How common is acne?

Acne is so common that it is affects almost all of us at least once in our life especially on our face.  About half of us will experienced acne on our back while acne on the chest and scalp is not so common (around 10-15%).

How a pimple forms

  1. People with acne have excess oil (sebum) production
  2. There is keratinocyte (skin cells) hyper proliferation at the hair follicle opening (pore)
  3. Propionibacterium multiples in the blocked pore
  4. Finally results in inflammation and disruption of skin barrier

Image Source: Amathair

In the early stage, a blocked gland due to plugged congealed oil or skin cells results in a whitehead. When this oil plug gets exposed to air, it becomes darker into brown or black, hence the term blackhead. Both whitehead and blackhead are non-inflammatory and not painful.  A pimple forms when bacteria gets inside (due to poor hygiene or using fingers to pick the pimple) resulting in inflammation and swelling.

Types of acne lesions which can be found

  • Comedones
  • Papules (small inflamed bump)
  • Pustules (pimple with pus at the tip also known as ‘zit’)
  • Nodules (large solid painful lumps)
  • Cystic lesions (painful pus-filled lesions)

Common sites for pimples

Acne typically appears on your face, forehead and nose (the typical T-zone). It can also occur on the chest, upper back and shoulders as well as the scalp.

Factors which worsen acne

  • Hormones produced during puberty in teenagers cause the sebaceous glands to enlarge and produce lots more oil. Hormonal changes during pregnancy, menopause or while taking oral contraceptive pills can cause pimples too
  • Medications such as steroids and testosterone can cause pimples
  • Unhealthy diet rich in refined sugars or fat, carbohydrate-rich foods and milk aggravate acne in some people. Fried or greasy foods, shellfish or nuts not proven but try to avoid
  • Stress can cause acne because of the stress hormones released in the body
  • Not removing make up from your face results in blocked pores


  • Keep your face clean by maintaining a regular face cleaning regime. Stick with a mild and non-perfumed brand of cleanser. Avoid skin products which block skin pores
  • Tie up your hair to prevent it from touching your face
  • Try not to pick your whiteheads or pimples as this can cause infection and pustule formation
  • Stop smoking or avoid smoky and dusty areas
  • Do regular exercise as sweating helps to clear the pores on a regular basis
  • Swimming is also good as chlorine in the water helps to dry up the skin
  • Avoid unhealthy diet high in sugar, oily greasy foods and refined carbohydrates

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