Whiteheads (closed comedones) are the earliest lesions of acne. This image displays prominent sebaceous follicles. This image displays small, slightly elevated lesions and scars in an adult with chronic acne. This image displays pus-filled lesions with whiteheads and blackheads (closed and open comedones) in an adult with moderate acne. This image displays one raised acne lesion and several flat, dark spots from prior inflammation, which may take months to resolve due to the patient's darker skin. This image displays multiple light skin scars typical of persistent acne over years. This image displays mild pus-filled lesions and bumps of acne on the chest. In people with darker skin, redness and inflammation of acne can be difficult to see. This image displays several large, inflamed bumps typical of acne vulgaris. Severe cystic acne on the back can leave permanent scars. This patient has numerous whiteheads (closed comedones) as well as red, inflammatory acne bumps on the forehead. This image displays darker color (pigment) in areas that had acne previously, which takes longer to heal in people with darker skin. In black patients, inflammatory lesions lead to unwanted dark spots, as displayed in this image.  This image displays whiteheads (closed comedones) on the chest. This image displays a large, inflamed acne cyst. This image displays a mix of pus-filled and inflammatory acne.  Blackheads (open comedones) are follicles plugged with scale and oil, as displayed in this image.  This image displays a mix of blackheads (open comedones), red bumps, and depressed scars typical of acne vulgaris. This image displays blackheads (open comedones) in the ear area typical of acne. This image displays numerous whiteheads (closed comedones) and acne pus-filled lesions on the forehead. This image displays pus-filled lesions and blackheads (open comedones), as well as darkened areas from previous acne lesions. This image displays dark spots from old acne marks (post-inflammatory hyperpigmentation) and one active cystic lesion on the cheek. This image displays bumps, pus-filled lesions, and dark, flat pigmented marks from previous acne lesions. This image displays numerous whiteheads (closed comedones) and scattered acne bumps. This image displays small acne pus-filled lesions as well as darker marks from previous lesions on the forehead. Close-up of pustules and inflammatory skin lesions of acne. This image displays small bumps, pus-filled lesions, and residual flat, red marks typical of acne. This image displays small bumps and pus-filled lesions, as well as dark, flat marks, typical of acne.
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Acne (Acne Vulgaris)  Teen information

Picture of Acne (Acne Vulgaris): Whiteheads (closed comedones) are the earliest lesions of acne. Divider line
Whiteheads (closed comedones) are the earliest lesions of acne.
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Self-Care Guidelines
  • Gently cleanse with mild soap or cleansers. (But don't scrub!)
  • Resist picking at lesions.
  • Avoid irritants (rubbing and other alcohols, abrasive scrubs) and oily creams, cosmetics, hair products, and sunscreens.
  • Use products labeled "water-based" or "noncomedogenic."
  • Keep hair, hands, and devices such as cell phones off the face.
  • Avoid greasy products on the skin and scalp.
Over-the-counter medications:
All over-the-counter therapies listed below should be used as a preventive therapy, applied in a thin to moderate quantity to entire regions. Acne treatment is not intended for existing individual lesions but is applied consistently over months to prevent new lesions. Expect slow improvement. Develop a skin care regimen that is modified slowly over time, not week to week.
  • Benzoyl peroxide (most effective), available in a variety of forms and strengths. Benzoyl peroxides tend to dry the skin. If you have dry skin, use a weaker concentration product; for oily skin, consider higher strengths.
  • A combination of a vitamin (nicotinamide) and zinc is available in cream and gel form.
  • Exfoliants (or peeling agents) such as salicylic acid, sulfur, resorcinol, alpha-hydroxy acids (glycolic, lactic, pyruvic, and citric acid).
  • Aluminum chloride hexahydrate (an antiperspirant available as Xerac-AC™) may be useful but can also be irritating.
  • Clinac OC is a copolymer that absorbs oil, helping reduce the look of "greasy skin." It also is produced combined with benzoyl peroxide.
Salon or office treatments:
Microdermabrasion performed every 7–10 days ("lunchtime peel") has been a popular (but costly) way to control mild acne. The same type of peeling agents (exfoliants) are available in over-the-counter products, which can be used at home at much less cost.

Of Note:

  • Acne can have significant psychological effects. Talk to your doctor about any feelings of depression.
  • Changes in diet have no proven effect.
When to Seek Medical Care
If you have moderate or severe acne that has not improved enough with self-care, seek medical help.
Last Modified: 16 Jul 2009