Acne: Causes, Symptoms, and Treatment
Written by Achuta Uppu, MD. Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Acne?
A dermatologist (a skin doctor) treats acne. A primary care doctor can also diagnose and treat it. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is acne?
Acne is a skin condition that causes pimples or "zits." Whiteheads, blackheads, red bumps, and cysts may develop. It happens when tiny pores on the skin become clogged. Each pore opens to a follicle, which holds a hair and an oil gland. When oil and dead skin cells block the pore, a plug forms. If bacteria get trapped in the plug, the immune system may react and cause pimples.
Acne commonly appears on the face and shoulders. It can also occur on the trunk, arms, legs, and buttocks. It is most common in teenagers, but anyone can get it. The problem tends to run in families.
Symptoms
Skin changes include:
- Whiteheads (closed comedones) and blackheads (open comedones), which are plugs of oil and skin cells in a pore.
- Papules, which are small red bumps.
- Pustules, which are small red bumps with white or yellow pus.
- Cysts, which are hard, painful lumps deep in the skin. Deep acne like this is called nodulocystic acne, and it can cause scarring.
Dark spots may appear after acne clears.
Causes and who gets it
Breakout triggers include:
- Hormonal changes that make the skin oilier, from puberty, menstrual periods, pregnancy, birth control pills, or stress.
- Greasy or oily cosmetic and hair products.
- Certain medicines, such as steroids, testosterone, estrogen, and phenytoin.
- Heavy sweating and humidity.
- Touching, resting on, or rubbing the skin.
Research does not show that chocolate, nuts, and greasy foods cause acne. Diets high in refined sugars or dairy may be related to acne in some people, but this link is debated.
How doctors diagnose it
A doctor diagnoses acne by looking at your skin, checking what types you have and where breakouts appear. Testing is not needed in most cases. A bacterial culture (a lab test that grows germs) may be done for certain patterns of acne or if large pus bumps last.
Treatment
Start with gentle skin care. Clean your skin with a mild, non-drying soap, once or twice a day and after exercising. Avoid scrubbing or repeated washing. Use noncomedogenic cosmetics and creams, which are tested not to clog pores in most people. Do not squeeze, scratch, pick, or rub pimples. This can lead to skin infections, slower healing, and scarring.
If that does not help, try over-the-counter acne medicines you apply to the skin. They may contain benzoyl peroxide, sulfur, adapalene, salicylic acid, or resorcinol. They work by killing bacteria, drying up skin oils, or peeling the top layer of skin. They may cause redness, drying, or peeling. Benzoyl peroxide reduces acne-causing bacteria and works best with another acne treatment.
A doctor can also prescribe stronger medicines:
- Retinoid creams or gels (forms of vitamin A) clear pores and can treat blackheads, whiteheads, and some pimples. Adapalene is available without a prescription.
- Antibiotics come as pills or skin creams. An oral antibiotic can treat moderate to severe pimples but not nodular acne. Using a skin antibiotic with benzoyl peroxide lowers the risk of antibiotic resistance (when the medicine stops working on germs).
- For hormonal acne, birth control pills or spironolactone (a hormone-blocking medicine) may help. Spironolactone can cause severe birth defects, so women who can become pregnant must use birth control. For severe acne with scarring, isotretinoin may be tried.
- Isotretinoin pills treat severe nodular acne that other treatments have not helped. Isotretinoin causes severe birth defects, so pregnant women should not take it. Women on it must use 2 forms of birth control and enroll in the iPLEDGE program. People on it need regular blood tests and close follow-up.
A dermatologist may inject a corticosteroid (a strong anti-swelling medicine) into a large painful breakout to ease pain and lower scar risk. Chemical peels, laser or light treatments, and acne surgery are other options.
When to see a doctor
Contact your doctor if self-care and over-the-counter medicine do not help after several months. Contact your doctor if your acne is very bad, such as a lot of redness around the pimples or painful cysts. Also call if acne is getting worse or scars appear as it clears. Tell someone how you feel if acne causes emotional stress.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can start skin care steps and common acne medicines. The doctor can also refer you to a dermatologist if you need specialist care.
Common questions
What causes acne?
It starts when pores get clogged with oil and skin cells. Triggers include hormonal changes, oily products, certain medicines, sweating, humidity, and rubbing the skin. The problem tends to run in families.
Does food cause acne?
Research does not show that chocolate, nuts, and greasy foods cause acne. Diets high in refined sugars or dairy may be related to acne in some people, but this link is debated.
How long does treatment take to work?
Acne often responds well to treatment, but responses may take 6 to 8 weeks. Acne may flare up from time to time.
Can acne cause scars?
Scarring may occur if severe acne is not treated. Do not pick or squeeze pimples, since this can lead to scarring and skin infections.
Sources
- MedlinePlus - Acne
- MedlinePlus - Acne - self-care
- American Academy of Dermatology Association - Acne: Diagnosis and treatment
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
