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Acne: definition, causes and symptoms

by Josephine Andrews
Published: Last Updated on 245 views

Acne is a skin disease that occurs mainly during puberty and is often caused by hormonal changes. But other factors also come into play. Acne is characterized by symptoms such as pustules, pimples and blackheads and affects almost all adolescents, but also many adults. Read everything you need to know about acne here: causes, symptoms and prognosis.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.


quick overview

  • Causes and risk factors: Often due to hormones, as well as stress, certain medications and cosmetic products.
  • Symptoms: thickening of the skin , blackheads, pimples, pustule.
  • Diagnostics: Usually based on the external appearance.
  • Treatment: You can read everything you need to know about therapy in the acne treatment article .
  • Course of the disease and prognosis: With good treatment, acne vulgaris usually heals quickly, but in individual cases it persists up to the age of 40 and beyond.

Definition: What is acne?

Acne is the most common skin disease worldwide. Acne occurs primarily in adolescents during puberty and is not considered contagious. To the questions: “What is acne exactly?” and “How does acne develop?” There is no one-size-fits-all answer because the disease manifests itself in different forms and due to various factors.

Most people with facial acne develop pustules, pimples and blackheads, mainly on the forehead and chin. Acne also occurs on other parts of the body. For example, acne also occurs on the back and décolleté in men and women, but is less common. In addition, acne develops in those affected, for example, on the neck or bottom (buttocks), on the shoulders, chest, scalp or thighs.

Mild acne or mild forms can usually be treated yourself with washing and care products from the drugstore or pharmacy. In the case of severe or extreme acne, it is recommended to have it treated by a dermatologist.

Almost every teenager is affected by acne to a greater or lesser extent. Acne in adults (late acne or acne tarda), on the other hand, is less common.

Acne vulgaris: The most common type

Acne vulgaris is the most well-known form of acne and is also called “common acne”. It is triggered by the hormonal changes during puberty (hormonal or hormonally induced acne). Boys tend to be more affected by puberty acne than girls. 

While some people only have mild acne, other people are affected by severe acne (e.g. on the face).
Depending on the severity, acne vulgaris is divided into three sub-types:

  • Acne comedonica: It is the mildest form of acne and only affects the face (forehead, nose and cheeks), more rarely the back. Acne comedonica is characterized by blackheads that may become infected if you squeeze them.
  • Acne papulopustulosa: This moderately severe acne is characterized by blackheads and inflamed pimples. Acne papulopustulosa often affects the face and back.
  • Acne conglobata: Acne conglobata is the most severe form of acne. Here, the pimples form real knots, which become easily inflamed and leave visible scars when the acne heals. This form of acne can also cause cystic changes in the skin.

Other types of acne

Other forms of acne may arise if the skin does not tolerate certain substances found in care products (e.g. face cream), medicines or food. This includes:

  • Contact, cosmetic or chlorine acne
  • Medication Acne (Acne medicamentosa)
  • doping acne

These forms of acne are special forms of an allergic reaction and can be specifically combated by stopping the substance to which the skin reacts. In order to determine the cause of the disease, allergy tests at the doctor’s are helpful.

Other types of acne are Mallorca acne and acne inversa . Children can also be affected by acne. A distinction is made between newborn acne and infant acne. Colloquially, newborn acne and infant acne are often referred to together as infant acne or baby acne. However, this is not medically correct.

On the Internet, for example, one also comes across the terms ” fungal acne ” and ” fungal acne “. In fact, there is an acne-like skin disease caused by fungi that is often confused with acne vulgaris. Responsible for this skin disease, however, is an overgrowth of naturally occurring yeast fungi (Malassezia) on the skin, which is why doctors speak of Malassezia folliculitis.

This supposed fungal acne can be recognized, among other things, by papules and pustules, which appear in particular on the face (e.g. on the chin or cheeks), on the chest, arms or back.

neonatal acne

In newborn acne (“baby acne”, acne neonatorum), small blackheads are mainly found on the cheeks. They may already exist before birth or form in the course of the first few weeks of life. Therapy is not necessary because newborn acne resolves on its own within a few weeks.

infant acne

Infant acne (“toddler acne”, acne infantum) occurs between the third and twelve months of life, more frequently in boys than in girls. It is characterized by small yellowish pimples that form mainly on the forehead and cheeks. Scars may develop as a result. It is recommended that infant acne be treated by a doctor in any case.

Most people with infant acne develop acne vulgaris later in life.

Mallorca acne

Another special form is the so-called Mallorca acne (Acne aestivalis). It is not a typical acne disease, but actually a light allergy or a special form of sun eczema (polymorphic light eruption).

With Mallorca acne, small pustules form mainly in the décolleté and on the arms and legs, very rarely on the face. An unpleasant side effect of this form of acne is itching and severe redness, which only occur in some cases.

The cause of Mallorca acne (eg on the arms or face) is a reaction of sunlight or UV radiation with the sebum of the skin or with the fats in sun creams, which produces substances harmful to the skin. Scientists also suspect a genetic predisposition. Young people (women more often than men) with oily skin are particularly at risk.

Mallorca acne usually forms at the beginning of a vacation or in the first days of summer, as the skin is not yet used to the sun’s rays. There is little that can be done about them. Regarding the course of Mallorca acne, it can be said that it usually heals on its own within a few days.

It is important to avoid renewed exposure to the sun during these days. Keratolytic therapy may help heal people who are prone to acne.

Prevent Mallorca acne: Slowly get your skin used to the sun. Also, avoid oily lotions or sunscreens. There are also special sun protection products for allergic skin that help prevent Mallorca acne.

Acne inverse

Acne inversa is a severe form of acne and usually occurs in the armpits and genital area. You can read more about this in the article acne inversa .

What are the causes of acne?

Acne is caused by various factors.

The most common form, acne vulgaris, is mostly hormonal . The causes here are the male sex hormones, called androgens (main representative: testosterone). These are not only produced in men, but also to a lesser extent in women (especially during puberty). However, since they are found in larger quantities in men, men are also more affected by the skin disease.

Androgens stimulate the skin’s sebaceous glands to produce more sebum. Normally, the skin releases this sebum to the outside through the pores. However, during the hormonal change during puberty, the production of horny material in the skin also increases, which closes the excretory ducts. The sebum builds up under the surface of the skin and so-called closed blackheads form. The whitish-looking sebum pours into this.

At some point, the skin tears open on the excretory duct. The blackhead turns black when it comes into contact with the oxygen in the air. That means: Blackheads are open blackheads.

The sebum in the blackheads “attracts” bacteria. These break down the sebum and produce breakdown products that promote inflammatory reactions (“blooming pimples”) and stimulate the formation of new blackheads.

Hormone fluctuations (and with them acne) do not only occur during puberty, but under certain circumstances also during pregnancy, during the menopause (menopause) and when stopping the contraceptive pill. The same applies during menstruation when the skin is more greasy.

Other risk factors

But not only the hormones are responsible for the development of acne. Studies also show that hereditary predisposition as well as strong mental stress and strain support the development of acne.

In addition, fats in cosmetic products , ingredients in medicines and certain foods may stimulate sebum production or contribute to the blockage of the excretory ducts. Medications that may cause acne include:

  • corticosteroid (cortisone)
  • anabolic steroids
  • Adrenocorticotropin (ACTH)
  • psychotropic drugs
  • Sleeping pills and tranquilizers containing bromine
  • Neuroleptics (drugs for various mental illnesses)
  • Halogens as disinfectants
  • antibiotics
  • Vitamins B2, B6, B12
  • certain medicines used to treat cancer (EGF receptor agonists)

Depending on the composition of the preparation, acne can also occur when taking hormonal contraceptives (birth control pills).

Diet also contributes to the development of acne in some people . Here it may help some sufferers with acne to create a nutrition plan in consultation with their doctor. Very high-fat foods and chocolate, for example, have a bad reputation in this regard. Milk and dairy products are also suspected of worsening acne. However, these connections have not yet been scientifically proven.

Various factors such as humidity, cigarette smoke and scratching the pimples can make symptoms worse.

What are the symptoms of acne?

In the early stages of acne, a small red dot or nodule forms on the skin. This feels like thickening of the skin. Such a blackhead (comedo) occurs when the excretory duct of a sebaceous gland in the skin in acne becomes blocked due to excessive cornification (cornification disorder). The sebum accumulates, the blackhead is visible as a small white dot.

If such a blackhead tears open, air gets to the sebum, causing the blackhead to turn black. If bacteria (Propioni bacteria) are added to acne, inflammation develops – a “blooming” pimple is formed.

Acne forms mainly on the face, preferably in the so-called T-zone, i.e. on the forehead, chin and bridge of the nose. Depending on the disposition and skin type, severe acne can also appear on the cheeks. The back and chest are less commonly affected.

If you have the following symptoms, it is advisable to consult a dermatologist:

  • big sore pimples
  • sudden deterioration of the complexion
  • severe mental stress from the pimples
  • acne scars

Acne: scars

How exactly acne scars form and how they can be removed can be read in the article Acne scars .

Acne: research and diagnosis

Acne is easy to diagnose based on its external appearance. The pustules, blackheads and pimples are usually a clear symptom.

However, before you start treatment on your own, it is advisable to consult a specialist in skin diseases in order to have another skin disease ruled out. The specialist also determines what form of acne it is and what the best therapy is.

If the doctor suspects that there is an infection, he may take some secretion from the blackheads to have it analyzed. This shows whether and, if so, which bacteria are causing the infection. After that, the treatment will follow.

Acne: treatment

You can read everything you need to know about treating acne in the article acne treatment .

Acne care tips

Basically, the skin or facial cleansing for acne should not be too aggressive. Syndets specially designed for impure and acne-prone skin enable gentle skin cleansing. For face and skin care, it is recommended to avoid greasy products and instead to use a light oil-in-water moisturizer for acne.

If you have acne and want to cover it up with makeup, choose products that are non-comedogenic or use antiseptic concealers. In order to prevent the development of inflammation and scars in existing acne, it is advisable not to squeeze blackheads and pimples yourself.

Acne: course of the disease and prognosis

With good treatment, acne vulgaris usually heals quickly. If left untreated, it usually resolves on its own by the age of 25. In individual cases, however, the symptoms persist up to the age of 40 and beyond.

Stress and psychological strain can have a strong influence on the course of the disease. Acne tarda (acne tarda) can suddenly break out again into old age in acute stressful situations .

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