Acne and pimples

Acne and pimples are a disorder of the hair follicles and sebaceous glands. It is caused by a combination of several factors. Genetic predisposition is the key factor for both women and men. The presence of hormonal imbalance, such as polycystic ovaries, hypothyroidism, diabetes can be major triggers for acne primarily in women and less often in men.
Acne or pimples most often occur in adolescents during puberty, and about 80% of young people aged between 12. do 25. and 25 years have acne, but also about 3% of people over 45 years still have problematic skin.

How are acne formed?

Acne occurs when sebaceous glands overproduce, due to a genetic predisposition, even at the normal level of sex hormones. With the accumulation of sebum, blackheads or comedones are created, widening the excretory duct and allowing the accumulation of dead skin cells. It can be followed by an inflammation, resulting in the appearance of pus and nodules. The development of microcomedones can go in two directions. If, under the influence of sebum, comedones open up, blackheads are formed on the skin that do not cause the inflammation. If comedone is closed, sebum accumulates inside, it grows, Propionibacterium acnes multiplies, leading to the formation of inflammatory acne, purulent nodules, pustules.

Clinical picture and types of acne

Acne most often appears on the central part of the face, back and chest. They can occur as comedonal acne dominated by blackheads. Papulopustular acne, in addition to blackheads, have visible pustules and smaller nodules. Nodulocystic acne is characterised by deep inflammation, painful nodes, blackheads and purulent processes. The most severe form of acne is acne conglobata which occurs when acne cysts and nodules begin to grow together deep below the skin deformed by pus and inflammation.

In addition to these types, acne excoriée (also known as “picker’s acne”) can be provoked by constant scratching and squeezing of small skin lesions, that is, by mechanical trauma of the skin, causing the formation of scratches, rhagades and acne scars.

Acne scars can develop even without touching the inflammatory process, spontaneously, as a genetic predisposition.

Also, some medications (most often corticosteroids, less often antibiotics and other medications) can cause acne — acne medicamentosa. Less often acne can occur in newborns, who are completely healthy, and spontaneously resolve by the third month, less by the sixth month. In some people (more often women) and after puberty, adult acne can occur. These people most often have polycystic ovary syndrome, hormonal imbalance, hyperandrogenism.

Acne scars treatment before and after
Acne scars treatment before and after 3 months

How to treat acne and pimples

It is important to start the treatment of acne and pimples as soon as possible in order to minimize the possibility of scar formation. The gradual pigmentation is very common and most often passes in 6 months to a year, in some cases it can be long lasting. Permanent scars are common, especially after conglobate and nodular acne, and they can be atrophic and hypertrophic.

Depending on the form of the condition, the therapy is individual and can be local and systemic. When it comes to local preparations benzoyl peroxide, azelaic acid, local retinoids, salicylic acid, glycolic acid are used in treatments. If it is a more severe form, antibiotics, isotretinoin, as well as contraceptives are included in the therapy. In addition to daily therapy, it is possible to perform laser treatments and peels.

If scars are left on the skin after acne and pimples have healed, they can be treated with peels, fractionated CO2 laser and other methods. For further reading on this subject check out the text about the treatment of red spots from acne with a VBeam laser.


Svetlana Đurišić specijalista dermatovenerologije

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