Acne Treatments: What Causes Acne?

Experts at the American Academy of Dermatology say acne develops when hormonal shifts (like the kind that occur during puberty and, for women, before a menstrual cycle, and prior to menopause) cause an overproduction of oil and cells inside a skin follicle. Together, they form a kind of biological traffic jam that plugs the opening of the pore and causes the follicle beneath to swell.

Crutchfield says this causes an overgrowth of bacteria normally found on the skin, which in turn produce irritating chemical substances that fuel inflammation. The end result is whiteheads, blackheads, hard tiny pimples, or pus-filled lesions.

Indeed, because doctors now believe that inflammation plays such a key role in acne, many say the future of treatment will involve drugs that specifically target the inflammatory response in skin.

“We’re not there yet, but the future of acne treatments will definitely bemedications that focus on the inflammatory aspect – and that is where the real solution might lie,” says dermatologist Doris Day, MD, associate professor at NYU School of Medicine in New York City and author of 100 Questions and Answers About Acne

Acne Treatments: What Works Right Now

Meanwhile, there are many acne treatment options to choose from right now. These treatments fit one of two categories: “pore cleansers” that suppress acne by preventing the “traffic jam” inside the pores; and products that target the production of either oil or hormones, which are thought to trigger breakouts.

Pore-cleaners are over-the-counter medications that contain benzyl peroxide and/or salicylic acid, and usually are very effective, Day says. “For many patients, this might be all the treatment that’s needed, particularly if breakouts are not causing scarring.”