试含有雌孕激素的避孕药，疗程≥6个月方可显效。 瘢痕 小的瘢痕可用化学剥脱、激光换肤、磨削术等治疗。深而散的瘢痕可予以切除。 宽而浅的凹坑可采用皮下切除，或注射胶原蛋白或其他填充物来治疗。包括胶原蛋白，透明质酸和聚甲基丙烯酸甲酯在内的填充物的功效是暂时的，必须定期重复使用。 治疗参考文献 1.Dall'Oglio F, Nasca M, Fiorentini F, Micali G: Diet and acne: Review of the evidence from 2009 to 2020.Int J Dermatol 60(6):672–685, 2021. doi: 10.1111/ijd.15390. 2.Bienenfeld A, Nagler AR, Orlow SJ: Oral antibacterial therapy for acne vulgaris: An evidence-based review.Am J Clin Dermatol 18(4):469–490, 2017.doi: 10.1007/s40257-017-0267-z 3.Hebert A, Thiboutot D, Stein Gold L, et al: Efficacy and safety of topical clascoterone cream, 1%, for treatment in patients with facial acne: Two phase 3 randomized clinical trials.JAMA Dermatol 156(6):621–630, 2020.doi:10.1001/jamadermatol.2020.0465 4.Blasiak RC, Stamey CR, Burkhart CN, et al: High-dose isotretinoin treatment and the rate of retrial, relapse, and adverse effects in patients with acne vulgaris.JAMA Dermatol 149(12):1392–1398, 2013.doi: 10.1001/jamadermatol.2013.6746 5.Lee SY, Jamal MM, Nguyen ET, et al: Does exposure to isotretinoin increase the risk for the development of inflammatory bowel disease?A meta-analysis.Eur J Gastroenterol Hepatol 28(2):210–216, 2016. doi: 10.1097/MEG.0000000000000496 更多信息 以下英语资源可能会有用。 请注意，本手册对这些资源的内容不承担任何责任。 American Academy of Dermatology: Guidelines of care for the management of acne vulgaris (2016) 关键点 非炎性痤疮表现为粉刺，而炎性痤疮主要表现为丘疹、脓疱、结节和囊肿。 在20岁中期之前，轻度和中度痤疮通常愈后不留疤痕。 建议患者避免诱发因素（如可阻塞毛囊的化妆品和衣物、清洁剂、乳液、高湿度、一些药物和化学品，以及大量摄入牛奶或高血糖饮食）。 不仅要考虑到痤疮给患者生理上带来的影响，还要考虑到心理上的负面影响。 可以处方粉刺溶解剂（如维甲酸），对于炎症性痤疮，可加用过氧化苯甲酰、外用抗生素，或两者联合。 中度痤疮可处方口服抗生素，重度痤疮可处方异维A酸。 皮损内注射曲安奈德治疗囊性痤疮的急性病变
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Acne: Types, Causes, Treatment & Prevention
: Types, Causes, Treatment & Prevention800.223.2273100 Years of Cleveland ClinicMyChartNeed Help?GivingCareersSearchClevelandClinic.orgFind A DoctorLocations & DirectionsPatients & VisitorsHealth LibraryInstitutes & DepartmentsAppointmentsHome/Health Library/Diseases & Conditions/AcneAdvertisementAdvertisementAdvertisementAcneAcne is a very common skin condition that causes pimples. You’ll usually get pimples on your face. Clogged pores cause acne. Teenagers and young adults most often get acne, but it can also occur during adulthood for many people. Treatment is available to clear acne from your skin and prevent scarring.ContentsArrow DownOverviewSymptoms and CausesDiagnosis and TestsManagement and TreatmentPreventionOutlook / PrognosisLiving WithContentsArrow DownOverviewSymptoms and CausesDiagnosis and TestsManagement and TreatmentPreventionOutlook / PrognosisLiving WithOverviewWhat is acne?Acne is a common skin condition where the pores of your skin clog. Pore blockages produce blackheads, whiteheads and other types of pimples. Pimples are pus-filled, sometimes painful, bumps on your skin.The medical term for acne is acne vulgaris.AdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. PolicyWhat are the types of acne?There are several types of acne, including:Fungal acne (pityrosporum folliculitis): Fungal acne occurs when yeast builds up in your hair follicles. These can be itchy and inflamed.Cystic acne: Cystic acne causes deep, pus-filled pimples and nodules. These can cause scars.Hormonal acne: Hormonal acne affects adults who have an overproduction of sebum that clogs their pores.Nodular acne: Nodular acne is a severe form of acne that causes pimples on the surface of your skin, and tender, nodular lumps under your skin.All of these forms of acne can affect your self-esteem, and both cystic and nodular acne can lead to permanent skin damage in the form of scarring. It’s best to seek help from a healthcare provider early so they can determine the best treatment option(s) for you.Who does acne affect?Acne usually affects everyone at some point in their lifetime. It’s most common among teenagers and young adults undergoing hormonal changes, but acne can also occur during adulthood. Adult acne is more common among women and people assigned female at birth (AFAB). You may be more at risk of developing acne if you have a family history of acne (genetics).AdvertisementHow common is acne?If you have acne, know that you’re not alone. Acne is the most common skin condition that people experience. An estimated 80% of people ages 11 to 30 will have at least a mild form of acne.Where on my body will I have acne?The most common places where you might have acne are on your:Face.Forehead.Chest.Shoulders.Upper back.Oil glands exist all over your body. The common locations of acne are where oil glands exist the most.AdvertisementSymptoms and CausesWhat are the symptoms of acne?Symptoms of acne on your skin include:Pimples (pustules): Pus-filled bumps (papules).Papules: Small, discolored bumps, often red to purple or darker than your natural skin tone.Blackheads: Plugged pores with a black top.Whiteheads: Plugged pores with a white top.Nodules: Large lumps under your skin that are painful.Cysts: Painful fluid-filled (pus) lumps under your skin.Acne can be mild and cause a few occasional pimples or it can be moderate and cause inflammatory papules. Severe acne causes nodules and cysts.What causes acne?Clogged hair follicles or pores cause acne. Your hair follicles are small tubes that hold a strand of your hair. There are several glands that empty into your hair follicles. When too much material is inside your hair follicle, a clog occurs. Your pores can clog with:Sebum: An oily substance that provides a protective barrier for your skin.Bacteria: Small amounts of bacteria naturally live on your skin. If you have too much bacteria, it can clog your pores.Dead skin cells: Your skin cells shed often to make room for more cells to grow. When your skin releases dead skin cells, they can get stuck in your hair follicles.When your pores clog, substances plug up your hair follicle, creating a pimple. This triggers inflammation, which you feel as pain and swelling. You can also see inflammation through skin discoloration like redness around a pimple.Triggers of acneCertain things in your environment contribute to acne or they can make an acne breakout worse, including:Wearing tight-fitting clothing and headgear, like hats and sports helmets.Air pollution and certain weather conditions, especially high humidity.Using oily or greasy personal care products, like heavy lotions and creams, or working in an area where you routinely come in contact with grease, such as working at a restaurant with frying oil.Stress, which increases the hormone cortisol.A side effect of a medication.Picking at your acne.Foods that cause acneSome studies link particular foods and diets to acne, like:Skim milk.Whey protein.Diets high in sugar.While high-sugar diets may lead to acne outbreaks, chocolate isn’t directly linked to acne.To reduce your risk of acne, choose to eat a balanced, nutritious diet with plenty of fresh fruits and vegetables, especially those rich in vitamin C and beta-carotene, which helps reduce inflammation.Hormones and acneAcne is largely a hormonal condition that’s driven by androgen hormones (testosterone). This typically becomes active during teenage and young adult years. You might also notice acne forming around the time of your period as a result of hormone activity. Sensitivity to this hormone — combined with surface bacteria on your skin and substances released from your body’s glands — can result in acne.Diagnosis and TestsHow is acne diagnosed?A healthcare provider can diagnose acne during a skin exam. During this exam, the provider will closely look at your skin to learn more about your symptoms. In addition, they may also ask about risk factors for acne, like:Are you feeling stressed?Do you have a family history of acne?If a woman or person AFAB, do you notice breakouts during your menstrual cycle?What medications do you currently take?Your healthcare provider won’t need to run any diagnostic tests for acne, but they may offer tests to diagnose any underlying conditions if you have sudden, severe acne outbreaks, especially if you’re an adult.Who treats acne?A general healthcare provider or a dermatologist can diagnose and treat acne. If you have stubborn acne that doesn’t improve with treatment, a dermatologist can help.How severe can acne get?Dermatologists rank acne by severity:Grade 1 (mild): Mostly whiteheads and blackheads, with a few papules and pustules.Grade 2 (moderate or pustular acne): Multiple papules and pustules, mostly on your face.Grade 3 (moderately severe or nodulocystic acne): Numerous papules and pustules, along with occasionally inflamed nodules. Your back and chest may also be affected.Grade 4 (severe nodulocystic acne): Numerous large, painful and inflamed pustules and nodules.Management and TreatmentHow is acne treated?There are several ways to treat acne. Each type of treatment varies based on your age, the type of acne you have and the severity. A healthcare provider might recommend taking oral medications, using topical medications or using medicated therapies to treat your skin. The goal of acne treatment is to stop new pimples from forming and to heal the existing blemishes on your skin.Topical acne medicationsYour healthcare provider may recommend using a topical acne medication to treat your skin. You can rub these medications directly onto your skin as you would a lotion or a moisturizer. These could include products that contain one of the following ingredients:Benzoyl peroxide: This is available as an over-the-counter product (such as Clearasil®, Stridex® and PanOxyl®) as a leave-on gel or wash. It targets surface bacteria, which often aggravates acne. Lower concentrations and wash formulations are less irritating to your skin.Salicylic acid: This is available over the counter for acne as a cleanser or lotion. It helps remove the top layer of damaged skin. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging.Azelaic acid: This is a natural acid found in various grains such as barley, wheat and rye. It kills microorganisms on the skin and reduces swelling.Retinoids (vitamin A derivatives): Retinol, such as Retin-A®, Tazorac® and Differin®, which is available without a prescription, breaks up blackheads and whiteheads and helps prevent clogged pores, the first signs of acne. Most people are candidates for retinoid therapy. These medications aren’t spot treatments and must be used on the entire area of skin affected by acne to prevent the formation of new pimples. You often need to use these for several months before noticing positive results.Antibiotics: Topical antibiotics like clindamycin and erythromycin control surface bacteria that aggravate and cause acne. Antibiotics are more effective when combined with benzoyl peroxide.Dapsone: Dapsone (Aczone®) is a topical gel, which also has antibacterial properties. It treats inflamed acne.Oral acne medicationsOral acne medications are pills that you take by mouth to clear your acne. Types of oral acne medications could include:Antibiotics: Antibiotics treat acne caused by bacteria. Common antibiotics for acne include tetracycline, minocycline and doxycycline. These are best for moderate to severe acne.Isotretinoin (Amnesteem®, Claravis® and Sotret®): Isotretinoin is an oral retinoid. Isotretinoin shrinks the size of oil glands, which contributes to acne formation.Contraceptives: The use of certain contraceptives can sometimes help women and people AFAB who have acne. The U.S. Food and Drug Administration (FDA) approved several types of birth control pills for treating acne. Some brand names include Estrostep®, Beyaz®, Ortho Tri-Cyclen® and Yaz®. These pills contain a combination of estrogen (the primary AFAB sex hormone) and progesterone (a natural form of steroid that helps regulate menstruation).Hormone therapy: Hormone therapy is helpful for some people with acne, especially if you experience acne flare-ups during menstruation or irregular periods caused by excess androgen (a hormone). Hormone therapy consists of low-dose estrogen and progesterone (birth control pills) or a medication called spironolactone that blocks the effect of certain hormones at the level of your hair follicles and oil glands.Additional acne therapiesIf topical or oral medications don’t work well for your acne or if you have scars from your acne, a healthcare provider may recommend different types of acne therapies to clear your skin, including:Steroids: Steroids can treat severe acne with injections into large nodules to reduce inflammation.Lasers: Lasers and light therapy treat acne scars. A laser delivers heat to the scarred collagen under your skin. This relies on your body’s wound-healing response to create new, healthy collagen, which encourages growth of new skin to replace it.Chemical peels: This treatment uses special chemicals to remove the top layer of old skin. After removal of the top layer of skin, new skin grows in smoother and can lessen acne scars.How do antibiotics treat acne?Antibiotics are medications that target bacteria. Some used to treat acne also can decrease inflammation. Bacteria can clog your pores and cause acne. Antibiotics are responsible for:Blocking bacteria from entering your body.Destroying bacteria.Preventing bacteria from multiplying.A healthcare provider will recommend antibiotics if you have acne caused by bacteria or if you have an infection. Antibiotics get rid of an infection if bacteria gets into a popped pimple, which can swell and become painful. This medication isn’t a cure for acne and you shouldn’t take it long-term to treat acne.How can I make my acne go away at home?If you have acne, you can start an at-home skin care routine to help your acne go away by:Washing your skin at least once daily with warm (not hot) water and a gentle cleanser. Cleansers are over-the-counter skin care products that help clean your skin.Washing your skin after you exercise or sweat.Avoid using skin care products with alcohol, astringents, toners and exfoliants, which can irritate your skin.Removing your makeup at the end of the day or before you go to bed.Choosing an oil-free moisturizer to apply on your skin after cleansing.Avoid popping, picking or squeezing your acne. Let your skin heal naturally to prevent scars from forming on your skin.If your at-home skin care routine isn’t effective at treating acne, visit a healthcare provider.Is acne treatment safe for people who are pregnant?Many topical and oral acne treatments aren’t safe to take during pregnancy. If you’re pregnant or planning on becoming pregnant, it’s important to discuss acne treatments with your healthcare provider and notify them if you become pregnant.How long does it take for acne to go away?On average, it can take between one to two weeks for acne pimples to clear up on their own. With medicated treatment and a good skin care routine, you can speed up your body’s healing time to make acne go away faster. For severe acne, it can take several weeks for your acne to go away, even with treatment.Care at Cleveland ClinicFind a Primary Care ProviderSchedule an AppointmentPreventionHow can I prevent acne?You can’t completely prevent acne, especially during hormone changes, but you can reduce your risk of developing acne by:Washing your face daily with warm water and a facial cleanser.Using an oil-free moisturizer.Wearing “noncomedogenic” makeup products and removing makeup at the end of each day.Keeping your hands away from your face.Outlook / PrognosisWhat can I expect if I have acne?Acne often goes away in early adulthood, though some people will continue to experience acne throughout adulthood. Your healthcare provider or a board-certified dermatologist can help you manage this condition. Various medications and therapies are effective forms of treatment. They target the underlying factors that contribute to acne. It may take several different types of treatment before you and your healthcare provider find one that works best for your skin. The skin care products that work for you might not work for someone else with similar symptoms.Can acne cause scars?Yes, sometimes acne can cause scarring. This happens when the acne penetrates the top layer of your skin and damages deeper skin layers. Inflammation makes your acne pores swell and the pore walls start to breakdown, which causes skin damage. Scarring can be a source of anxiety, which is normal. Before treatment, your healthcare provider will determine what type of acne caused your scars. There are several treatment options available for acne scars.How does acne affect my mental health?Acne can cause disruptions in your mental health because it affects your appearance and self-esteem. Often, acne development is out of your control if hormones cause it. This can create stress, which can influence future breakouts. Acne can be challenging for teenagers and young adults. If your acne causes you to feel anxious or it prevents you from participating in social activities with your friends and family, talk to a healthcare provider or a mental health professional.Living WithWhen should I see my healthcare provider?Visit a healthcare provider as soon as you notice pimples so you can start treatment immediately before scarring occurs. If you’re using an acne treatment that isn’t working to clear your acne or it causes skin irritation like itchiness or skin discoloration, visit a provider.What questions should I ask my doctor?What type of acne do I have?How severe is my acne?Do I need to see a dermatologist?What over-the-counter medications do you recommend?What prescription medications do you recommend?A note from Cleveland ClinicAcne is the most common of all skin conditions and it can have an impact on your mental health and self-esteem. If you have stubborn acne, visit a healthcare provider or a dermatologist to treat your acne. Sometimes, your acne needs a little extra help to go away with a medication if at-home skin care treatments don’t work. While it may be tempting, try not to pick at your acne or pop pimples to prevent scarring. Remember that acne is temporary and will go away with the right treatment designed for your skin.Medically ReviewedLast reviewed by a Cleveland Clinic medical professional on 01/04/2023.Learn more about our editorial process.ReferencesAdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. 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All Rights Reserved.什麼是青春痘 (Acne) | NIAMS
什麼是青春痘 (Acne) | NIAMS
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什麼是青春痘 (Acne)
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概述, 症状, & 起因
诊断, 治疗, & 采取的步骤
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需要記住的有關痤瘡的要點
痤瘡是常見的皮膚狀況，是由皮膚下面的毛囊堵塞造成的。
痤瘡會造成若干類型的病灶，又稱粉刺。
藥物和其他程序（例如鐳射和光療法）是最常見的治療方法。
治療的目的是幫助病灶癒合、停止新的病灶形成和預防形成疤痕。
痤瘡可令人感到難堪，或者讓您感覺羞怯或焦慮。如果您有以上任何感受，請與醫生商談。
什麼是痤瘡？
痤瘡是常見的皮膚狀況，是由皮膚下面的毛囊堵塞造成的。油脂和死亡的皮膚細胞堵住毛孔，可爆發皮膚病灶（通常稱為粉刺或青春痘）。爆發最常見於面部，但也可出現在背部、胸部和肩部。
大多數人的痤瘡通常會在三十多歲之前消失，但有些人到四十多歲和五十多歲時仍然還有這一皮膚問題
哪些人會患上痤瘡？
任何種族和年齡的人都可患上痤瘡，但最常見於青少年和青年人。青少年期出現的痤瘡更常見於男性。痤瘡可以在成年後繼續，而這樣的情況更常見於女性。
青春痘的治療方法有哪些？
痤瘡會造成若干類型的病灶，又稱粉刺。部分類型如下：
痤瘡位於皮下，產生白色丘疹（稱為白頭）。
痤瘡到達皮膚表面，出現開口（稱為黑頭）
皮膚上的粉紅色小丘疹，有觸痛。
頂部是白色或黃色的膿皰，底部可能發紅。
皮膚內深處的較大疼痛硬結。
造成深部疼痛的膿皰。
痤瘡的病因是什麼？
醫生們認為以下一種或多種情況可導致痤瘡：
毛孔內油脂過多。
毛孔內死亡的皮膚細胞沉積。
毛孔內有細菌生長。
以下因素可導致您更有可能患上痤瘡：
荷爾蒙。
家族史。
藥物。
年齡。
以下因素不會引起痤瘡，但可能讓痤瘡更嚴重。
某些食物。
壓力。
穿戴運動頭盔、緊身衣物或背包產生的壓力。
污染和高濕度。
擠壓或摳粉刺。
用過大力氣搓揉皮膚。
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Acne - Diagnosis and treatment - Mayo Clinic
Acne - Diagnosis and treatment - Mayo Clinic
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TreatmentIf you've tried over-the-counter (nonprescription) acne products for several weeks and they haven't helped, ask your doctor about prescription-strength medications. A dermatologist can help you:
Control your acne
Avoid scarring or other damage to your skin
Make scars less noticeable
Acne medications work by reducing oil production and swelling or by treating bacterial infection. With most prescription acne drugs, you may not see results for four to eight weeks. It can take many months or years for your acne to clear up completely.
The treatment regimen your doctor recommends depends on your age, the type and severity of your acne, and what you are willing to commit to. For example, you may need to wash and apply medications to the affected skin twice a day for several weeks. Topical medications and drugs you take by mouth (oral medication) are often used in combination. Treatment options for pregnant women are limited due to the risk of side effects.
Talk with your doctor about the risks and benefits of medications and other treatments you are considering. And make follow-up appointments with your doctor every three to six months until your skin improves.
Topical medicationsThe most common topical prescription medications for acne are:
Retinoids and retinoid-like drugs. Drugs that contain retinoic acids or tretinoin are often useful for moderate acne. These come as creams, gels and lotions. Examples include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage, others). You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It prevents plugging of hair follicles. Do not apply tretinoin at the same time as benzoyl peroxide.
Topical retinoids increase your skin's sun sensitivity. They can also cause dry skin and redness, especially in people with brown or Black skin. Adapalene may be tolerated best.
Antibiotics. These work by killing excess skin bacteria and reducing redness and inflammation. For the first few months of treatment, you may use both a retinoid and an antibiotic, with the antibiotic applied in the morning and the retinoid in the evening. The antibiotics are often combined with benzoyl peroxide to reduce the likelihood of developing antibiotic resistance. Examples include clindamycin with benzoyl peroxide (Benzaclin, Duac, others) and erythromycin with benzoyl peroxide (Benzamycin). Topical antibiotics alone aren't recommended.
Azelaic acid and salicylic acid. Azelaic acid is a naturally occurring acid produced by a yeast. It has antibacterial properties. A 20% azelaic acid cream or gel seems to be as effective as many conventional acne treatments when used twice a day. Prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding. It can also be used to manage discoloration that occurs with some types of acne. Side effects include skin redness and minor skin irritation.
Salicylic acid may help prevent plugged hair follicles and is available as both wash-off and leave-on products. Studies showing its effectiveness are limited. Side effects include skin discoloration and minor skin irritation.
Dapsone. Dapsone (Aczone) 5% gel twice daily is recommended for inflammatory acne, especially in women with acne. Side effects include redness and dryness.
Evidence is not strong in support of using zinc, sulfur, nicotinamide, resorcinol, sulfacetamide sodium or aluminum chloride in topical treatments for acne.
Oral medications
Antibiotics. For moderate to severe acne, you may need oral antibiotics to reduce bacteria. Usually the first choice for treating acne is a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin). A macrolide might be an option for people who can't take tetracyclines, including pregnant women and children under 8 years old.
Oral antibiotics should be used for the shortest time possible to prevent antibiotic resistance. And they should be combined with other drugs, such as benzoyl peroxide, to reduce the risk of developing antibiotic resistance.
Severe side effects from the use of antibiotics to treat acne are uncommon. These drugs do increase your skin's sun sensitivity.
Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine progestin and estrogen (Ortho Tri-Cyclen 21, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it for the first few weeks may help.
Common side effects of combined oral contraceptives are weight gain, breast tenderness and nausea. These drugs are also associated with increased risk of cardiovascular problems, breast cancer and cervical cancer.
Anti-androgen agents. The drug spironolactone (Aldactone) may be considered for women and adolescent girls if oral antibiotics aren't helping. It works by blocking the effect of androgen hormones on the oil-producing glands. Possible side effects include breast tenderness and painful periods.
Isotretinoin. Isotretinoin (Amnesteem, Claravis, others) is a derivative of vitamin A. It may be prescribed for people whose moderate or severe acne hasn't responded to other treatments.
Potential side effects of oral isotretinoin include inflammatory bowel disease, depression and severe birth defects. All people receiving isotretinoin must participate in an FDA-approved risk management program. And they'll need to see their doctors regularly to monitor for side effects.
TherapiesFor some people, the following therapies might be helpful, either alone or in combination with medications.
Light therapy. A variety of light-based therapies have been tried with some success. Most will require multiple visits to your doctor's office. Further study is needed to determine the ideal method, light source and dose.
Chemical peel. This procedure uses repeated applications of a chemical solution, such as salicylic acid, glycolic acid or retinoic acid. This treatment is for mild acne. It might improve the appearance of the skin, though the change is not long lasting and repeat treatments are usually needed.
Drainage and extraction. Your doctor may use special tools to gently remove whiteheads and blackheads (comedos) or cysts that haven't cleared up with topical medications. This technique temporarily improves the appearance of your skin, but it might also cause scarring.
Steroid injection. Nodular and cystic lesions can be treated by injecting a steroid drug into them. This therapy has resulted in rapid improvement and decreased pain. Side effects may include skin thinning and discoloration in the treated area.
Treating childrenMost studies of acne drugs have involved people 12 years of age or older. Increasingly, younger children are getting acne as well. The FDA has expanded the number of topical products approved for use in children. And guidelines from the American Academy of Dermatology indicate that topical benzoyl peroxide, adapalene and tretinoin in preadolescent children are effective and don't cause increased risk of side effects.
If your child has acne, consider consulting a pediatric dermatologist. Ask about drugs to avoid in children, appropriate doses, drug interactions, side effects, and how treatment may affect a child's growth and development.More InformationAcne scars: What's the best treatment?Chemical peelDermabrasionLaser resurfacingShow more related information
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Alternative medicineSome alternative and integrative medicine approaches might be helpful in reducing acne:
Tea tree oil. Gels containing at least 5% tea tree oil may be as effective as lotions containing 5% benzoyl peroxide, although tea tree oil might work more slowly. Possible side effects include minor itching, burning, redness and dryness, which make it a poor choice for people with rosacea.
Brewer's yeast. A strain of brewer's yeast called Hansen CBS seems to help decrease acne when taken orally. It may cause gas (flatulence).
More research is needed to establish the potential effectiveness and long-term safety of these and other integrative approaches, such as biofeedback and ayurvedic compounds. Talk with your doctor about the pros and cons of specific treatments before you try them.
Lifestyle and home remediesYou can try to avoid or control mild or moderate acne with nonprescription products, good basic skin care and other self-care techniques:
Wash problem areas with a gentle cleanser. Twice a day, use your hands to wash your face with mild soap or a gentle cleanser (Cetaphil, Vanicream, others) and warm water. And be gentle if you're shaving affected skin.
Avoid certain products, such as facial scrubs, astringents and masks. They tend to irritate the skin, which can worsen acne. Too much washing and scrubbing also can irritate the skin.
Try over-the-counter acne products to dry excess oil and promote peeling. Look for products containing benzoyl peroxide and adapalene as the active ingredients. You might also try products containing salicylic acid, glycolic acid or alpha hydroxy acids. It may take a few weeks of using a product before you see any improvement.
Creams are less irritating than gels or ointments. Nonprescription acne medications may cause initial side effects — such as redness, dryness and scaling — that often improve after the first month of using them.
Avoid irritants. Oily or greasy cosmetics, sunscreens, hairstyling products or acne concealers can worsen acne. Instead, use products labeled water-based or noncomedogenic, which means they are less likely to cause acne.
Protect your skin from the sun. For some people, the sun worsens the discoloration that sometimes lingers after the acne has cleared. And some acne medications make you more susceptible to sunburn. Check with your doctor to see if your medication is one of these. If it is, stay out of the sun as much as possible. Regularly use a nonoily (noncomedogenic) moisturizer that includes a sunscreen.
Avoid friction or pressure on your skin. Protect your acne-prone skin from contact with items such as phones, helmets, tight collars or straps, and backpacks.
Avoid touching or picking acne-prone areas. Doing so can trigger more acne or lead to infection or scarring.
Shower after strenuous activities. Oil and sweat on your skin can lead to breakouts.
More InformationNonprescription acne treatment: Which products work best?
Coping and supportAcne and acne scars can cause anxiety and may affect your social relationships and self-image. Sometimes it can help to talk with your family, a support group or a counselor.
Stress can worsen acne. Try to manage stress by getting enough sleep and practicing relaxation techniques.
Preparing for your appointmentIf you have acne that's not responding to self-care and over-the-counter treatments, make an appointment with your doctor. Early, effective treatment of acne reduces the risk of scarring and of lasting damage to your self-esteem. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of skin conditions (dermatologist).
Here's some information to help you get ready for your appointment.
What you can do
List your key medical information, such as other conditions you're dealing with and any prescription or over-the-counter products you're using, including vitamins and supplements.
List key personal information, including any major stresses or recent life changes.
List questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.
Below are some basic questions to ask your doctor about acne. If any additional questions occur to you during your visit, don't hesitate to ask.
What treatment approach do you recommend for me?
If the first treatment doesn't work, what will you recommend next?
What are the possible side effects of the medications you're prescribing?
How long can I safely use the medications you're prescribing?
How soon after beginning treatment might my symptoms start to improve?
When will you see me again to evaluate whether my treatment is working?
Is it safe to stop my medications if they don't seem to be working?
What self-care steps might improve my symptoms?
Do you recommend any changes to my diet?
Do you recommend any changes to the over-the-counter products I'm using on my skin, including soaps, lotions, sunscreens and cosmetics?
What to expect from your doctorYour doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:
When did you first develop this problem?
Does anything in particular seem to trigger an acne flare, such as stress or — in girls and women — your menstrual cycle?
What medications are you taking, including over-the-counter and prescription drugs as well as vitamins and supplements?
In girls and women: Do you use oral contraceptives?
In girls and women: Do you have regular menstrual periods?
In girls and women: Are you pregnant, or do you plan to become pregnant soon?
What types of soaps, lotions, sunscreens, hair products or cosmetics do you use?
How is acne affecting your self-esteem and your confidence in social situations?
Do you have a family history of acne?
What treatments and self-care steps have you tried so far? Have any been effective?
Have other family members had isotretinoin treatment or hormone therapy to treat their acne? Has it been effective?
By Mayo Clinic Staff
Request an appointment
Symptoms & causesDoctors & departments
Oct. 08, 2022
Show references
AskMayoExpert. Acne. Mayo Clinic; 2019.
American Academy of Dermatology. Guidelines of care for the management of acne vulgaris. https://doi.org/10.1016/j.jaad.2015.12.037.
Alpha hydroxyl acids (AHAs). Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed July 9, 2020.
Rakel D, ed. Acne vulgaris and acne rosacea. In: Integrative Medicine. 4th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Sept. 5, 2017.
Dinulos JGH. Acne, rosacea, and related disorders. Habif's Clinical Dermatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 6, 2020.
Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/acne. Accessed July 9, 2020.
Graber E. Treatment of acne vulgaris. https://www.uptodate.com/contents/search. Accessed July 9, 2020.
Thiboutot D, et al. Pathogenesis, clinical manifestations and diagnosis of acne vulgaris. https://www.uptodate.com/contents/search. Accessed July 9, 2020.
Kermott CA, et al., eds. Acne. In: Mayo Clinic Book of Home Remedies. 2nd ed. Time; 2017.
Maymone M, et al. Common skin disorders in pediatric skin of color. Journal of Pediatric Health Care. 2019; doi:10.1016/j.pedhc.2019.04.019.
Matthes BM, et al. Intralesional corticosteroid injection. https://www.uptodate.com/contents/search. Accessed July 8, 2020.
Gibson LE (expert opinion). Mayo Clinic. July 20, 2020.
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Acne | Johns Hopkins Medicine
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What is acne?
Acne is a disorder of the hair follicles and oil glands (sebaceous glands). The sebaceous glands secrete oils (sebum) to keep the skin moist. When the glands get clogged, it can lead to pimples and cysts.
Acne is very common. People of all races and ages have acne. In fact, most people in the U.S. between 11 and 30 years old will be affected by it. Even people in their 40s and 50s can have acne. However, acne most often begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls. This causes the sebaceous glands to make more oil.
Normally, the sebum produced travels through the hair follicles to the skin. However, skin cells can plug the follicles. This can block the sebum. When follicles become plugged, skin bacteria begin to grow inside the follicles. Inflammation and pimples then develop. The most common types of pimples are:
Whiteheads (closed comedones): These pimples are sealed over and have a small white pus filled top.
Blackheads (open comedones): These pimples have a small, black opening at the top. Although these pimples are black, the color is not from dirt. It's from the process of oxidation when the sebum is exposed to air.
Papules: These are tender, small pink bumps.
Pustules: Pimples that have pus on the top and are red on the bottom of the lesion. These are characteristics of inflammatory acne.
Nodules: These are hard, large, painful pimples that arise deep in the skin.
Cysts: Pus-filled, deep, painful pimples that often result in scars.
The basic acne lesion is called a comedo.
What causes acne?
Rising hormone levels during puberty may cause acne. Also, acne is often inherited. Other causes of acne may include the following:
Hormone level changes during a woman’s menstrual cycle
Hormone changes during pregnancy
Starting or stopping birth control pills
Certain medicines (such as corticosteroids, lithium, and barbiturates)
Oil and grease from the scalp, mineral or cooking oil, and certain cosmetics
Diet may also play a role
Squeezing the pimples or scrubbing the skin too hard can make acne worse. Skin may also become irritated with friction or pressure from helmets, backpacks, or tight collars. Pollution or humidity can also irritate the skin.
What are the symptoms of acne?
Acne can appear as pimples without abscesses or pus-filled cysts that rupture and result in larger abscesses. It can happen anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands, including:
Face
Chest
Upper back
Shoulders
Neck
Acne may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.
How is acne diagnosed?
Your healthcare provider can usually diagnose acne by examining your skin.
How is acne treated?
Your healthcare provider will consider your age, overall health, the severity of the acne and other factors in determining what treatment is best for you.
Treatment for acne focuses on minimizing scarring and improving appearance. Treatment for acne may include medicines you apply to your skin or medicine you take in pill form. Some of these medicines need to be prescribed by your healthcare provider. In some cases, a combination of both types of medicines may be advised.
Medicines you apply to the skin are often prescribed to treat acne. These may be in the form of a cream, gel, lotion, or solution. Examples include:
Treatment Option
Effect
Benzoyl peroxide
Kills the bacteria
Antibiotics
Helps stop or slow down the growth of the bacteria and reduces inflammation. Erythromycin and clindamycin are commonly used.
Retinoids
Stops the development of new acne lesions and encourages cell turnover, unplugging pimples. These include tretinoin, adapalene, and tazarotene.
Topical tazorotene, azelaic acid, salicylic acid, and dapsone are also commonly used.
Acne medicines you take by mouth, or oral antibiotics, are often prescribed to treat moderate to severe acne, and may include the following:
Doxycycline
Erythromycin
Tetracycline
Minocycline
Trimethoprim
Sulfamethasoxazole/trimethoprim
Dapsone
Spironolactone or birth control can be used by women to affect hormones to control acne.
Photodynamic therapy is a laser procedure used to control moderate to severe acne.
Isotretinoin is a prescription medicine taken by mouth for severe, cystic, or inflammatory acne. It is used when other methods can’t prevent extensive scarring. Isotretinoin reduces the size of the sebaceous glands that make the skin oil. It also increases skin cell shedding, and affects the hair follicles. These effects reduce the development of acne. Isotretinoin can clear acne in the majority of people who use it. However, the medicine has major side effects, including potential psychiatric side effects. It is very important to discuss this medicine with your healthcare provider.
Women who are pregnant or who are able to become pregnant must not take isotretinoin. It can cause birth defects. Isotretinoin can also cause miscarriage or premature birth.
Your healthcare provider can recommend specific steps to minimize acne scars.
Although acne often is a chronic condition, even if it lasts only during adolescence, it can leave lifelong scars. Acne scars typically look like "ice pick" pit scars or crater-like scars. Although proper treatment may help reduce scarring, several dermatological procedures may help to further reduce any acne scars, including the following:
Dermabrasion: This may be used to minimize small scars, minor skin surface irregularities, surgical scars, and acne scars. It involves removing the top layers of skin with an electrical machine that "abrades" the skin. As the skin heals from the procedure, the surface appears smoother and fresher.
Chemical peels: These are often used to reduce sun-damaged skin, irregular pigment, and superficial scars. The top layer of skin is removed with a chemical applied to the skin. By removing the top layer, the skin regenerates, often improving the skin's appearance.
Dermal filler injections: These are injected beneath the skin to replace the body's natural collagen that has been lost. Injectable dermal fillers are generally used to treat wrinkles, scars, and facial lines.
Laser resurfacing: This uses high-energy light to burn away damaged skin. It may be used to reduce wrinkles and fine scars.
Phototherapy or blue light therapy: Phototherapy using a blue light source. It has been shown to decrease the number of acne-causing bacteria with minimal side effects, such as dry skin. Blue light therapy does not use ultraviolet (UV) light, so it does not damage the skin as earlier types of light therapy did.
Pulsed light and heat energy (LHE) therapy: This type of combined light and heat therapy is believed to work by destroying acne-causing bacteria. It also shrinks the glands in the skin that make oil. The FDA has approved an LHE system that uses green light and heat pulses for treating mild to moderate acne.
Punch grafts: Punch grafts are small skin grafts used to replace scarred skin. A hole is punched in the skin to remove the scar. This is then replaced with unscarred skin (often from the back of the earlobe). Punch grafts can help treat deep acne scars.
Autologous fat transfer: An autologous fat transfer uses fat taken from another site on your own body and injects it into your skin. The fat is placed beneath the surface of the skin to push up the depressed scars. This method is used to correct deep contour defects caused by scarring from severe acne. Because the fat may be reabsorbed into the skin over months, you may need to have it repeated.
What are the complications of acne?
Acne can leave lifelong physical scars. It can also cause self-esteem problems.
Can acne be prevented?
Acne is caused by normal hormonal changes that happen during puberty. This makes prevention of acne very difficult, or even impossible.
However, avoiding substances that can cause acne may help. This includes certain medicines (such as corticosteroids, lithium, and barbiturates), mineral or cooking oil, or certain cosmetics. Also, daily shampooing helps prevent oil and grease on the scalp from getting on your face or back. Early treatment of acne may prevent it from getting worse and causing scars.
When should I call my healthcare provider?
Acne is a common condition. If you have acne that isn't helped with home care or is severe or leaving scars, see your healthcare provider.
Key points about acne
Acne is a disorder of the hair follicles and sebaceous glands that become clogged. This leads to pimples and cysts.
Acne is a common condition that usually begins during puberty because of hormonal changes.
Acne can be either superficial or deep.
If untreated, acne can cause scaring that can last a lifetime.
Avoiding substances that make acne worse, and early treatment of acne, can reduce or prevent acne scars.
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Acne (Acne Vulgaris) > Fact Sheets > Yale Medicine
Acne (Acne Vulgaris) > Fact Sheets > Yale Medicine
Skip to Main Content1-877-YALEMDSSearch forSpecialistsFact SheetsDepartmentsClinical TrialsNewsPatient ToolsSearch1-877-YALEMDSAcne (Acne Vulgaris)•A common skin condition that occurs when the hair follicles get clogged with oil, skin cells, and bacteria•Symptoms include blackheads, whiteheads, pimples, and painful nodules under the skin•Treatments include lifestyle modifications and medications•Involves medical dermatology and pediatric dermatologyRelated Terms:AcneAcne and Acne-RelatedGrover's Disease, Transient Acantholytic DermatosisRosaceaAcne ScarOverviewWhat is acne?What causes acne?What are the risk factors for acne?What are the symptoms of acne?How is acne diagnosed?How is acne treated?What is the outlook for people with acne?What is unique about Yale Medicine's approach to treating acne?Related SpecialistsJonathan LeventhalMDDermatology, Medical Oncology, Melanoma and Onco-DermatologyJeffrey CohenMDDermatologyMatthew VeselyMD, PhDDermatologyMore Related SpecialistsAcne (Acne Vulgaris)PrintShareOverviewAcne, one of the most common skin disorders, peaks in adolescence and early adulthood, affecting around 85% of people between the ages of 12 and 24. Though it is often thought of as a teenage problem, acne can occur in people of any age, though it grows less common as time goes on. Still, over 25% of women and 12% of men in their 40s report having acne.
“It’s a common misconception to think of acne as a teenage disease,” says Yale Medicine dermatologist Christopher Bunick, MD, PhD. “One of the most common reasons adult women between the ages 20 of 40, for example, come to the dermatology clinic is for acne. Clinical trial data revealed that approximately 50% of women in their 20s, 33% of women in their 30s, and 25% of women in their 40s suffer from acne. The good news is there are many treatment options available to help.”What is acne?Acne is a category of skin complaints that includes pimples, blackheads, and whiteheads, which can appear on the face, back, and chest. Pimples that contain pus are known as pustules. Those without pus are called papules. Blackheads and whiteheads are together known as comedones.
Severe cases of acne can cause cysts and nodules to form under the skin and can result in scarring, which can be permanent.
Doctors classify acne based on a number of factors, including the type of lesions (comedones, papules, pustules, etc.) and severity. Comedonal acne. Comedones and a limited number of pustules and papules are present, but without nodules. This type of acne is often called mild acne. Papular, pustular, and non-scarring inflammatory acne. The skin has some comedones, along with a greater number of pustules and papules than are seen in comedonal acne. No nodules, or only a few, are present. This type of acne is also known as moderate acne. Cystic acne and scarring acne. Comedones, more pustules and papules than are seen in moderate acne, as well as nodules and/or cysts are present. Scarring may occur. This type of acne may also be called severe, cystic, or nodulocystic acne. What causes acne?Acne develops when hair follicles—the small, tube-shaped cavities near the surface of the skin from which tiny hairs grow—get clogged with oils, dead skin cells, and bacteria. The oil comes from the sebaceous glands that are connected to the hair follicles under the skin surface. They secrete sebum, an oily substance that travels up the follicle to the surface, where it moisturizes the skin and hair. Sebaceous glands get their cues to produce sebum from hormones called androgens (one of which is testosterone). When puberty hits, the body increases the production of androgens, which can stimulate the sebaceous glands to produce excess sebum. The excess sebum, along with dead skin cells (which are formed as part of the normal skin cells cycle) clogs hair follicles. Other conditions that cause hormonal changes can trigger acne such as pregnancy, the menstrual cycle (including menopause), and certain medical disorders. Medications that affect hormonal levels, such as oral contraceptives for some women, can also cause acne to flare up.
But bacteria also play a role. Cutibacterium acnes, or C. acnes, is a type of gram-positive bacteria that normally lives on the skin. When the sebaceous glands produce lots of sebum, C. acnes thrives and reproduces, which further clogs the hair follicles and leads to skin inflammation. The plugged hair follicles can form blackheads and whiteheads. If they become inflamed, red, raised pimples develop on the skin, or nodules or cysts may form under the skin. What are the risk factors for acne?Scientists are still working out why acne affects some people, but not others. In addition to fluctuations in the levels of androgens, other factors have been associated with acne:
Genetic factors. There is evidence that people with a family history of acne—especially moderate to severe acne—may be more likely to develop it themselves. Diet. Some studies suggest that a high glycemic load diet may contribute to the development or worsening of acne. High glycemic load foods are those that cause blood sugar levels to rise quickly such as white bread, cornflakes, and white potatoes. Other studies have linked the consumption of cow’s milk, particularly skim milk, with acne. More rigorous research studies are needed to fully validate the role of diet in acne vulgaris.
Endocrine disorders. Certain endocrine disorders, such as polycystic ovary syndrome and congenital adrenal hyperplasia, can raise androgen levels.
Medications and drugs. Various medications and drugs can trigger acne, including corticosteroids and anabolic steroids. Stress. There is some evidence that emotional stress can exacerbate acne. Skin care products. Certain skin care products such as cosmetics, sunscreens, and moisturizers can clog hair follicles, and may play a role in the formation of acne. Many skincare products now report whether they are “non-comedogenic,” meaning they do not exacerbate the formation of comedonal acne.What are the symptoms of acne?Acne most frequently occurs on the face, neck, shoulders, chest, and upper back. A person with this condition may notice any or all of the following:
Inflamed, raised bumps (papules)
Inflamed, raised bumps with yellow or white tops, filled with pus (pustules)
Tiny bumps that may be dark (blackheads) or white (whiteheads)
Bumps under the skin that are often painful (cysts or nodules)
Darkened spots on the skin that may remain for several weeks or months after acne lesions clear up; this is called “post-inflammatory hyperpigmentation” and is distinct from scarring
Scarring, which may appear as indentations, pits, or raised marks
With all of the above, the affected areas may be tender or painful.
While acne is mainly thought of as a skin problem that “only” affects one’s appearance, it often leads to social and mental health issues. People who have acne or the scarring that sometimes follows may be self-conscious, and because of this, may avoid social activities. How is acne diagnosed?Doctors will usually begin by asking about your medical history. In particular, they may ask whether you have a family history of acne, take any medications that can affect hormone levels, or use skin care products that may clog hair follicles. Your doctor will also ask about your symptoms and when they began. A physical exam is essential for diagnosis of acne. Your doctor will look at affected areas of skin to determine the type and severity of acne. Though a diagnosis of acne can usually be made on the basis of a medical history and physical exam, blood tests are sometimes helpful to measure the levels of hormones (such as testosterone) associated with acne. How is acne treated?Acne is usually treated with a combination of lifestyle modifications and medications. Lifestyle modifications. Some people benefit from changes in their skincare habits, including: Use “non-comedogenic” skincare products (moisturizers, sunscreens, makeup, etc.) These products will not clog pores and are therefore less likely to contribute to acne. Wash affected skin with a gentle soap no more than twice a day. Avoid abrasive cleansers and scrubs. Medications. Various medications are used to treat acne, including: Benzoyl Peroxide. Available in various strengths with a prescription or over-the-counter, benzoyl peroxide washes, creams, and gels can kill C. acnes, the bacteria associated with acne. It also helps to prevent pores from getting clogged up. Salicylic Acid. This topical medication can help to keep pores from clogging. It is available over-the-counter and as a prescription. Azelaic Acid. Available as a gel or cream, this prescription medication kills bacteria involved in the formation of acne, and reduces the clogging of pores. This particular acne medicine is safe during pregnancy. Antibiotics. Doctors often prescribe topical (lotions, gels, foams) and oral antibiotics to reduce the number of potentially acne-causing bacteria. Frequently used antibiotics include clindamycin, erythromycin, doxycycline, minocycline, and sacrecycline. Antibiotics also have powerful anti-inflammatory properties, which the dermatologist is also taking advantage of when prescribing antibiotics for acne.Topical Retinoids. These creams and gels can help to reduce the clogging of pores. Tretinoin (Retin-A) is one of the most commonly prescribed topical retinoids for acne treatment. They can also help reduce the pigment alterations and scarring caused by acne. Oral Isotretinoin. This oral retinoid is usually reserved for severe cases of acne, cases with scarring, or acne that does not respond to all other therapies. It is particularly effective in treating cystic and nodular acne. Hormonal Therapy. Women with acne may be treated with medications that reduce the level of androgens, such as oral spironolactone. Steroid Injections. To treat severe forms of acne, doctors sometimes inject corticosteroids into acne nodules and cysts to reduce inflammation. Acne scars are treated using a variety of techniques, including dermabrasion, laser therapy, chemical peels, microneedling, and fillers.What is the outlook for people with acne?Nearly everyone has experienced acne at some point in their lives, and for most, the outlook is excellent. In general, acne peaks during the teen years and usually clears up on its own in early adulthood. But some people continue to experience acne into adulthood.
In moderate and severe cases, scarring can occur. Fortunately, many treatment options are available that can effectively alleviate symptoms and minimize or remove acne scars.
What is unique about Yale Medicine's approach to treating acne?“Yale Medicine dermatologists work closely with each patient to tailor an acne care regimen optimized for their particular situation. No two patients are exactly alike, and here at Yale Medicine we strive to take the various factors outlined above, such as gender, age, type of acne, scarring, pigmentation, location of acne—face, chest, back, buttocks, etc.—and other medical conditions into account when we treat patients,” says Dr. Bunick. “This holistic approach to treating acne enhances the doctor–patient relationship and leads to better treatment outcomes for our patients.” Related Fact SheetsShowing 4 of 13RosaceaRosacea is a chronic, inflammatory skin condition that causes red patches and/or bumps on the face, often on the nose, cheeks, or chin.AchalasiaAchalasia is a disorder of the esophagus that makes it difficult to swallow food and liquids.Pemphigus and PemphigoidPemphigus and pemphigoid are two rare autoimmune blistering disorders that are not contagious. Learn about symptoms and treatment.Grover's DiseaseA skin disorder marked by a rash of small, raised skin-colored or reddish spots.More Related Fact SheetsRelated Clinical TrialsShowing 2 of 6MelanomaA Phase 1/2a Open-Label, Dose Escalation and Expansion Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics and Efficacy of Mirdametinib in Combination With BGB-3245 in Patients With Advanced Solid TumorsMelanomaA Phase 2 Randomized Study of Adjuvant Immunotherapy With the Personalized Cancer Vaccine mRNA-4157 and Pembrolizumab Versus Pembrolizumab Alone After Complete Resection of High-Risk Melanoma (KEYNOTE- 942)More Related Clinical TrialsRelated NewsShowing 3 of 4Family Health, Doctors & AdviceMaskne: What Is It and How Do You Prevent It?Research & InnovationPOEM Procedure: A Minimally Invasive Treatment for AchalasiaDoctors & AdviceKeeping Your Pandemic Beard? Solve Skin Problems Caused by Your Facial HairMore Related NewsAbout UsContact UsDonateReferring DoctorsClinical Keywords333 Cedar St.New Haven, CT 06510Yale School of MedicineYale UniversityWebsite FeedbackTerms & Privacy PoliciesAccessibility at YSMPatient RightsHIPAA at YaleManage Cookie PreferencesCopyright 2024 Yale Medicine
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