5 tips to keep acne in check

Acne is one of the most common skin problems in the world. It affects most teenagers at some point, and many adults deal with it too. The good news is that a few simple daily habits can help you keep acne in check and lower the risk of scars. This post explains what acne is, what really causes it, five practical tips from skin experts, the treatments you can try and when it is time to see a doctor.

Our old post on this topic had some useful ideas but also a few skin care myths. We have rewritten it in plain English and checked the advice against guidance from dermatologists and health services. This post is general information and does not replace advice from your own doctor.

What Is Acne?

Acne starts in the hair follicles, the tiny openings in the skin from which hairs grow. Each follicle is linked to an oil gland that makes sebum, a natural oil that keeps the skin soft. When dead skin cells and too much sebum block a follicle, a spot can form.

Acne can show up in several forms:

• Whiteheads: small bumps the same colour as the skin.
• Blackheads: dark spots that are usually flat.
• Papules: small raised bumps that may look red, brown or purple.
• Pustules: raised bumps filled with pus.
• Nodules and cysts: larger, deeper lumps that can be painful and are more likely to scar.

Acne most often appears on the face, chest and back. It can also affect how people feel about themselves, leading to low confidence or anxiety, so it is worth taking seriously.

What Really Causes Acne?

Many people believe acne is caused by dirt or poor hygiene. That is not true. Research does not link cleanliness with acne. The main causes are inside the skin:

• Genes: acne tends to run in families, and genetics explain most of a person’s risk.
• Hormones: during puberty, hormones called androgens make oil glands grow and produce more sebum. Hormone changes during periods, pregnancy and conditions such as polycystic ovary syndrome can also play a part.
• Bacteria: a bacterium that normally lives on the skin, Cutibacterium acnes, adds to the swelling and redness.
• Blocked follicles: extra skin cells build up inside the follicle and form a plug.

Other factors are less certain. Some studies suggest that diets high in sugary and refined foods may make acne worse, and there is weak evidence linking milk to acne. Current evidence does not support a link between chocolate or salt and acne. The role of stress is still unclear. For more on food and skin, see our post on diet for good skin care.

How to Keep Acne in Check: 5 Tips

These five habits are simple, cheap and easy to build into your day. Together they can help you keep acne in check while any treatment you use does its work.

1. Do Not Over Wash Your Face

It is tempting to wash an oily face again and again, but this can backfire. Washing many times a day, or scrubbing hard, irritates the skin and can make acne flare. Skin experts suggest a simple routine:

• Wash your face twice a day, once after waking and once before bed, and again after sweating.
• Use a mild, gentle cleanser and apply it with your fingertips, not a rough cloth, sponge or brush.
• Rinse with warm water and pat your skin dry with a clean towel.
• Avoid harsh astringents, toners and scrubs that dry the skin. Dry skin is irritated skin, and irritation can lead to more spots.

There is no need to finish with a splash of cold water to close your pores. Gentle washing and rinsing is what matters.

2. Change Your Pillow Covers Often

Your pillow cover touches your face for hours every night and collects oil from your hair and skin, along with sweat and skin cells. Changing it often is a simple habit that many people find helpful, though there is no fixed rule for how often. Keeping your hair clean matters too. Oil from the hair can cause acne along the forehead, so if your hair is oily, shampoo it more often and keep it away from your face.

3. Keep Your Phone Clean

A mobile phone pressed against the cheek and jaw for long calls carries oil, sweat and makeup from your skin and hands. Wiping it clean regularly is easy. Pressure and rubbing can also make existing acne worse, as doctors have seen with helmets and chin straps.

4. Remove Your Makeup Before Sleeping

Dermatologists say that even makeup labelled noncomedogenic, meaning it is made not to clog pores, can cause acne if you sleep in it. So remove all makeup before bed, every night. If you are too tired to wash properly, a gentle makeup remover wipe is better than nothing.

Also choose makeup, sunscreen and hair products labelled noncomedogenic, and do not share makeup, brushes or sponges with others, since oil and skin cells can pass from one face to another.

5. Do Not Pick or Squeeze Your Spots

This is the hardest tip to follow and one of the most important. Popping or squeezing a spot pushes its contents deeper into the skin. That increases swelling and pain, makes the spot last longer and raises the risk of scars and dark marks. Touching your face often through the day can also make acne flare. If a spot is deep or painful, leave it alone and speak to a doctor instead.

For more habits to avoid, read our posts on daily skin care mistakes and common skincare blunders.

Treatments You Can Buy

For mild acne, products sold at chemists often help. Common active ingredients include:

• Benzoyl peroxide: helps kill the bacteria linked to acne.
• Salicylic acid: helps clear blocked pores.
• Azelaic acid: helps with spots and can also fade dark marks.

A pharmacist can help you choose. Spread a thin layer over the whole area where you tend to break out, not just on the spots you can see, so it can help prevent new ones. Be patient. Dermatologists say a product needs six to eight weeks to show some improvement, and full clearing often takes three to four months. Switching products too often can irritate the skin. If your skin feels dry, use a light moisturiser made for acne prone skin.

Acne in Adults

Acne does not stop at the teenage years. Children and adults can get it before and after puberty. In women, hormone shifts around periods, pregnancy and the years leading up to menopause can trigger breakouts. If acne appears suddenly in adulthood, it is worth seeing a doctor, because hormone conditions such as polycystic ovary syndrome can be the cause.

Why Acne Scars Happen

Scars form when deep swelling damages the lower layers of the skin and it heals unevenly. Most acne scars are small pits or dents, known as ice pick, boxcar and rolling scars. Raised scars are less common. Dark marks left after a spot often fade with time, unlike true scars. The best way to avoid scars is to keep acne in check early and never pick at it.

Sun and Acne

Some people think a tan dries out spots. In fact, tanning damages the skin and can make acne worse. Some acne treatments also make skin more sensitive to the sun. When you go out, use a sunscreen labelled noncomedogenic and seek shade.

When to See a Doctor

See a doctor or skin specialist if:

• You have tried treating acne yourself for a few months and it is not improving.
• You have many spots, or they are deep, painful or leaving scars.
• The skin looks hot, swollen and red, which can be a sign of infection.
• Acne is affecting your mood, confidence or mental health.

A doctor may suggest stronger creams such as retinoids or antibiotics, antibiotic tablets, or for some women a hormonal pill. For severe acne, a specialist may consider isotretinoin, a strong medicine that needs close medical care. Never take these medicines without a prescription. You can learn more in our guide to acne symptoms and treatment.

What We Changed From the Old Post

We rewrote the post in plain English and kept its five tips, but updated the advice to match guidance from skin experts.

We removed myths, including the idea that dirt causes acne, that cold water closes pores, and that everyone gets acne. We replaced the old warning that makeup breeds bacteria with the sourced advice that sleeping in makeup can cause breakouts.

We added what acne is, its real causes, the role of diet, treatments you can buy, sun care and clear signs that you should see a doctor.

Frequently Asked Questions

How many times a day should I wash my face if I have acne?

Twice a day, and again after sweating, using a gentle cleanser and your fingertips.

Does dirt cause acne?

No. Acne is mainly caused by genes, hormones, extra oil and blocked hair follicles, not dirt.

Is it bad to pop pimples?

Yes. Popping pushes material deeper into the skin and raises the risk of scars and dark spots.

How long do acne treatments take to work?

Usually six to eight weeks for some improvement, and three to four months for clearer skin.