603-889-4149 | 76 Allds Street | Nashua, NH 03060

Acne Treatment

acne treatment

Acne Treatment

Acne is the most common skin condition in the United States. Dermatology Associates of Southern New Hampshire offers acne treatment for people of all ages. Though common, accurate information about acne can be scarce. This can make it difficult to get clearer skin. The information on this site can help you understand acne and how to successfully treat it.

Why Treat Acne?

Myths about acne are common as the skin problem. One common myth is that you have to let acne run its course. Dermatologists know that letting acne run its course is not always the best advice. Here’s why:

  • Without treatment, dark spots and permanent scars can appear on the skin as acne clears.
  • Treating acne often boosts a person’s self-esteem.
  • Many effective treatments are available

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  • Who Gets Acne?

    Most people who have acne are teenagers or young adults, but acne can occur at any age. Newborn babies can get acne. Men and women get acne. Some women get acne when they reach middle age.

    If you have a bad case of acne, you may feel that you are the only one. But many people have acne. It is the most common skin problem in the United States. About 40–50 million Americans have acne at any one time.

  • What Causes Acne?

    Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to the surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.

    Sometimes bacteria that live on our skin, p. acnes, also get inside the clogged pore.   The bacteria have a perfect environment for multiplying very quickly. With loads of bacteria inside, the pore becomes inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule appears.

    Acne Signs

    Many people think that acne is just pimples. But a person who has acne can have any of these blemishes:
    — Blackheads
    — Whiteheads
    — Papules
    — Pustules (what many people call pimples)
    — Cysts
    — Nodules.

    Acne can appear on the back, chest, neck, shoulders, upper arms and buttocks.

    Acne Symptoms

    Acne can cause more than blemishes. Studies show that people who have acne can have:

    Low self-esteem: Many people who have acne say their acne makes them feel bad about themselves. Because of their acne, they do not want to be with friends.  They miss school and work. Grades can slide, and absenteeism can become a problem because of their acne.

    Depression: Many people who have acne suffer from more than low self-esteem.  Acne can lead to a medical condition called depression. The depression can be so bad that people think about what it would be like to commit suicide. Many studies have found that teens who believe that they have “bad” acne were likely to think about committing suicide.

    Dark spots on the skin: These spots appear when the acne heals. It can take months or years for the dark spots to disappear.

    Scars (permanent): People who get acne cysts and nodules often see scars when the acne clears. You can prevent these scars. Be sure to see a dermatologist for treatment if you get acne early – between 8 and 12 years old. If someone in your family had acne cysts and nodules, you also should see a dermatologist if you get acne.  Treating acne before cysts and nodules appear can prevent scars.


  • How Do Dermatologists Diagnose Acne?

    To diagnose acne, a dermatologist will first examine your skin to make sure you have acne. Other skin conditions can look like acne. If you have acne, the dermatologist will:

    — Grade the acne. Grade 1 is mild acne. Grade 4 is severe acne.

    — Note what type, or types, of acne appear on your skin.

    How Do Dermatologists Treat Acne?

    Today, there are many effective acne treatments. This does not mean that every acne treatment works for everyone who has acne. But it does mean that virtually every case of acne can be controlled.

    People who have mild acne have a few blemishes. They may have whiteheads, blackheads, papules, and/or pustules (aka pimples). Many people can treat mild acne with products that you can buy without a prescription. A product containing benzoyl peroxide or salicylic acid often clears the skin. This does not mean that the acne will clear overnight.

    Despite the claims, acne treatment does not work overnight. At-home treatment requires 4-8 weeks to see improvement. Once acne clears, you must continue to treat the skin to prevent breakouts.

    If you have a lot of acne, cysts, or nodules, a medicine that you can buy without a prescription may not work. If you want to see clearer skin, you should see a dermatologist.  Dermatologists offer the following types of treatment:

    Acne treatment that you apply to the skin: Most acne treatments are applied to the skin.  Your dermatologist may call this topical treatment. There are many topical acne treatments. Some topicals help kill the bacteria. Others work on reducing the oil.   The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid. Your dermatologist will determine what you need.

    Acne treatment that works throughout the body: Medicine that works throughout the body may be necessary when you have red, swollen types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. Your dermatologist may prescribe one or more of these:

    — Antibiotics (helps to kill bacteria and reduce inflammation).

    — Birth control pills and other medicine that works on hormones (can be helpful for women).

    — Isotretinoin (the only treatment that works on all that causes acne).

    Procedures that treat acne: Your dermatologist may treat your acne with a procedure that can be performed during an office visit. These treatments include:

    Lasers and other light therapies: These devices reduce the p. acnes bacteria. Your dermatologist can determine whether this type of treatment can be helpful.

    Chemical peels: You cannot buy the chemical peels that dermatologists use.  Dermatologists use chemical peels to treat 2 types of acne – blackheads and papules.

    Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.


    Waiting for acne to clear on its own can be frustrating. Without treatment, acne can cause permanent scars, low self-esteem, depression, and anxiety.

    To avoid these possible outcomes, dermatologists recommend the people treat acne. When the skin clears, treatment should continue. Treatment prevents new breakouts. Your dermatologist can tell you when you no longer need to treat acne to prevent breakouts.


  • Adult Acne:  A Fact of Life for Many Women

    Adult acne can be particularly frustrating. Treatment that worked so well during adolescence often is ineffective. Over-the-counter topical medications tend to irritate the skin, making acne worse. Some women try numerous treatments without success.

    This lack of effectiveness can make one wonder if it really is acne. After all, do adults in midlife and older get acne?

    Types of Adult Acne

    The truth is that acne can persist well into one’s 30, 40, and even 50’s. Dermatologists call acne that does not clear by one’s mid-20’s persistent acne. Often causing deep-seated, tender, inflamed pimples and nodules, this type of acne is more common in women.  Persistent acne tends to form on the lower face, predominantly around the mouth, on the chin, and along the jawline.

    Adults also develop late-onset acne. Again, women are more susceptible. People who have not had acne for years can suddenly see deep-seated, inflamed pimples and nodules. Even those who have never had acne get late-onset acne. For some women, acne becomes a problem during menopause. Adult-onset acne generally forms on the chin, jawline, and around the mouth. Lesions can appear on the chest and back.

    Why Adults Get Acne

    Regardless of age, acne develops when excess sebum (an oil that our bodies produce to naturally moisturize the skin), skin cells, and bacteria accumulate. Researchers have discovered that the following may trigger this in adults:

    Fluctuating hormones. Acne is typically associated with the hormonal swings of puberty, but any time hormones fluctuate, acne can flare. Many women are familiar with the once-a-month breakout. Hormonal swings also occur during pregnancy and menopause, causing acne in some women.

    Discontinuing birth control pills. Some women get acne when they stop taking birth control pills.  The pills may have been keeping their acne at bay.

    — Taking certain medications. Birth control pills that contain estrogen and progestins often help control acne in women. When a birth control pill contains only progestins, it may make acne worse.

    Acne is a possible side effect of other medications as well. These include anticonvulsants, corticosteroids, and sobriety drugs. Never stop taking a prescription medication because acne develops or worsens.  Talk with the doctor who prescribed the medication.  Ask if a different medication can be prescribed that will not cause acne to flare.  If only one medication can be prescribed, talk with a dermatologist about ways to control the acne.  Do not stop taking the medication.

    Family history of acne. In one study, researchers found that 50% of the adults with acne had a first-degree relative (parent, sibling, or child) who had acne. This suggests that some people may have a genetic predisposition to acne.

    Stress. Studies indicate that stress may trigger acne in women. Researchers have found a relationship between increased stress levels and higher levels of acne in women with fast-paced careers. In response to stress, the body produces more androgens (a type of hormone). These hormones stimulate the oil glands and hair follicles in the skin. When over-stimulated such as during times of stress, acne can flare.

    Products used on hair and skin. Some products such as oily sunscreens and hair greases promote a type of acne called acne cosmetica. When buying products to be used on the skin or hair, look for products labeled “non-comedogenic” or “non-acnegenic.” This means that they are less likely to cause acne.

    Acne Can Be a Warning Sign

    Acne may also be warning to a woman of an underlying medical condition. When a woman’s acne is accompanied by excessive facial hair, thinning hair or bald patches on the scalp, and irregular periods, it may be a sign of polycystic ovaries (a condition that causes cyst to develop in the ovaries) or adrenal hyperplasia (a group of adrenal gland disorders). It also is possible that the woman has a hormone-secreting tumor located in her adrenal gland or an ovary. Testing can find the cause and allow the doctor to determine the best treatment. The acne will not clear until the medical condition is treated.

    Treatment Available

    Barring an underlying medical condition, most cases of adult acne can be effectively controlled with acne therapy. Yet, researchers have found that many women do not seek treatment.  Most believe treatment is not available. Dermatologists want women to know while adult acne can be stubborn, effective control is possible.


Beth Israel Deaconess Medical Center Dermatology Department

How can I get more information?

Call our office at 603-889-4149
(SmartPhone users: just tap the phone number).