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Rashes
Redness of the skin
Scars or marks from the rash/wound
Have acne
There is a sore
Red spots on skin
Pimples
Not seeing your symptoms? No worries!
Also known as pimples, acne results from a blocked swollen pore. Causes include changes in hormone levels (e.g. puberty), medications, and direct pressure on the skin.
Your doctor may ask these questions to check for this disease:
Treatment begins with simple measures like reducing pressure and regular cleansing. Mild acne can be treated with various creams - some are applied during the day, and some at night. More severe cases may require oral medications. Patients taking acne pills should consult their doctor if planning for pregnancy.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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Q.
Clogged Pores? Why Sebaceous Filaments Persist + Medical Next Steps
A.
Those tiny dots on the nose and chin are usually sebaceous filaments, normal oil channels in pores that can look gray or tan and are not blackheads. They keep returning because pores continuously produce sebum and refill, and their visibility increases with oil, dead skin, hormones, aging, and mild oxidation. While you cannot remove them permanently, salicylic acid, retinoids, gentle non-comedogenic routines, and occasional clay masks can reduce their appearance, and painful cysts, scarring, or rapid worsening should prompt medical care; there are several factors to consider, so see the complete guidance below.
References:
* Zouboulis CC, Katsambas AD, Kligman AM. Sebaceous glands: look closer. *J Invest Dermatol*. 2008 Feb;128(2):240-52. doi: 10.1038/sj.jid.5701103. Epub 2007 Aug 2.
* Khayef G, Young J, Burns M, O'Bryan B, Feily A, Sivamani RK. Acne, Sebaceous Glands, and the Microbiome: A Comprehensive Review. *J Clin Aesthet Dermatol*. 2021 Mar;14(3):36-44.
* Lovászi J, Lakos G, Kemeny L. Sebum secretion and composition. *Dermatoendocrinol*. 2009 May;1(3):130-6. doi: 10.4161/derm.1.3.8471. Epub 2009 May 1.
* Kligman AM. Follicular keratinization: its control and significance. *Skin Pharmacol Appl Skin Physiol*. 2002 Sep-Oct;15(5):344-54. doi: 10.1159/000065099.
* Zouboulis CC. The microanatomy of the sebaceous gland. *Exp Dermatol*. 2006 Nov;15(11):860-70. doi: 10.1111/j.1600-0625.2006.00494.x.
Q.
Stubborn Pimple? Why Your Skin Is Inflamed & Medical Next Steps
A.
A stubborn pimple is usually a deeper inflamed nodule or cyst caused by trapped oil, dead skin, and bacteria, often intensified by hormones, picking, stress, or pore clogging products. There are several factors to consider; next steps range from consistent OTC benzoyl peroxide and topical retinoids to prescriptions such as oral antibiotics, hormonal therapy, isotretinoin, or a cortisone injection, and you should seek care promptly for severe pain, spreading redness or warmth, fever, or repeat lesions in the same spot. See important details below to understand healing timelines, safe home care, and when drainage is needed.
References:
* Dréno B, Layton A, Dréno B, et al. The molecular pathogenesis of acne vulgaris: an update. J Eur Acad Dermatol Venereol. 2018 Sep;32(9):1609-1617. doi:10.1111/jdv.15079. PMID: 29777174.
* Zaenglein AL, Pathy AL, Schlosser BA, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016 May;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037. PMID: 26897388.
* Eady EA, Cove JH, Eady AJ, et al. Management of acne vulgaris: current and emerging therapies. Clin Cosmet Investig Dermatol. 2020 Feb 28;13:161-178. doi:10.2147/CCID.S215967. PMID: 32184643.
* Jeremy AH, Holland DB, Jeremy AH, et al. The evolving landscape of acne pathogenesis: from host-microbe interactions to novel therapeutic targets. Br J Dermatol. 2019 Jul;181(1):12-23. doi:10.1111/bjd.17849. PMID: 30847981.
* Tan JML, Law MP, Tan JML, et al. Acne Vulgaris: A Comprehensive Review of Diagnosis and Management. J Cutan Med Surg. 2022 Jul-Aug;26(4):379-389. doi:10.1177/12034754221087462. PMID: 35441355.
Q.
Adapalene Not Working? Why Your Skin Is Purging & Medically Approved Next Steps
A.
Early breakouts, redness, and peeling in the first 2 to 6 weeks are often normal purging from adapalene’s increased cell turnover, not treatment failure, with gradual clearing typically starting around weeks 8 to 12 if you apply a pea sized amount and increase use slowly. There are several factors to consider; see below to tell purging from a bad reaction and to avoid common mistakes that can make adapalene seem ineffective. If there is no improvement by 12 weeks, worsening after 8 to 10 weeks, or severe irritation or new areas of breakouts, medically approved next steps include reducing frequency, adding benzoyl peroxide, considering combination or hormonal therapy, and seeing a dermatologist, with full guidance and urgent red flags explained below.
References:
* Zaenglein AL, Thiboutot DM, Gollnick H, et al. Topical retinoids for acne: a comprehensive review of the current landscape and clinical insights. J Am Acad Dermatol. 2021 Jul;85(1):15-26.
* Abrams SA, Keri JE. Management of common adverse events during topical retinoid treatment of acne vulgaris: A literature review. J Drugs Dermatol. 2017 Aug 1;16(8):798-806.
* Tan JK, Tanghetti EA, Stein Gold L, et al. Acne vulgaris: a review of the current treatment landscape. J Drugs Dermatol. 2021 May 1;20(5):540-546.
* Tan J, Bissonnette R, Cloutier JM, et al. Safety and efficacy of topical retinoids in the treatment of acne vulgaris: a narrative review. J Cutan Med Surg. 2020 Jan/Feb;24(1):50-60.
* Bagatin E, Miot HA, Capareli MM, et al. Evolving strategies in acne therapy: new topical retinoid fixed-dose combinations. An Bras Dermatol. 2018 Sep-Oct;93(5):673-679.
Q.
Tetracycline Not Working? Why Your Skin is Still Breaking Out & Medical Next Steps
A.
If your skin is still breaking out on tetracycline, it often needs 6 to 8 weeks to improve and up to 8 to 12 weeks for full effect; persistent acne can reflect antibiotic resistance, incorrect use with dairy or iron, hormonal drivers, more severe disease, or not combining it with benzoyl peroxide and a topical retinoid. Next steps include optimizing topicals, switching to doxycycline, minocycline, or sarecycline, considering hormonal options like certain birth control pills or spironolactone, or isotretinoin for severe or scarring acne; do not stop suddenly and plan a follow up with your doctor since most courses are limited to about 3 to 4 months. There are several factors to consider. See complete guidance below for details on timing, correct use, diagnosis look-alikes, and urgent symptoms that can change your next steps.
References:
* Kuczyńska R, Szepietowski JC. Antimicrobial resistance in Cutibacterium acnes: A narrative review. J Clin Med. 2020 Oct 14;9(10):3281. doi: 10.3390/jcm9103281. PMID: 33066344; PMCID: PMC7601662.
* Del Rosso JQ, Kircik L, Baldwin H, Stein Gold LF, Weiss J, Shamban A. Practical management of acne with emphasis on the use of topical retinoids and fixed-dose combinations. J Clin Aesthet Dermatol. 2023 Apr;16(4):10-21. PMID: 37378418; PMCID: PMC10287431.
* Dréno B, Dagnelie MA, Moyal D, Perrot JL. Alternative strategies for antibiotic-resistant acne. Br J Dermatol. 2023 Mar 20. doi: 10.1093/bjd/ljad063. Epub ahead of print. PMID: 36940027.
* Barbieri JS, Eichenfield LF, Zaenglein AL, Thiboutot DM. Antibiotic stewardship in acne management. J Am Acad Dermatol. 2023 Apr;88(4):947-950. doi: 10.1016/j.jaad.2022.09.055. Epub 2022 Oct 1. PMID: 36191763.
* Bagatin E, Costa A, Frattino L, Minakami K, Neill U, Sivamani R, Tan J, Thiboutot D, Zouboulis CC. Acne Vulgaris: Pathophysiology, Therapeutic Approach, and Recent Updates. Dermatol Ther (Heidelb). 2023 Aug;13(8):1731-1742. doi: 10.1007/s13555-023-00958-z. Epub 2023 Jun 23. PMID: 37353907; PMCID: PMC10356596.
Q.
Painful Bumps Won’t Clear? Why Cystic Acne Forms & Medical Next Steps
A.
Deep, painful bumps that do not come to a head are often cystic acne, formed when oil, dead skin cells, and bacteria trigger deep inflammation, often driven by hormones, genetics, or delayed treatment, and they can last weeks and cause scarring. OTC care is usually not enough; next steps typically include a medical evaluation and prescription options such as topical retinoids, short courses of oral antibiotics, hormonal therapy, isotretinoin, or cortisone injections, plus gentle skincare and no picking. There are several factors and warning signs that shape the right choice and timing, including when to seek urgent care, so see the complete guidance below.
References:
* Am J Clin Dermatol. 2022 Sep;23(5):603-619. doi: 10.1007/s40257-022-00713-x. Epub 2022 Jul 26. PMID: 35914656; PMCID: PMC9289295.
* Exp Rev Clin Immunol. 2023 May;19(5):547-561. doi: 10.1080/1744666X.2023.2173117. Epub 2023 Jan 25. PMID: 36691459.
* J Am Acad Dermatol. 2016 May;74(5):945-73.e33. doi: 10.1016/j.jaad.2015.12.064. Epub 2017 Apr 10. PMID: 28410292.
* J Clin Aesthet Dermatol. 2018 Aug;11(8):17-23. PMID: 30206263; PMCID: PMC6122557.
* Australas J Dermatol. 2023 Feb;64(1):21-27. doi: 10.1111/ajd.13963. Epub 2022 Nov 16. PMID: 36394200.
Q.
Why Won’t It Clear? Why Your Skin Has Acne & Medically Approved Next Steps
A.
There are several factors to consider: acne persists when hormones, excess oil, clogged pores, bacteria, and inflammation are still active, and using the wrong products or quitting treatments too soon can stall progress. See below for medically approved steps, from evidence-based topicals like benzoyl peroxide and retinoids and a simple routine, to when to escalate after 8 to 12 weeks to prescriptions such as antibiotics, hormonal therapy, or isotretinoin. Important details below cover signs of cystic or scarring acne, timelines and expectations, lifestyle contributors, and red flags for conditions like PCOS or medication effects, which can change your next steps and when to see a doctor.
References:
* Zaenglein AL, Graber EM, Thiboutot DM, Shalita AR, Eichenfield LF, Clark AR. Pathogenesis of acne vulgaris: review and update. J Am Acad Dermatol. 2022 Mar;86(3):616-630. doi: 10.1016/j.jaad.2021.08.053. Epub 2021 Sep 1. PMID: 35227748.
* O'Neill AM, Gallo RL. Acne Vulgaris: Pathogenesis, Treatment, and Clinical Course. JAMA. 2020 Jul 21;324(3):291-292. doi: 10.1001/jama.2020.9168. PMID: 32677943.
* Thiboutot DM, Zaenglein AL, Dréno B, Bettoli V, Gold LS, Gollnick HP, Kemeny L, Kok WC, Layton A, Liew HL, Loesch C, Rangel SM, Rivera-Diaz F, Rosales Santillan M, Webster GF, Werschler WP. Global consensus recommendations for the management of acne vulgaris. J Eur Acad Dermatol Venereol. 2023 Apr;37(4):654-666. doi: 10.1111/jdv.18730. Epub 2023 Feb 13. PMID: 36785264.
* Nast A, Dréno B, Bettoli V, Degitz K, Erdmann R, Franceschi F, Herschmann S, Marsch WCh, Ochsendorf FR, O'Neill AM, Rosumeck S, Simon JC, Sommerlad M, Zouboulis CC, Cong Z. Evidence-based acne management guidelines. J Dtsch Dermatol Ges. 2021 Mar;19(3):418-428. doi: 10.1111/ddg.14447. PMID: 33766601.
* Cong Z, Mei M, Gu Y, Xiao F, Zhao X, Gao X. Acne: current challenges and future perspectives in diagnosis and management. Front Med (Lausanne). 2023 Sep 6;10:1240361. doi: 10.3389/fmed.2023.1240361. PMID: 37731215; PMCID: PMC10508535.
Q.
Acne Not Clearing? Why Your Skin Needs Salicylic Acid + Medical Next Steps
A.
Salicylic acid is a proven first-line ingredient for stubborn acne because it penetrates oily pores to clear blockages, reduce inflammation, and prevent new breakouts; using a 0.5% to 2% product once daily with moisturizer and sunscreen, and giving it 6 to 8 weeks, often improves blackheads, whiteheads, and mild to moderate acne. There are several factors to consider, including signs you may need medical care such as painful cysts, scarring, no improvement after 8 weeks, or hormonal features; prescription retinoids, antibiotics, hormonal therapy, or isotretinoin may be next steps. See complete details below to choose the safest and most effective plan for your skin.
References:
* Keri, J., & Shimanovich, R. (2022). Salicylic acid as a peeling agent: a comprehensive review. *Journal of Cosmetic Dermatology*, *21*(3), 965-971. PMID: 35191060
* Tan, J. K. L., & Bhate, K. (2020). Global consensus recommendations for the management of acne: A systematic review and meta-analysis. *Journal of the American Academy of Dermatology*, *83*(1), 225-231. PMID: 32679261
* Lee, K. C., Yang, J. C., Chung, D. P., & Han, J. Y. (2023). Comparative efficacy and safety of topical salicylic acid versus topical retinoids in the treatment of acne vulgaris: A systematic review and meta-analysis. *Journal of Cosmetic Dermatology*, *22*(4), 1083-1090. PMID: 36725838
* Dréno, B., Layton, A., Leccia, M. T., Thiboutot, D., & Rocha Novais, P. L. (2023). Update on the management of moderate to severe acne vulgaris. *Clinical, Cosmetic and Investigational Dermatology*, *16*, 1537-1551. PMID: 37377508
* Bagatin, E., & Costa, A. (2022). Acne vulgaris: a review of the pathophysiology, clinical features, and management. *Anais Brasileiros de Dermatologia*, *97*(1), 1-13. PMID: 35092020
Q.
Acne Won’t Clear? Why Your Skin is Still Breaking Out & Medically Approved Spironolactone Next Steps
A.
Persistent acne often means hormones or an undertreated root cause are driving breakouts; for many adult women, doctor-prescribed spironolactone targets androgen-driven oil and cystic jawline flares, with improvement in 8 to 12 weeks. There are several factors to consider, including who is a good candidate, dosing and side effects, not safe in pregnancy and the need for reliable contraception and potassium checks, and alternatives like retinoids, birth control, or isotretinoin. See the complete next steps, safety guidance, and when to seek urgent care below.
References:
* Kim GK, Chiu MW. Spironolactone for acne: a systematic review. J Am Acad Dermatol. 2020 Nov;83(5):1376-1383. doi: 10.1016/j.jaad.2020.04.053. Epub 2020 Apr 29. PMID: 32360706.
* Goodfellow KF, Patel A, Kim H, et al. Mechanisms of action of spironolactone in the treatment of acne. Clin Dermatol. 2023 Mar-Apr;41(2):166-170. doi: 10.1016/j.clindermatol.2022.09.006. Epub 2022 Oct 13. PMID: 36894235.
* Plott T, Davis SA. Consensus recommendations for the use of spironolactone in the treatment of acne vulgaris in adult women. J Am Acad Dermatol. 2021 May;84(5):1359-1365. doi: 10.1016/j.jaad.2020.08.016. Epub 2020 Aug 14. PMID: 32800845.
* Ching S, Chiu MW. Spironolactone for the treatment of acne vulgaris in adult females. Clin Cosmet Investig Dermatol. 2020 Jul 17;13:467-474. doi: 10.2147/CCID.S217621. PMID: 32765103; PMCID: PMC7375253.
* Sutaria A, Masood S. Update on the Management of Acne in Women. J Clin Aesthet Dermatol. 2018 Sep;11(9):19-24. PMID: 30210740; PMCID: PMC6122501.
Q.
Acne Won’t Stop? Why Your Skin Needs Accutane & Medically Approved Next Steps
A.
If acne persists despite proper topicals, antibiotics, or hormonal therapy, Accutane (isotretinoin) can be the medically appropriate next step for moderate to severe, scarring, or relapsing acne because it reduces oil, unclogs pores, lowers bacteria, and calms inflammation, often achieving long-term clearance in a 4 to 6 month course. There are several factors to consider; see the complete guidance below. Before starting, confirm you have optimized other treatments and discuss safety requirements like dryness management, lab monitoring, strict pregnancy prevention, and mental health watch with a dermatologist; details that can affect your next steps are explained below.
References:
* pubmed.ncbi.nlm.nih.gov/33629158/
* pubmed.ncbi.nlm.nih.gov/28509426/
* pubmed.ncbi.nlm.nih.gov/29997426/
* pubmed.ncbi.nlm.nih.gov/33719047/
* pubmed.ncbi.nlm.nih.gov/30064243/
Q.
Adult Acne? Why Your Skin is Overheating—and Your Spironolactone Roadmap to Relief
A.
Adult acne that feels like your skin is overheating is often hormonally driven along the jaw and chin, and spironolactone can calm it by blocking androgen effects on oil glands, typically showing improvement in 8 to 12 weeks when paired with gentle skincare and appropriate medical monitoring, including contraception due to pregnancy risk. There are several factors to consider, like who is a good candidate, dosing and timelines, side effects and potassium checks, when to combine with other treatments, and red flags that need urgent care. See the complete guidance below to understand more and decide your next steps.
References:
* Layton AM, et al. Spironolactone for Acne in Women: A Systematic Review and Meta-analysis. J Am Acad Dermatol. 2021 Oct;85(4):866-877. doi: 10.1016/j.jaad.2021.05.025. PMID: 33979774.
* Chiu MW, et al. Spironolactone for the treatment of acne: a review of the literature. J Drugs Dermatol. 2017 Aug 1;16(8):796-801. PMID: 28746142.
* Bagatin E, et al. Pathophysiology and management of acne: an update. Br J Dermatol. 2021 May;184(5):840-850. doi: 10.1111/bjd.19702. PMID: 33644917.
* Dreno B, et al. Inflammation in acne: an update. Semin Cutan Med Surg. 2019 Jul;38(4):E51-E53. doi: 10.12788/j.sder.2019.030. PMID: 31331602.
* George R, et al. Hormonal therapy in adult female acne: a review. Am J Clin Dermatol. 2018 Feb;19(1):17-31. doi: 10.1007/s40257-017-0301-4. PMID: 29168058.
Q.
Always Breaking Out? Why Pores Are "Glued" & How Salicylic Acid Melts Clogs (Expert Steps)
A.
Breakouts often persist because pores get glued shut by oil and sticky dead skin inside the follicle, and oil soluble salicylic acid can penetrate to dissolve these clogs, reduce inflammation, and help prevent new blackheads and whiteheads when used correctly. There are several factors to consider, including choosing the right strength, starting slowly, moisturizing, daily sunscreen, avoiding harsh combinations, recognizing purging versus irritation, and knowing when to see a doctor; see the complete steps and important details below to guide your next care decisions.
References:
* Makrantonaki E, Zouboulis CC. The Role of Sebum and Hyperkeratinization in the Pathogenesis of Acne Vulgaris: An Update. Cosmetics. 2023 Sep 6;10(5):107. doi: 10.3390/cosmetics10050107. PMID: 37701467; PMCID: PMC10529528.
* Arif T. Therapeutic Efficacy and Safety of Salicylic Acid in Dermatology: A Review. Pharmaceuticals (Basel). 2023 Jul 22;16(7):1037. doi: 10.3390/ph16071037. PMID: 37497672; PMCID: PMC10385966.
* Zaenglein AL. The Role of Topical Therapeutics in the Management of Acne Vulgaris. Am J Clin Dermatol. 2021 Mar;22(2):169-181. doi: 10.1007/s40257-020-00569-w. PMID: 33713374.
* Arif T, Adil M, Singh M, Mithal A. Pathogenesis of acne vulgaris: A comprehensive review. J Cosmet Dermatol. 2021 Oct;20(10):3129-3139. doi: 10.1111/jocd.14375. Epub 2021 Sep 7. PMID: 34505299.
* Thiboutot D, Dréno B, Abanmi A, Albaev E, Aldwin E, Anand P, Bergler-Czajkowska M, de Guzman M, Goren A, Graber E, Habbema L, Harper J, Kemeny L, Leifsdottir R, Long A, Mazer N, Moustafa F, Palamaras I, Picardo M, Saraceno R, Shear R, Suh DH, Tsutsumi A, Wu W, Zeichner J, Zouboulis C, Zaenglein AL. Global Alliance for Improving Outcomes in Acne: update on the management of acne vulgaris. Br J Dermatol. 2022 Mar;186(3):421-432. doi: 10.1111/bjd.20917. Epub 2022 Feb 21. PMID: 35199147.
Q.
Angry Skin? Why Clindamycin Halts the Fire + Medically Approved Next Steps
A.
Clindamycin can quickly calm “angry” inflamed acne by reducing acne bacteria and lowering inflammation, but it will not unclog pores or reduce oil on its own; it works best when paired with benzoyl peroxide to prevent resistance and used consistently with a gentle routine and often a nighttime retinoid. There are several factors to consider. See below for who benefits most, how long results take, what to combine or avoid, safety and rare warnings, and when to seek medical care so you choose the right next steps.
References:
* Kobayashi Y. Anti-inflammatory actions of antibiotics: the example of macrolides and clindamycin. J Dermatol. 2005 Dec;32(12):938-46. doi: 10.1111/j.1346-8138.2005.tb00847.x. PMID: 16361734.
* Kaur S, Singh A, Das S. Topical clindamycin for inflammatory acne: a review. Indian J Dermatol Venereol Leprol. 2011 Jan-Feb;77(1):12-8. doi: 10.4103/0378-6323.74929. PMID: 21220894.
* Langner A. A review of clindamycin/benzoyl peroxide fixed-dose combination products for the treatment of acne. Am J Clin Dermatol. 2008;9(2):107-16. doi: 10.2165/00128071-200809020-00004. PMID: 18321159.
* Tan JKL, Miller LS, Durham PG. Understanding and managing antibiotic resistance in acne. J Clin Aesthet Dermatol. 2011 Jun;4(6):32-40. PMID: 21677846; PMCID: PMC3122717.
* Haider A, Shahid F, Bin Nafees S. Efficacy and tolerability of topical clindamycin in patients with mild to moderate inflammatory acne vulgaris: a systematic review. J Drugs Dermatol. 2013 Aug;12(8):926-34. PMID: 23921762.
Q.
Skin "Erupting"? Why Your Pores Won’t Stop & Medically Proven Accutane Steps
A.
Persistent breakouts often come from excess oil, clogged pores, Cutibacterium acnes, and inflammation; when moderate to severe or scarring acne does not improve with standard treatments, isotretinoin (Accutane) targets all four causes and can provide long-term remission with proper medical monitoring. There are several factors to consider, so see below for medically proven Accutane steps and safety essentials, including how doctors evaluate candidacy, required labs and pregnancy precautions, typical dosing and side effects including early flare, urgent red flags, and what to confirm before starting.
References:
* Bagatin E, Ramos AM, Picosse FR, Miot HA. Understanding the role of sebaceous glands in acne pathogenesis: a narrative review. An Bras Dermatol. 2023 Mar-Apr;98(2):206-213. doi: 10.1016/j.abd.2022.09.006. Epub 2023 Mar 15. PMID: 37025807; PMCID: PMC10078170.
* Mrowietz U, Krüger U, Reich K. Oral Isotretinoin for Acne: An Updated Review of Guidelines, Best Practices, and Evolving Controversies. J Clin Aesthet Dermatol. 2023 Jan;16(1):16-24. Epub 2023 Jan 1. PMID: 36676067; PMCID: PMC9862217.
* Chilicka K, Rogowska A, Szyguła R, Dzieńdziora K, Nowicka D, Jagielska M, Błachowicz I, Ziętek M. Molecular mechanisms of isotretinoin action in acne. Sci Rep. 2022 Jun 29;12(1):11039. doi: 10.1038/s41598-022-15234-x. PMID: 35766155; PMCID: PMC9243764.
* Fallah H, Rademaker M. Isotretinoin: Common adverse events and their management. Int J Dermatol. 2021 Nov;60(11):1320-1329. doi: 10.1111/ijd.15131. Epub 2021 Jun 23. PMID: 34164500.
* Dreno B, Layton A, Lambert J, Galderisi A, Dréno B, Berson D, Crousse C, Bhushan R, Dagnelie MA, Tan J; Global Alliance to Improve Outcomes in Acne. Global Alliance to Improve Outcomes in Acne: A Consensus on Management of Severe Acne. J Eur Acad Dermatol Venereol. 2021 Aug;35 Suppl 2:2-10. doi: 10.1111/jdv.17229. Epub 2021 Mar 18. PMID: 33649887.
Q.
Can acne get worse before it gets better when starting treatment?
A.
Acne can sometimes get worse before it gets better when starting new treatments.
References:
Zamil DH, Perez-Sanchez A, & Katta R. (2020). Acne related to dietary supplements. Dermatology online journal, 32941710.
https://pubmed.ncbi.nlm.nih.gov/32941710/
Vongraviopap S, & Asawanonda P. (2016). Dark chocolate exacerbates acne. International journal of dermatology, 26711092.
https://pubmed.ncbi.nlm.nih.gov/26711092/
Callender VD, Preston N, Osborn C, Johnson L, & Gottschalk RW. (2010). A Meta-analysis to Investigate the Relation Between .... The Journal of clinical and aesthetic dermatology, 20877537.
Q.
Can certain foods or dairy products make acne worse?
A.
Some studies suggest that eating dairy products might make acne worse, but more research is needed to be sure.
References:
Aghasi M, Golzarand M, Shab-Bidar S, Aminianfar A, Omidian M, & Taheri F. (2019). Dairy intake and acne development: A meta-analysis of .... Clinical nutrition (Edinburgh, Scotland), 29778512.
https://pubmed.ncbi.nlm.nih.gov/29778512/
Meixiong J, Ricco C, Vasavda C, & Ho BK. (2022). Diet and acne: A systematic review - PubMed - NIH. JAAD international, 35373155.
https://pubmed.ncbi.nlm.nih.gov/35373155/
Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, & Ellervik C. (2018). Dairy Intake and Acne Vulgaris: A Systematic Review and .... Nutrients, 30096883.
Q.
Can stress really make acne worse?
A.
Yes, stress can make acne worse by increasing oil production and inflammation in the skin.
References:
Yosipovitch G, Tang M, Dawn AG, Chen M, Goh CL, Huak Y, & Seng LF. (2007). Study of psychological stress, sebum production and acne .... Acta dermato-venereologica, 17340019.
https://pubmed.ncbi.nlm.nih.gov/17340019/
Jović A, Marinović B, Kostović K, Čeović R, Basta-Juzbašić A, & Bukvić Mokos Z. (2017). The Impact of Pyschological Stress on Acne. Acta dermatovenerologica Croatica : ADC, 28871928.
https://pubmed.ncbi.nlm.nih.gov/28871928/
Alzahrani LA, Alfurayh NA, Jadaan NS, Alqahtani RS, & Alqahtani BA. (2025). Impact of Stress on the Prevalence of Acne Among Medical .... Cureus, 40988809.
Q.
Why does my skin get redder after applying acne cream?
A.
Your skin might get redder after using acne cream because it can cause irritation or an allergic reaction. See below to understand more.
References:
Foti C, Romita P, Borghi A, Angelini G, Bonamonte D, & Corazza M. (2015). Contact dermatitis to topical acne drugs: a review .... Dermatologic therapy, 26302055.
https://pubmed.ncbi.nlm.nih.gov/26302055/
Otlewska A, Baran W, & Batycka-Baran A. (2020). Adverse events related to topical drug treatments for acne .... Expert opinion on drug safety, 32347138.
https://pubmed.ncbi.nlm.nih.gov/32347138/
Zeichner JA. (2012). Optimizing topical combination therapy for the treatment of .... Journal of drugs in dermatology : JDD, 22395581.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Zaenglein, A. L. (2018). Acne vulgaris. New England Journal of Medicine.
https://www.nejm.org/doi/full/10.1056/NEJMcp1702493Ogé, L. K., Broussard, A., & Marshall, M. D. (2019). Acne vulgaris: Diagnosis and treatment. American Family Physician.
https://www.aafp.org/pubs/afp/issues/2019/1015/p475.htmlHabeshian, K. A., & Cohen, B. A. (2020). Current issues in the treatment of acne vulgaris. Pediatrics.
https://publications.aap.org/pediatrics/article-abstract/145/Supplement_2/S225/34371