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The condition primarily happens to people during adolescence with more than 80% of teenagers in the United States being affected. However, acne can also present in people of any age, with approximately 20% of cases occurring in adults.

What causes Acne?

Acne is a skin condition which causes a person to suffer from whiteheads, blackheads, and skin inflammations which cause red pimples and in worst cases, cysts which are filled with pus and fluid. With 60 million people having active acne and some 20 million experiencing acne badly enough to cause scarring, only 11% of people actually seek medical attention.  There are adult acne treatment options to alleviate the symptoms or correct severe cases of scarring related to acne. 

Acne is caused by a variety of different reasons, but the most common reason is because of a blockage within the follicles of the skin.  Keratin and sebum become hyperkeratized and the sebaceous glands become enlarged and as a result, an increase of sebum leads to the formation of acne.  With an increase in androgen production, the mircomedo becomes enlarged and can form either a comedone (blackhead) or a closed comedone (whitehead).

The reason why some people develop acne and others do not is not completely understood.  There are experts who feel the condition can develop for other reasons such as:

  • Use of anabolic steroids
  • Inflammation of the skin
  • Hormonal activity/imbalance
  • Family/ genetic history
  • Bacteria in pores
  • Hyperactive sebaceous glands
  • Over-accumulation of dead skin cells which block or cover the opening to pores
  • Certain prescription medications or use of illegal drugs
  • Stress
  • Chemical exposure to substances such as dioxins.
  • Halogen exposure
  • Chronic and prolonged use of amphetamines or similar types of medications.

Different Grades of Acne

There are different forms and grades of acne which a person can suffer from, which include the following:

  1. Grade I:  consists mainly of whiteheads and blackheads, with an occasional inflammatory lesion.  With this grade of acne a person will experience at least 25 lesions on either side of the face at any point in time.
  2. Grade II:  called Maturation Arrest Acne, hardest to treat and evaluate.  The person’s face becomes overrun with many whiteheads and can look clear from a distance; however, up close the face feels roughly textured.  The lesions can number anywhere from 50-100 on one or both sides of the face and the person might experience an occasional breakout and inflammatory lesion.
  3. Grade III:  in addition to experiencing whiteheads and blackheads, the person will also have a considerable number of (6-10) pustules, papules and other painful lesions on the face at any given time.
  4. Grade IV:  cystic acne is a condition which contains all three previously mentioned grades in addition to nodules and cysts.  Grade IV is considerably painful physically and emotionally for a person and the skin contains purple or reddish colored lesions, which responds quickly to treatment because the lesions are located on the skin surface.

Conditions Which can Aggravate Acne

There are many different causes of acne, and also conditions which can aggravate or exacerbate already existing acne which can include any of the following:

Stress:  when a person becomes stressed the body stimulates the adrenal glands to produce adrenaline and the pituitary gland which makes the hormone progesterone goes into overdrive.  An overproduction of stress hormones is responsible for causing small blockages (whiteheads and blackheads) into developing into a fully mature lesion within a short time period. Avoiding stressful situations can help someone alleviate stress-related breakouts and help minimize an existing acne breakout.

Heat and Humidity: a high ambient temperature or a humid environment can lead someone to experience a flare-up in acne because of the skin swelling from the cardiovascular system.  Skin swells in response to the freshly oxygenated blood traveling to the surface of the skin and when a person perspires, acids and salts rise to cool down body temperature.  As a result, the skin becomes prone to breaking out in acne.  When sweating it can be beneficial for some people to spray the face down with a mild mixture of witch hazel and tepid water and pat dry with a clean cloth, which can alleviate skin swelling and remove the layer of sweat which can cause a breakout of acne.

Medications can cause a person to experience breakouts and can lead to the condition developing in those who did not previously have it.  Medications such as birth control pills, progesterone, and other hormone drugs can cause a person to develop acne because of an increase in sebum production. 

Hormone imbalance in women during menopause can lead to an overproduction of facial hair, oily skin and acne.  By adding the proper balance of progesterone and estrogen through hormone replacement therapy, a woman can clear up hormonally influenced acne.

Pregnancy can cause some women to develop acne on various parts of the body such as the face, chest and back.  Due to the pregnancy hormone many women will experience a “flare-up” of acne because the female body is making extra progesterone.  The condition usually abates between the 4th and 9th month of pregnancy and the first three months after the birth of an infant.

Treatment Options for Acne Scars

There are many over the counter and professional medical treatments which can actually treat acne, however, for those people who suffer from Grade IV acne the resulting scars can be disheartening and emotionally traumatic.  The following treatments can help alleviate or reduce the amount of scarring a person suffers as a result of disfiguring acne:

Topical bactericidal:  products containing benzoyl peroxide can be used in minimal to moderate amounts with some success.  A gel or cream containing a benzoyl peroxide solution can be applied directly to the area two times per day to reduce the inflammation and redness associated with acne breakouts and can minimize and lighten the amount of scarring experienced.

Dermabrasion:   the most common form of treating acne scars which involves the use of abrasive tools to remove the outer skin surface in order to produce a better appearance.  Dermabrasion is available in either topical or deep form, depending upon the level of scarring and whichever form is believed to produce the best results.

Laser resurfacing:  use of a high-energy light beam to target specific skin structures and reduce the amount of redness or depth of scars.  Much like dermabrasion, laser resurfacing also involves ablative techniques which destroy the skin’s outer layer in order to produce a smoother surface with less visible acne scarring.

Subsicion:  a technique primarily used for the treatment of cystic acne scarring.  A local anesthetic is applied to the surface of the skin and a needle is then inserted under the skin in order to loosen up the scar tissue.  The method has recently been tested and is considered to be substantially effective in improving the appearance of the skin.

Punch excision and grafting:  for deep acne scaring the treatment involves a complete removal of the scar tissue.  A small, rounded device is used to cut out the scar tissue and the edges of the wound are closed with a small stitch.  In cases of deep, large scaring the area can be removed and a graft is put into place which is later contoured with dermabrasion to improve the appearance and help the area blend into the surrounding skin.

Fillers:  compounds which add fullness to the skin can be used alone or in combination with other procedures in order to improve the appearance of acne scars.  Fillers provide a temporary improvement and must be maintained on a regular basis in order to continue the effects.

Chemical peels:  also called chemical resurfacing, the treatments are done to produce an improvement of the skin surface.  Chemical peels are done to promote the growth of new skin that has a better appearance.  There are many different chemicals which can be used such as glycolic acid, trichloroacetic acid, phenol or salicylic acid.  Different chemicals produce different levels of dermal penetration depending upon the level of scarring present.


There are many different levels of scarring which can occur from acne.  The results can be physically and emotionally damaging, but with proper treatment and medical intervention the condition can be treated effectively.  There are currently many breakthroughs in the treatment and management of acne, as well as improvements being made in the treatment of any resulting scars.  A person should consult with a dermatologist in order to find the proper treatment which can minimize any scarring and possibly improve the appearance of any resulting scars that can occur from acne.