{"id":19401,"date":"2026-07-24T18:37:19","date_gmt":"2026-07-24T18:37:19","guid":{"rendered":"https:\/\/tastyrecipes.milaf.ma\/?p=19401"},"modified":"2026-07-24T18:37:19","modified_gmt":"2026-07-24T18:37:19","slug":"acne-causes-types-and-best-treatments","status":"publish","type":"post","link":"https:\/\/tastyrecipes.milaf.ma\/index.php\/2026\/07\/24\/acne-causes-types-and-best-treatments\/","title":{"rendered":"Acne: Causes, Types, and Best Treatments"},"content":{"rendered":"

Acne often begins with small pimples on the face during the teenage years, but in some sufferers it can turn into a chronic disease that leaves permanent scars and pigmentation, sometimes continuing into the thirties and forties, especially in women.<\/span><\/p>\n

Recent studies and treatment guidelines indicate that the disease is more complex than just an increase in fat or the accumulation of dirt on the skin; it arises from the interaction of hormones, sebum secretion, blockage of hair follicles, inflammation, and an imbalance among the microorganisms that naturally live on the surface of the skin.<\/span><\/p>\n

The way acne is treated has changed in recent years, with a preference for formulations that target more than one cause at the same time, a reduction in long-term reliance on antibiotics, an expansion of the use of hormone therapy for women, and the emergence of topical preparations that combine 3 drugs in one dose.<\/span><\/p>\n

Meanwhile, studies published during 2025 and 2026 added new information about the chances of the disease returning after treatment with the drug “isotretinoin”, the drug’s effect on growth, and the possible relationship between diet and acne severity.<\/span><\/p>\n

Isotretinoin is an effective drug derived from vitamin A that is used to treat severe cases of acne that have not responded to other medications (such as antibiotics), and is dispensed exclusively by prescription.<\/span><\/p>\n

Acne disease begins inside the hair follicle.<\/span><\/h2>\n

Acne, or common acne, affects the pilosebaceous unit, which consists of the hair follicle and the sebaceous gland connected to it, and often appears on the face, chest, back and shoulders, where there are large numbers of sebaceous glands.<\/span><\/p>\n

The infection begins when keratinized skin cells and sebum accumulate inside the follicle opening, forming a microscopic plug called a primary comedon. If the opening remains closed, a whitehead appears, but if it opens onto the skin surface, a blackhead is formed.<\/span><\/p>\n

Sebum is a waxy, oily substance produced by the sebaceous glands in the skin. It consists of triglycerides and waxes, and its purpose is to moisturize the skin and protect it from dryness and external factors.<\/span><\/p>\n

The black color is not due to the presence of dirt, but rather to the oxidation of fats and melanin pigment inside the plug when exposed to air. Therefore, washing the face vigorously or rubbing it constantly does not remove blackheads, but may increase irritation and inflammation.<\/span><\/p>\n

Researchers have identified four main pathways to the disease: increased sebum production, disruption of cell keratinization within the follicle, bacterial activity, and then an inflammatory and immune response that may lead to rupture of the follicle wall and the formation of deep grains and nodules.<\/span><\/p>\n

But the presence of these bacteria alone does not mean infection, as they live naturally on the skin of healthy people as well. Recent research suggests that the problem may be related to an imbalance between their strains and the way the immune system reacts to them, rather than acne being a simple bacterial infection that requires all skin microbes to be eliminated in order to treat it.<\/span><\/p>\n

The role of hormones in acne<\/span><\/h2>\n

Male hormones, or androgens, play a key role in acne, even when their levels in the blood are within normal ranges. During puberty, the sebaceous glands enlarge under the influence of these hormones and produce larger amounts of sebum, which explains the widespread prevalence of acne among teenagers.<\/span><\/p>\n

Genetic predisposition may increase the sensitivity of sebaceous glands to hormones, and therefore the chances of severe injury and scarring are higher in those with a similar family history.<\/span><\/p>\n

Acne does not necessarily disappear after the end of adolescence; it may persist into adulthood or appear for the first time after the age of twenty-five.<\/span><\/p>\n

The American Academy of Dermatology says that between 20 and 40 percent of women who develop acne in adulthood did not develop it during adolescence, but rather it first appeared in adulthood.<\/span><\/p>\n

Hormonal acne in women often appears as inflamed, deep pimples around the jaw and chin, and may increase before menstruation. In some cases, it may be associated with polycystic ovary syndrome, especially if accompanied by irregular periods, increased facial and body hair, hair loss, or weight gain.<\/span><\/p>\n

However, the sudden and severe appearance of acne in an adult woman, especially with signs of increased male hormones, may warrant a medical evaluation to rule out ovarian or adrenal gland disorders.<\/span><\/p>\n

Causes of increased acne<\/span><\/h2>\n

Poor hygiene does not cause acne, but some factors can increase follicle blockage or inflammation, including the use of oily products that clog pores, wearing helmets, masks, and tight clothing for long periods, sweating with friction, and using some oily hair products that come into contact with the forehead.<\/span><\/p>\n

Acne-like blisters may appear with medications such as cortisone, anabolic steroids, lithium, and some epilepsy medications. Trying to squeeze or pop pimples with fingernails can push inflammation deeper into the layers and increase the risk of pigmentation and scarring.<\/span><\/p>\n

Psychological stress is not the sole cause of the disease, but it may increase the severity of existing acne, possibly through hormones, inflammatory mediators, increased skin picking, and sleep disturbances.<\/span><\/p>\n

Acne ranges from mild cases consisting mainly of whiteheads and blackheads, to inflamed red pimples and pus-filled pustules, and in more severe cases, painful deep nodules or cysts appear that may extend under the skin and leave visible scars.<\/span><\/p>\n

The assessment of disease severity does not depend solely on the number of pimples. The location of the infection, the likelihood of scarring, skin color, the presence of pigmentation, and the disease’s impact on psychological state and social life are all factors that go into determining treatment.<\/span><\/p>\n

The inflammation may leave red or brown spots even after the pimple disappears. These spots do not necessarily represent permanent scars, but they may last for months, especially in people with dark skin, while true scars are low in the form of pits or raised and thick in some people.<\/span><\/p>\n

Acne, especially when it affects the face, is linked to decreased self-esteem, anxiety, and social isolation. The psychological burden can be significant even when a doctor classifies the condition as moderate. Therefore, guidelines recommend considering psychological distress and the risk of scarring when deciding on treatment.<\/span><\/p>\n

Topical treatment for acne<\/span><\/h2>\n

In 2024, the American Academy of Dermatology issued updated guidelines that included 18 evidence-based recommendations and 5 good clinical practices for treating adults, adolescents, and children aged nine and older.<\/span><\/p>\n

The guidelines provided strong recommendations for the use of benzoyl peroxide, topical retinoids, and topical antibiotics, along with combinations that combine two or more of these drugs.<\/span><\/p>\n

Benzoyl peroxide works to reduce acne bacteria and inflammation, while topical retinoids, such as adapalene, tretinoin, tazarotene and trefarotene, help to prevent clogged pores and the formation of new comedones, and also reduce inflammation.\u00a0<\/span><\/p>\n

The treatment is not usually applied only to the existing pimple, but to the entire exposed area, because the primary goal is to prevent the formation of new microscopic infections before they become visible.<\/span><\/p>\n

Azelaic acid provides an anti-inflammatory effect and helps to open pores and lighten dark spots that remain after acne has healed.\u00a0<\/span><\/p>\n

The guidelines also included topical clascoterone as a conditional option, a drug that blocks androgen receptors in the skin, targeting one of the hormonal drivers of fat production without oral hormone therapy.<\/span><\/p>\n

One product for treating acne<\/span><\/h2>\n

Topical treatment for acne<\/span><\/h2>\n

In 2024, the American Academy of Dermatology issued updated guidelines that included 18 evidence-based recommendations and 5 good clinical practices for treating adults, adolescents, and children aged nine and older.<\/span><\/p>\n

The guidelines provided strong recommendations for the use of benzoyl peroxide, topical retinoids, and topical antibiotics, along with combinations that combine two or more of these drugs.<\/span><\/p>\n

Benzoyl peroxide works to reduce acne bacteria and inflammation, while topical retinoids, such as adapalene, tretinoin, tazarotene and trefarotene, help to prevent clogged pores and the formation of new comedones, and also reduce inflammation.\u00a0<\/span><\/p>\n

The treatment is not usually applied only to the existing pimple, but to the entire exposed area, because the primary goal is to prevent the formation of new microscopic infections before they become visible.<\/span><\/p>\n

Azelaic acid provides an anti-inflammatory effect and helps to open pores and lighten dark spots that remain after acne has healed.\u00a0<\/span><\/p>\n

The guidelines also included topical clascoterone as a conditional option, a drug that blocks androgen receptors in the skin, targeting one of the hormonal drivers of fat production without oral hormone therapy.<\/span><\/p>\n

One product for treating acne<\/span><\/h2>\n

Some women may benefit from combined oral contraceptive pills or spironolactone, which reduces the effect of androgens in the sebaceous glands. Spironolactone has been used for years to treat acne in women, although its original license was for heart disease, blood pressure, and fluid retention.<\/span><\/p>\n

The British SAFA trial provided important randomized evidence of its effectiveness. The trial included 342 adult women with persistent acne and compared spironolactone to a placebo, in addition to usual topical treatment.<\/span><\/p>\n

The results showed greater improvement in the spironolactone group, with the difference being more pronounced after 24 weeks than after 12 weeks, indicating that hormone therapy needs time before reaching its maximum effect. The researchers said the drug could represent a useful alternative to oral antibiotics for women.<\/span><\/p>\n

Spironolactone is not usually used to treat acne in men because of its potential hormonal effects.<\/span><\/p>\n

Isotretinoin remains the most effective medication for achieving long-term relief in severe cases. It reduces the size of sebaceous glands and sebum production, and limits clogged pores, bacterial activity, and inflammation.<\/span><\/p>\n

The guidelines strongly recommend it when there is severe acne or scarring, significant psychological burden, or failure of topical treatments and appropriate antibiotics.<\/span><\/p>\n

Does acne return after treatment?<\/span><\/h2>\n

A group study published in JAMA Dermatology in 2025 showed that the drug isotretinoin does not prevent the recurrence of acne in all patients.<\/span><\/p>\n

The researchers analyzed data from 19,907 patients aged 12 years and older who had received treatment for at least 4 months, and found that 22.5% subsequently required new treatment due to a recurrence of acne, while 8.2% received another course of isotretinoin.<\/span><\/p>\n

Higher cumulative doses were associated with lower chances of relapse and treatment repetition, but increasing the daily dose did not provide a clear additional benefit in patients who had reached an appropriate cumulative dose.<\/span><\/p>\n

The researchers said the findings support the possibility of adjusting the daily dose according to the patient’s ability to tolerate dehydration and side effects, rather than assuming that a higher daily dose is always better, but the study was observational and relied on insurance claims data, and therefore does not prove a causal relationship on its own.<\/span><\/p>\n

The potential link between isotretinoin and depression or suicide has been a subject of debate for decades, but an analysis published in JAMA Dermatology, which included 25 studies and more than 1.6 million people, found no increase in the relative risk of psychiatric disorders or suicide at the population level of those who used the drug.<\/span><\/p>\n

The absolute risk over one year for suicide, suicide attempt, suicidal thoughts and self-harm was less than 0.5%, while the combined risk of depression was 3.83%.<\/span><\/p>\n

Despite the reassuring results, the researchers stressed the need to monitor mood, because rare psychological responses may occur in some individuals, and because severe acne itself may be linked to psychological distress and depression.<\/span><\/p>\n

Does food cause acne?<\/span><\/h2>\n

There is no strong evidence that any single food causes acne, nor is abstaining from chocolate or dairy products a substitute for proven medications.<\/span><\/p>\n

However, research suggests that high-glycemic-index foods, such as sweetened beverages, sweets, and bread made from highly refined flour, may increase insulin and insulin-like growth factor 1 (IGF-1), which may stimulate sebum production, keratinization, and hormonal signals associated with acne.<\/span><\/p>\n

Observational studies have linked milk, particularly among some adolescents and young adults, to an increased risk of developing or worsening the condition, but these findings do not prove that milk is the direct cause, nor does the relationship appear in all individuals.<\/span><\/p>\n

In a systematic review and meta-analysis published in November 2025, researchers found that greater adherence to the Mediterranean diet was associated with less severe acne, but was not significantly associated with a lower likelihood of developing the disease in the first place.<\/span><\/p>\n

The review included only 5 studies and 765 participants, and the quality of evidence was low due to the small sample sizes, the studies’ reliance on observation, and the large variability between them. Therefore, the researchers said that the results are not sufficient to describe the Mediterranean diet as a treatment for acne, and that better-designed trials are needed.<\/span><\/p>\n

A practical approach might be to reduce highly sugary and processed foods, and eat a balanced diet rich in vegetables, whole grains, and legumes, while monitoring the relationship between a specific food and grains rather than randomly eliminating entire food groups.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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