Acne (blackheads, pimples): what it is, types, scar, remedies, treatment

The acne is a very common skin problem and it is difficult for anyone who has not suffered from the problem at some stage of life. More frequent in adolescence, due to hormonal fluctuations, the condition usually affects self-esteem .

In adulthood, acne can also be a present problem, but fortunately, there are several ways to treat the problem.

Check in the text below all about the condition!


What is acne?

Acne is a skin disease caused by clogged pores in response to inflammation of the sebaceous glands. So they end up producing excess skin sebum. When the pores become clogged, blackheads and other symptoms such as pimples, pustules and cysts appear .

Acne is considered to be a chronic disease and not just a temporary change limited to the period of adolescence.

Despite being more frequent at this stage, acne can also manifest itself in adults, in different stages and for different reasons.

In adolescents, this disease is more common because it is at this stage that the production of hormones is greatest.

Being predominant during puberty, a phase naturally disturbed by changes in the adolescent’s body, acne becomes even more of a negative factor.

Commonly, problems of self-esteem, insecurity and shyness are associated with the disease.

In general, the cause is usually related to hormonal factors, stress , age, natural skin oils, genetics, pregnancy, premenstrual period and weather.

For having, in more severe cases, a disfiguring character, acne is a condition that affects patients physically, socially and psychologically.

According to the World Health Organization, which recognizes acne as a disease, treatment must be done early and guided by a specialist doctor

Thus, it is possible to prevent complications such as decreased self-esteem, depression and even discrimination.

According to the Ministry of Health, acne is responsible for affecting 80% of young people between 15 and 25 years old and 30% of the adult population.

In ICD-10, acne is found by the code L70 .

Acne, pimple or blackhead?

Although they are often used interchangeably, there are differences . Acne is the name given to the inflammation that occurs in the skin, which can be mild or severe. Pimples, on the other hand, are one of the signs of acne. It is a common type of lesion, characterized by the presence of small reddish elevations in the skin, with or without pus in its center.

On the other hand, blackheads are generally easily recognized. People already know that these are little dots, white or black, scattered over the face.

As with pimples, blackheads are also a type of acne lesion, the blackhead being only the clogging of the pores and the spine its most advanced stage, with the presence of inflammation by bacteria.

Is acne transmissible?

No , acne is not transmissible, so it is not possible to pass on or get the problem from someone else. Even though it is caused by a bacterial proliferation in the hair follicles, acne is not contagious, even in physical contact with the lesions.


Acne receives five classifications according to the degree of involvement. Even within these divisions, it can be considered as mild, moderate or severe. This classification receives the following denominations:

Comedonian acne (grade I)

Comedonian acne, or grade I acne, is a type considered mild and non-inflammatory . Its main characteristic is the presence of open comedones (blackheads) and closed comedones (whiteheads or skin-colored blackheads).

People who suffer from this type of acne tend to have a greater presence of blackheads in the nose, forehead and chin area.

Papule-pustular acne (grade II)

From grade II onwards, acne becomes an inflammatory condition , as occurs in papular-pustular acne.

This type of disease is characterized by the appearance of redheads and blackheads. In these cases, the number of comedones is much higher than in comedonian acne.

It is also the most common type of acne in adolescents, who at one time or another during this period, experience this type of skin problem. The face is the part most affected by these blackheads and pimples.

Nodulocystic acne (grade III)

It is a more serious type of acne, in which the presence of papules with redness, the presence of pus, seborrhea and blackheads occurs . By reaching a deeper layer of hair, this type of acne can cause nodules or even pseudocysts.

These pseudocysts, unlike “real” cysts, do not have their own lining. This means that acne pseudocysts are not, in fact, epidermal cysts, but lesions composed of fluid.

Normally, the severity of nodulocystic acne is measured by the size and number of lesions present in the patient, considered a cause for concern when 10 or more lesions with a diameter of 4 mm are present.

The diagnosis of nodulocystic acne also occurs when the lesions are resistant to the usual therapy.

In these cases, the lesions appear on the face, but they also spread over the trunk, and may leave scars more often than other types.

Some patients may suffer from complications such as keloids, a more prominent type of scar that appears after a wound heals.

Acne conglobata (grade IV)

It is considered a severe degree of acne, in which the symptoms already present in the cases of nodular-cystic acne become even more serious.

However, in this degree, purulent nodules are added to the signs , in greater quantity and size, which end up forming pus pockets ( abscess ) .

Conglobate acne is an inflammatory acne that can be disfiguring. It is more common in men, but it can affect both sexes.

Lesions can occur on the face, torso and other areas of the body such as arms, neck, chest and buttocks.

Fulminant acne (grade V)

Fulminant acne is the most serious manifestation of acne, as it occurs suddenly and with more worrying symptoms.

In addition to severe skin lesions, this type also causes symptoms such as fever , malaise, fatigue and body pain. It can also cause bleeding and necrosis in some lesions.


The types of acne can also be understood by the cause or age group in which they occur. In addition, in some conditions, types of acne can occur simultaneously, as in the case of vulgar and cosmetic acne, for example.

Acne neonatal

It is estimated that for every 10 newborns, 1 presents neonatal acne between the third and fourth week of life. With proper treatment, acnes tend to disappear within four to five weeks, leaving no scars.

It is considered a simple skin problem, which has no relation to breast milk. It is often also confused with miliaria, a condition in which dozens of red dots spread across the baby’s body.

Neonatal acne is caused by hormonal changes stimulated by maternal androgens (hormones such as testosterone and estrogen), and is unrelated to other types of acne.

It can cause inflammatory pimples on the face of the newborn, but the appearance of only blackheads is the most common.

The treatment usually consists of skin hygiene with the use of children’s soap and the aid of clean, soft cloths to dry.

You should not rub the child’s skin or use other products that are not recommended by the doctor.

Although it is a mild condition, it is recommended that parents pay attention to the possible appearance of blisters or pimples with pus, as it can be an alert to other problems.

Acne infantil

It usually occurs between the first 3 to 6 months of life and, unlike neonatal acne, it has no relationship with maternal hormones. Although it is less common, it can also happen at around 1 to 2 years of age.

The cause of this type of acne is associated with hormonal changes in the child, who ends up developing inflammatory papules and pustules on the skin of the face.

The follow-up of these cases by a dermatologist is important and prevention, afterwards, is also important. Children who have had childhood acne are at an increased risk of developing severe acne in adolescence.

Vulgar or juvenile acne

It is the most common type of acne during adolescence . Due to hormonal changes, which fluctuate in this stage of life, there is an increase in the production of the sebaceous gland, which ends up resulting in the appearance of blackheads and pimples.

Acne vulgaris is usually more common in males. It is believed that during this phase everyone will have this type of acne, but to varying degrees.

Old woman acne

It affects women aged 25 and over, who may (or may not) have had acne vulgaris in their teens. The main feature is the presence of inflammatory pimples, usually in the chin area and close to the nose. In such cases, the presence of blackheads is less common.

The cause is usually related to a hormonal issue. Treatment should be done continuously, as acnes often return in these cases.

Premenstrual acne

It is a common type of acne, similar to acne vulgaris, that becomes more intense during the premenstrual period. The most severe cases of premenstrual acne should be investigated to check for hormonal production and to rule out the possibility that it is a hormonal disease or polycystic ovary syndrome.

Read more: Menstrual Calendar (table): how to calculate the fertile period?

Adult acne

There are two types of adult acne: persistent and late.

As the name suggests, persistent acne does not just remain for a period of life, it can accompany the patient for long years. Usually, the skin problem starts in adolescence.

Persistent acne usually causes inflamed pimples, nodules or cysts in the mouth, chin and jaw area. They are more painful lesions than those that appear in acne vulgaris, and may leave scars.

In men, remission can happen around the age of 25, in women, persistent acne can last up to 40 years.

In the case of late acne, the onset occurs in adulthood and can be as severe as persistent acne.

It can affect people’s faces, backs and breasts, and causes such as hormonal changes, medications and even the contact of hair products with the skin.

Acne androgênica

It is caused by the excessive production of hormones, which can be triggered due to the presence of diseases such as polycystic ovary syndrome or other hormonal dysfunctions.

In addition to the skin problems it causes, androgenic acne can also be accompanied by signs such as seborrhea, increased body hair and hair loss .

Cosmetic acne

It is more common in women who use cosmetic products that end up clogging the pores, called comedogenic. It usually causes more blackheads than other typical acne signs, such as pimples and swelling.

Because it is caused by an external factor, this type of acne can be more easily prevented and treated. People who have oily skin by nature, should avoid using cosmetic products that are not oil free , or dry touch.

Cosmetic acne can happen simultaneously with common acne, affecting the face, close to the ears, back and neck, due to contact with products such as shampoo, conditioner, moisturizers and body oils.

Excoriated acne

Excoriated acne is a type of acne associated with disorders such as anxiety , because in these cases, the patient ends up causing abrasions and scars on the skin itself when trying to squeeze and puncture the pimples or blackheads.

It is common for people, in this type of acne, to be poking the same wounds, causing trauma and possible scarring on the skin.

Despite being associated with types of acne, the skin problem is not the most aggravating factor, as this is a condition that can be considered neurotic or psychotic.

The scars must be treated, but for this type of acne to be cured it is also necessary to treat what is causing this impulse.

Beach acne

Despite that name, the beach itself is not what causes acne. What happens is that during the summer, or on hot days when people take the opportunity to go to the beach or stay in swimming pools, the use of products such as moisturizers and oils is greater.

So, to avoid drying out the skin caused by heat, people apply more oily products to the body, which can develop this type of acne. These products should be avoided, as they can end up clogging the pores, favoring the appearance of blackheads and whiteheads.

Solar or summer acne

It is caused by an injury to the skin follicle caused by sunburn. The use of sunscreens and after-sun products ends up further aggravating the appearance of this type of acne, due to the oiliness present in the composition.

Usually, the parts of the body most affected by this type of acne are the shoulders and the torso.

Medicated acne

Medicated acne happens as a side effect to certain medications, and can cause injuries to the face, neck, trunk and limbs.

Generally, the drugs that cause this type of acne are those produced with synthetic hormones, which end up inducing an increase in skin oiliness.

Among the most common classes of remedies for continuous use that can cause this adverse effect are contraceptives, corticosteroids and anticonvulsants. Hormonal treatments can also cause this skin problem.

Acne in pregnancy

During pregnancy, it is common for women to experience some hormonal fluctuations. During the first few months, pimples and other skin changes, such as melasma (darker spots), can occur.

Friction or mechanical acne

It happens due to irritation caused by friction, which ends up causing edema . It is common, in this type of spine, that a bacterial infection occurs, due to the exposure caused by the edema.

Usually, this type of acne happens through the use of tight clothes or accessories such as caps, hat, helmet, bands and other items very close to the body.

Occupational acne

Occupational acne is associated with contact with substances that can cause greater oiliness in the skin or that, in some way, end up attacking it. It is more common in people working in the metallurgical, oil, mechanical and chemical industries.

What causes acne?

Acne happens when there is a clogging of the pores, caused by the accumulation of dead cells or by increased oiliness in the skin . Many factors can contribute to the increase of this sebum, such as hormonal variations, use of medications, stress, genetics, cosmetics, supplements and heat.

This type of fat (sebum) is produced by the adrenal glands and aims to protect the skin.

The problem is when this production is excessive, because when this excess is mixed with dead cells, both substances end up forming a plug in the hair follicle (structure that forms the hair).

In these cases, the sebum ends up clogging the pore (orifice) of the skin. If the follicle is close to the surface of the skin, it will swell outward, creating a pimple.

When the follicle is open in the skin, it will create a blackhead.

Consequently, excess sebum can increase the chances of bacteria growing at the site, as is the case with Propionibacterium acnes, which feeds on secretions manufactured by the sebaceous glands.

Thus, when these bacteria come into contact with the pores, they end up causing an inflammation and resulting in the appearance of acne lesions.

Inflammation causes more reddish lesions on the skin. In severe cases, when the inflammation is more advanced, the follicle wall may break and release the material present, such as fatty acids, bacteria, cells and lipids.

This rupture can lead to more severe and deeper inflammation.

It is understood, therefore, that acne can be caused by three main factors:

Tallow production

Sebum, as seen, is nothing more than an oily substance secreted by the sebaceous glands. This oiliness is important for the lubrication of the skin and hair.

Many factors can influence this production.

One of the main reasons is the change in hormones called androgens and estrogens.

The production of estrogens is higher in women and the production of androgens is more common in males.

These hormones are produced by the ovaries, testes and the adrenal glands, and the androgen hormones are responsible for the initial functioning of the sebaceous glands.

These glands, which are more active in the face, chest, back and hair leather, have been present in people’s bodies since birth. However, it is at puberty that they are most active.

In people who have a genetic predisposition, these glands are responsible for causing the increase in oiliness of the skin and hair.

In addition to interfering with the appearance of acne, sebum production can also trigger other problems, such as seborrheic dermatitis .

However, although hormonal changes are one of the main factors for the production of sebum, other items can interfere with this skin oiliness, such as the weather, medications and the use of oily products.

Microbial colonization (bacteria)

There are some types of bacteria that live on the skin, without causing serious health problems, such as Propionibacterium acnes . When these bacteria accumulate, however, this can be a problem.

When in excess, these bacteria can form a kind of colony in the clogged pores to feed on sebum. In this way, they end up causing an inflammation and resulting in the typical symptoms of acne.


Hyperkeratosis, a condition also called hyperkeratinization, occurs when the outer layer of the skin thickens.

Usually, this hyperkeratinization happens as a form of natural skin protection. However, this thickening ends up preventing dead cells from being removed easily.

In addition to the excessive production of sebum, this ends up becoming another triggering factor for acne, as it ends up causing the obstruction of the hair follicle.

Risk factors

The risk factors for acne are very close to the causes. In some cases, they can be prevented and treated more easily.

Some symptoms can contribute to the worsening of acne, which is important for those who already suffer from the condition. The main reasons for the appearance of the injury are:

  • Genetic predisposition;
  • Heredity;
  • Stress;
  • Infection caused by bacteria;
  • Hormonal changes;
  • Naturally oily skin;
  • Use of products such as moisturizers, sunscreen and makeup with fat composition.

In addition to these factors, some patients may notice a worsening of acne due to some fatty foods, such as fried foods and chocolates, for example. However, there are not enough studies to affirm that diet is a determining factor for the appearance of pimples.

However, the patient can talk to the doctor and, if necessary, remove from the diet food that may be worsening the lesions.

Groups of risk

Acne is a very common disease and can affect everyone in general. It is estimated that 80% of the population suffers, throughout their lives, with some type of acne.

However, the prevalence is higher in adolescence (80%) and in males.

Other risk groups include:

  • Pregnant women;
  • Women during the premenstrual period;
  • Men, in general, due to genetic predisposition and hormones such as testosterone;
  • Patients being treated with cortisone-based drugs and other drugs with synthetic hormones.

What are the symptoms of acne?

The symptoms of acne are easily recognized, due to the fact that this type of skin problem is so common. Typically, lesions appear on the face, chest and back. They can also appear on the neck, arms and buttocks, depending on the type of acne.

People may experience, in more severe cases, the presence of pain, itching and irritation at the site of the injuries. This is the case of acne on the back , since the region is in constant friction with other surfaces.

There are six main types of injuries caused by acne. Are they:


Blackheads, also known as comedones , occur due to the accumulation of sebum in the clogged pores of the skin. This is due to excessive oil production or dead cells.

They are quite common in people with oily skin, but it happens in almost all skin types. They can be opened (black carnations) or closed (white carnations).


They are the most characteristic signs of acne. When it comes to acne, it is common for people to associate pimples synonymously.

They may look similar to carnations, with white dots in the center and a more reddish hue around them, which may or may not contain pus.

Although some people feel a strong urge to squeeze them, this is not a practice that should be done, as pimples can become inflamed and end up scarring over time.


The papules are small bumps on the skin, firm and, in some cases, pointy like pimples. They can be the same color as the skin or have a more reddish tone.


Pustules are lesions similar to papules, but are more swollen and white due to the accumulation of pus. They are more sensitive and inflammatory lesions, which can leave scars if injured.

When these lesions occur in a more agglomerated manner and in large quantities, the patient can be diagnosed with severe acne.


Nodules are usually larger, more solid and more painful lesions, which occur inside the dermis, layer below the epidermis.

The types of acne that have nodules are generally more difficult to treat, which is also because it is an inflammatory type of the disease.


They are considered a serious symptom caused by acne. They are usually larger than other types of lesions and are full of pus, resembling boils.

They have a higher risk of causing permanent scarring and should therefore be treated early.

Body parts affected by acne

Acne happens, specifically, in the part of the skin called the pilosebaceous unit. The hair follicle, the sebaceous gland and the vellus type ( thinner hair) are part of this unit .

The appearance of acnes on the face, neck and chest region is more common, because in these parts of the body the presence of sebaceous glands is greater.

In the face, for example, the number of glands is more prevalent, being up to 900 glands / cm², while in the rest of the body it is 100 glands / cm².

However, acne can also manifest itself in other regions of the body, such as arms, legs, back and buttocks.


The diagnosis of acne, to identify the type and appropriate treatment, is usually made by a dermatologist . Treatment, depending on the cause, can also be done with the support of professionals in the field of endocrinology or gynecology .

The problem is usually recognized by the patient himself, who, dissatisfied with the impact of the disease on his appearance, tends to seek medical help to get rid of skin lesions.

To identify the type of acne and the cause, the doctor must perform a clinical diagnosis and investigate the patient’s history, analyzing the symptoms and factors that may be causing the acne.

Does acne have a cure?

Acne is a skin problem that can be treated and cured, but that requires constant care, as it can have remission. In addition to having a medical follow-up, you need to be very patient during treatment.

The results can take months or years, depending on the degree of the acne lesions and the cause that is causing this disease.

It is important, first of all, to investigate the causes and correctly follow the skin care, which must be done daily.

When it comes to a more serious case of acne, the help of a dermatologist is essential to prevent the situation from getting worse and scarring.

However, in these cases, it is possible to be positive and research aesthetic treatments that can help to soften the spots and marks left by the disease.


There are several methods and techniques for treating acne, which should be done according to medical advice. As each skin reacts differently, the same treatment will not always be effective for all cases.

The method used must be chosen according to the type and degree of involvement of the acne.

The earlier the treatment, the better it will be for the patient in order to avoid scarring and other complications, such as low self-esteem.

According to the Brazilian Society of Dermatology, understanding acne as something normal for age and setting aside treatment is not a recommended practice.

In addition to being a skin health issue, it also interferes with psychological issues.

The treatment, therefore, can be done with the use of oral medications, with aesthetic procedures and specific products. It can also be done through a combination of treatments.

In milder cases, it is possible to treat only with a change in skin care and with the use of products that help control your oiliness.

In all cases, whether severe or mild, it is important to emphasize that in order to have a good treatment result, the patient should not squeeze or nudge the lesions , as this can result in more difficult to treat stains and scars.

Know the main treatments:


When there is a medical recommendation, the treatment of acne can be done through medications for oral or topical use (applied on the spot), such as anti-inflammatories and antibiotics specific to this type of problem.

Depending on the cause, hormonal treatment or the indication of specific contraceptives can be performed to adjust for a possible imbalance in the production of hormones, which is causing acne.


Surgical treatment of acne should be done when there is a need to extract blackheads, cysts and scars.

Usually, this type of treatment is done to repair the complications that acne has caused on the skin, with no claim to cure the problem.

People who remain with depressions in the skin (small holes), can resort to filling with hyaluronic acid to alleviate the flaws caused by the lesions.

In the case of raised scars, plastic surgery helps to level the skin.


They are made to help reduce the oiliness of the skin, to remove blackheads and to prevent inflammation caused by injuries. They also serve to prevent disease and keep your skin healthy.

Skin cleansin

The skin cleansing is an aesthetic and dermatological fairly common treatment for maintaining health and beauty skin, but when it comes to acne – prone skin is necessary that this procedure is done with some care the most.

According to the type of acne, as in the case of inflammatory acne, the professional needs to adapt the processes, so as not to further aggravate the lesions.

Unlike what is done on skins without acne, for example, exfoliation on acne skins should be done with products for chemical exfoliation, as the granules present in common products can hurt the patient’s skin.

Normally, cleansing the skin is recommended for the extraction of the blackheads, in order to prevent the pilosebaceous follicles from becoming infected.

In order to know how often to clean it is necessary to analyze the type of skin. Deeper cleanings should not be done frequently, as they can end up hurting the skin or causing a rebound effect, further increasing skin oiliness.

At home, cleaning should be done according to medical recommendations. The use of products that do not harm the skin and that do not stimulate the production of sebum are essential.

It is recommended that this type of treatment should be done with a beautician in the types of acne of grade I and II.

In more severe cases of the disease, this procedure should be done, preferably, with the accompaniment of a dermatologist.


Peeling is a type of exfoliation microdermabrasion treatment, used to remove dead cells and renew the skin, which helps to make the skin more uniform.

In the case of acne, it is done to help reduce oiliness and soothe scars and superficial blemishes caused by the disease.

This is because this procedure aims to provide a renewal of the skin cells through peeling.

This peeling can be induced by two types of peeling: physical or chemical. In physical peeling, this renewal is induced by the use of abrasive products, sandpaper and microabrasion devices.

For those with acne-prone skin, chemical peeling may be the most recommended.

It is made with the application of acids such as salicylic acid and retinoic acid, responsible for providing the removal of the superficial layers of the skin, normally the most affected by the lesions caused by acne.

This type of cosmetic procedure is considered safe, but it can cause burning and swelling. When this happens, the patient can use cold compresses to relieve the burning sensation.

After performing the peeling, some precautions must be taken, such as avoiding exposure to the sun, using neutral soaps and the use of sunscreens for sensitive skin.

Peeling can be done together with skin cleansing, but to understand which treatment will bring the best results, it is important to consult with a dermatologist.

Laser and radio frequency treatments

Usually, they are indicated for patients who have spots and scars from the lesions.

Laser therapy, for example, can be recommended due to the anti-inflammatory and bactericidal action of laser light. It also provides benefits by helping to reorganize the skin’s collagen.

Alternative methods

Alternative acne treatments are inspired by traditional Chinese medicine techniques. They are thought of as complements to traditional treatments, also used to prevent this and other diseases.

Some of the techniques are auriculotherapy (stimulation of ear points), phytotherapy (medicinal plants) and acupuncture.

These treatments can help to reduce the oiliness of the skin, in addition to contributing to the reduction of inflammation.

These are techniques considered interesting in the sense of providing a physical, emotional and hormonal improvement to the patient.

Medicines: what are the remedies for acne?

Acne remedies can be used topically or orally.

They can be creams, ointments, gels, antibiotics and contraceptives. They must be used in accordance with the medical prescription and with the supervision of a specialist.

Ointments, creams and gels

Topical medications are indicated for direct application under the lesions and must be used according to medical recommendation, to avoid complications.

Dosage and frequency of use should be done gradually, starting with low-concentration drugs and increasing as needed.

Depending on the type of skin, the presentation of the medication may vary. For example, it is recommended to use creams for people with dry skin, gels for oily skin and solutions for application in larger areas, such as chest and back.

Esses cremes para acne apresentam em sua composição a presença de antibióticos e retinoides (forma oxidada de vitamina A), que ajudam a diminuir a inflamação, proporcionam renovação das células e reduzem a produção de oleosidade.

Alguns exemplos de medicamentos tópicos usados para tratar a acne são os que apresentam os princípios ativos ácido salicílico e clindamicina.

Outros incluem:

Retinoides tópicos

Os retinoides tópicos trabalham reduzindo a produção de sebo e evitando o entupimento dos folículos pilosos pelas células mortas da pele.

Dentre os retinoides mais utilizados no tratamento da acne estão os que contêm tretinoína (Vitacid) e adapaleno, disponíveis em forma de gel ou creme.

Usually, the application is performed once a day, preferably before bed or according to medical advice.

They must be applied to the area affected by acne, usually 20 minutes after cleaning the area.

It is important to note that the use of these drugs should be done in moderation, in addition to avoiding excessive exposure to sunlight and / or ultraviolet (UV) light.

Topical retinoids are not suitable for use during pregnancy, as there is a risk of causing problems to the fetus. The most common side effects are mild irritation and burning of the skin.

It usually takes six weeks for treatment, but continuation after that period may be advised, with a reduction in the frequency of use.

Topical antibiotics

Topical antibiotics, available in lotion or gel, help to eliminate the bacteria that favor infection of hair follicles. They should be applied between 1 to 2 times a day, for 6 to 8 weeks, or according to the recommendations given by the dermatologist.

The treatment time should not be too long, as there is a risk of bacteria becoming resistant to the drug. Side effects are rare, but can include irritation, redness, burning and peeling of the skin.

Benzoyl peroxide

The benzoyl peroxide helps prevent the hair follicles become clogged by dead cells build-up and contributes to bacteria on the skin are eliminated.

Usually, it is used in cream or gel, and it is recommended to use between 1 to 2 times a day. The application must be done 20 minutes after the skin is cleaned.

It is important to be careful with the use and always follow medical recommendations, as this medication can make your skin sensitive.

After application, the patient must avoid exposure to sunlight and ultraviolet (UV) light, always using an appropriate sunscreen.

In addition, due to the whitening effect of the medication, it is important to take care when passing the product close to the hair or clothes.

Adverse effects can include symptoms such as dry skin, burning, itching, peeling and redness of the skin. Usually, side effects are mild and tend to improve once treatment is finished.

Treatment time may vary for each patient, and may take an average of 6 weeks.

In order to know if the treatment should continue for a longer period or should be stopped, it is important to have a medical follow-up.

Azelaic acid

It is often used as an alternative treatment for acne, when the side effects of benzoyl peroxide or topical retinoids are bothersome.

The azelaic acid works by removing dead cells and eliminating the bacteria present on the skin.

The application must be made according to the medical recommendation. Generally, it is recommended to use 1 to 2 times a day, when the skin is sensitive.

The time of use prescribed can vary, but the most common is that the patient has to use the product for a month to achieve good results.

This medication should not cause sensitivity to sunlight, so the patient does not need to avoid exposure to the sun.

Side effects of azelaic acid are generally mild and can include symptoms such as itching, dry skin, redness, burning and skin irritation.

Oral antibiotics (tablets)

The use of tablets is usually initiated when the patient does not respond well to treatments with specific products to apply directly to the lesions.

Therefore, specific oral antibiotics can be used, such as those that are part of the class of cyclins, macrolides or sulfas.

Some of them include:

  • Tetracycline ;
  • Doxycycline ;
  • Minociclina;
  • Limecycline ;
  • Erythromycin ;
  • Sulfamethoxazole-trimethoprim .

The treatment time with the use of antibiotics, according to the Brazilian Society of Dermatology, should be done for a maximum of three months.

Usually, it is performed in 1 or up to 3 cycles, which should vary according to each patient.

In addition to the use of antibiotics, depending on the cause, acne can be alleviated with hormonal treatment, usually performed with the use of oral contraceptives.

Isotretinoin (Roacutan)

The isotretinoin , best known by the brand name Accutane , is one of the most popular medicines for acne treatment.

It should always be used under medical recommendation and when the patient does not have a good response to other types of treatment.

When the doctor assesses that the patient is more prone to scarring and that acne is causing great physical and emotional damage, this medication can be prescribed.

It is important to know, regarding this remedy, that it can also cause side effects such as dryness of the body’s skin, lips, nose and eyes, in addition to increased levels of cholesterol, triglycerides and liver enzymes.

Because of these adverse reactions, the patient being treated with isotretinoin should undergo blood tests before and during use.

In pregnant women, this treatment is contraindicated , as it can cause serious harm to the baby.

For this risk, women should only start treatment after ruling out the possibility of pregnancy with a test and after the start of menstruation.

In addition, during treatment, it is important to reinforce care when using contraceptives or other contraceptive methods.

This remedy does not prove to be a risk for future pregnancies, but it is advisable that the use of contraceptives be maintained for at least one month after the end of treatment.


Some birth control pills help to treat the appearance of pimples by controlling hormone levels (androgens), which cause greater oiliness of the skin and favor the appearance of acne.

The Diane 35 , Diclin , Aixa , Belara and other brands are some examples.

But to know which one will be the best, you need to talk to a gynecologist.

Remedy for pimples in pregnancy

During pregnancy, due to hormonal variations, there may be an unexpected appearance of pimples and other acne symptoms in women. As it is a more sensitive period, care with medicines should be doubled.

Read more: Can pregnant women take acetaminophen?

Therefore, one should not take any acne remedy without consulting a doctor.

This is because there are medications that have not been tested on pregnant women or that have substances that can pose a risk to the health of women and babies, such as some antibiotics, retinoic acid, salicylic acid and isotretinoin.

To contain the appearance of pimples, pregnant women can also opt for simpler skin care, such as skin cleaning at beauty clinics and correct skin hygiene on a daily basis.


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Living together

To be able to go through the treatment of acne without suffering major complications, it is necessary to understand that living with this type of disease needs some care and even daily self-acceptance exercises.

A few tips can help at this point:

Find a dermatologist

It is not always possible to get rid of acne just by changing habits and using anti-acne products purchased without prescription, especially in the most serious types of injury.

Therefore, one of the most important steps in living with this disease is to seek the guidance of a specialized professional.

Avoid home treatments

It is not necessary a long search on the internet to find several recipes that promise to end acne and, miraculously, make all lesions disappear.

The use of products that do not have any scientific evidence that they really work for the treatment of acne should be avoided. Experimenting with all sorts of homemade ingredients under the lesions can end up making the inflammation even worse.

So, be careful with the products you put on your skin and always try to listen to a specialist.

Do not nudge or squeeze the lesions

It is important to resist the urge to keep poking or squeezing blackheads and pimples, as this habit can end up aggravating the inflammation. In addition, it can lead to the appearance of permanent blemishes and scars on the skin.

Follow medical guidelines

Use medications and products according to the guidance given by the responsible doctor and try to maintain a skin care routine, so the treatment results will be better.

Be patient

It is important to be calm and patient while living with acne, as good as the treatment is, none of them are miraculous. The lesions may take time to heal and, in the meantime, it is essential that the patient does not become discouraged or abandon care.

Don’t let acne be an obstacle

As difficult as it is to deal with the changes that acne brings to life and how it negatively affects the way we see ourselves, it is important to try to overcome this difficulty.

It is essential not to let this disease prevent you from carrying out your day-to-day activities. It is possible to have a social life with acne, so don’t give up studying, working, having a relationship, going to parties and other commitments because of injuries.

Take care of your mental health

Acne can be a trigger for problems such as anxiety, depression and social phobia , as it is common to interfere with the self-esteem of those who suffer from the disease. Therefore, in addition to dermatological treatment, it may be necessary to follow up with a psychologist.


Acne is a disease with a positive prognosis. In most cases, remission occurs around the age of 20, considering that its highest prevalence occurs in the period of adolescence.

In some cases, it prevails after this period, and can manifest itself up to the age of 40, affecting more adult women.

In people, in general, acne can cause minor and occasional injuries throughout life, rarely leaving scars.

Because it has treatment and forms of prevention (in some types), acne usually leaves no major complications or sequelae. In cases of more severe acne, the patient may suffer from blemishes and scars, which can be alleviated with aesthetic treatments.

The greatest impacts of the disease are related to how it affects the patient’s mood, self-esteem and anxiety.

Due to emotional stress and the social problems caused by acne, psychological monitoring may be necessary so that the patient can deal with this moment and his emotions.


The main complications of acne are the problems that it brings to the psychological aspects of patients, especially when it affects adolescents, a phase of great insecurities about their own bodies.

In this sense, acne can cause complications such as impaired self-esteem, insecurity, unhappiness and shyness. For these reasons, acne can also lead the patient to depression.

Physically, the complications that acne can leave are blemishes and scars from the lesions, which is related to the emotional complications of the disease.

Atrophic or depressed scar

This type of scar causes small, deep holes in the surface of the skin. It is divided into three types: boxcar , ice pick and rolling .

These names correspond to the shape of the depressions caused by acne.

In the case of ice pick scars , the depressions are deeper, but on the surface the marks look like a skin pierced by a sharp object.

In the case of the boxcar and rolling types , the depressions are greater, like craters in the skin.

Hypertrophic or elevated scar

Unlike the atrophic scar, this type of scar causes elevations in the skin, leaving the skin uneven.

How to prevent?

Preventive habits are just as important as treatment. Some basic cares help to keep the oiliness of the skin under control, which helps to prevent the appearance of acne. Here are some important tips:

Keeping the skin clean

Even though knowing that the presence of acne does not mean poor hygiene, since it involves other factors, it is also important to know that maintaining the skin with proper hygiene can prevent them from appearing.

Therefore, people who have a predisposition or who have more oily skin, should resort to the use of soaps and cleaning products suitable for this type of skin.

Normally, it is recommended to clean the skin twice a day, in the morning and at night. Excessive washing of the face can end up causing the rebound effect, because when removing all the oil from the skin, the body can understand that it is necessary to produce more sebum.

The dermatologist can recommend the use of drying soaps, which are usually sold in pharmacies without a prescription. Some options that may help are products based on salicylic acid, chamomile and sulfur.

Taking care of the water temperature

Very hot baths are also not good for skin health, even during winter. To help keep it healthy, warm baths should be preferred.

It is important to be careful with hot water because it impairs the skin’s protective barrier, causing dryness. In the long run, it can end up causing a cracked effect on the skin, which can cause symptoms such as itching and redness.

For these reasons, the sebaceous glands may start to produce more oil, because they understand that the skin is unprotected. As a result of the hot baths, the skin ends up becoming dehydrated and oily.

Use moisturizers

Dry, oily, mixed, common or acne-prone skin: they all need hydration . It is common to have a certain fear of using moisturizers when you have oily skin, but in these cases this practice is also indispensable.

It is important to understand that oil and hydration are different things. Greasiness is related to excess sebum production, while hydration refers to the amount of water in the skin.

Not only in preventing hydration is important, but also during treatment. There are acne products and medications that promote dry skin.

Therefore, people with acne or oily skin need not be afraid of moisturizers. There are several products designed for these skin types.

Thus, in addition to listening to the dermatologist’s recommendations, people with more oily skin should pay attention to the labels, preferring products that are said to be oil free , oil control , matte effect and dry touch.

Avoid comedogenic cosmetics

Cosmetics called comedogenic are named because they are capable of causing comedones, that is, the clogging of the pores. To avoid acne, it is necessary to stay away from them.

Then, you should look for products without oil in the composition. Even if they are more expensive, investing in good products helps to keep your skin healthy.

Make regular inquiries

Hormonal dysfunctions are often the cause of the onset of acne. Therefore, investigating whether all is well in the production of hormones is important, as it may be a problem in the endocrine system.

Preventive exams and regular consultations are welcome and help to prevent acne caused by this reason.

Common questions

Why does stress cause acne?

Because when we are facing stressful situations, the cerebral cortex suffers interference and ends up causing an increase in the production of cortisol, which ends up increasing the activity of the sebaceous glands.

Consequently, they produce excess sebum and result in the presence of blackheads and whiteheads.

Can I use antibiotic or anti-inflammatory for inflamed pimple?

Ideally, a dermatologist should be consulted to indicate the best treatment. No anti-inflammatory or, above all, antibiotic should be used without a prescription, which can pose health risks.

For those painful pimples, with inflamed aspect, it is recommended to make warm compresses with water and hydration of the skin.

What are the best remedies for pimple: pill or cream?

The ideal is that there is a dermatological consultation to assess the condition. The best treatment, including the type of medication (cream, gel, pill) should be guided according to the medical evaluation.

In general, systemic treatments, that is, tablets, are used in severe or severe acne, in which only topical remedies are effective.

Are anti-inflammatory drugs used to treat acne?

In general, yes, but not those pills that sell in pharmacies. The agents used to fight inflammation of acneic skin are substances present in skin hygiene products.

Astringents, moisturizers and tonics can contain compounds that control and reduce inflammation, improving the appearance of the skin.

What over-the-counter acne remedies?

There are several product options that can be purchased without a prescription, but they are intended for skin cleansing, moisturizing or toning. There are also soaps or gels that act to accelerate the healing of pimples and the reduction of blackheads, for example:

  • Darrow Actine Control Soap ;
  • Asepxia soap ;
  • Acnase Cleansing Soap ;
  • Acnase Gel;
  • Asepxia Gel ;
  • Acnezil.

Does masturbation or lack of sex cause acne?

No . There is no scientific evidence to link such behaviors with the onset of acne.

Therefore, it is important that people know this information, as this myth is often used to embarrass people who suffer from acne, which makes living with the disease even more complicated.

Is acne a sign of poor hygiene?

No . Acne is not a disease related to poor hygiene, that is, people with acne-prone skin are no less clean than those without acne.

The cause of acne usually happens as a result of the action of the sebaceous glands. The blocks, therefore, happen in the narrowest channels of the skin, where it would not be possible to wash.

Can acne be hereditary?

Yes. One of the risk factors for acne is genetic predisposition. Characteristics such as the size of the sebaceous gland, the way it develops during puberty and the abnormal production of keratin in the hair follicle are things that can be transmitted by genetic inheritance.

Why do acne lesions appear in the same place?

There are areas of the skin that are more prone to the appearance of acne, as there is a greater number of microscopic pilosebaceous follicles.

Because they are grouped together, when an inflammation occurs, even if it is in a different follicle, the feeling is that the lesion always appears in the same place.

It can also happen that the lesion does not heal completely, being partially better and then returning to a more serious condition.

Does makeup make acne worse?

Cosmetics are not the cause of acne and therefore need not be avoided. There are products developed for acneic skins, which help to prevent the pores from being clogged.

People who suffer from acne should always opt for makeups of this type, which do not contain any oil in their composition. Therefore, it is not necessary to stop wearing makeup.

Using the right products and removing makeup properly every day shouldn’t get any worse.

These doubts can also be clarified during the consultation with a dermatologist, who, evaluating each specific case, will be able to say what will be the best for each skin.

Is there a relationship between diet and the appearance of acne?

Associating a diet rich in sugars and fats with the appearance of acne is something so common that, for many people, it is an absolute truth.

However, it is not yet possible to state that there is a diet capable of totally changing the appearance of acne.

This relationship is always questioned and has been studied for years by several research groups, however, there is still no consensus that fits all patients.

It is known that the excessive consumption of sugars and high levels of insulin (hyperinsulinemia) can cause an increase in the production of androgen hormones.

Consequently, hormonal fluctuations can cause acne to develop.

Thus, even if there is no evidence of a relationship between diet and acne, it is recommended that patients, when they perceive a worsening of the condition when consuming some food, avoid them.

In general, a healthy diet is suitable for all people, for the health of the skin and the body in general.

Why is acne more common in men?

Men are more prone to the appearance of acne because they have a higher production of androgen hormones.

This type of hormone, present in both sexes, stimulates the functioning of the sebaceous glands.

When a greater than expected stimulus occurs, this hormone ends up causing more sebum production and, consequently, results in acne.

Acne is a skin disease that manifests itself in different types and degrees, and can be mild for some people and quite serious for others.

Most people experience this problem during adolescence, a period marked by changes in the body, insecurities and conflicts typical of age.

With the appearance of blackheads and pimples, going through this phase can be even more complicated.

Many patients, in their teens or adulthood, suffer from self-esteem problems because of acne.

For this reason, it is considered a disease that also interferes in emotional and social issues, and may lead the patient to exclusion.

The earlier the diagnosis and treatment is, the better it will be for the patient, in all aspects.

For your physical and mental health, it is important to know the types of treatment and to know that it is possible to live free of acne or, at the very least, keep it under control.

If you suffer from this type of problem or have already experienced this condition, feel free to leave us your report in the comments space.

Thanks for reading!