Acne treatments abound but what works? Expert gets into pimples and skincare essentials

We've all experienced it before: waking up and lazily strolling into the bathroom before catching our reflection in the mirror. Then we spot it − that little red bump in the middle of our face, a pimple determined to ruin our day before it even begins. 

Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually, per the American Academy of Dermatology. It's especially common in adolescents and young adults, affecting some 85% of people between ages 12 and 24. Though prevalent, "there are many ways to treat it," says Mary Stevenson, MD, associate professor of dermatology at NYU Langone Health. 

There are also specific dos and don'ts when it comes to dealing with a pimple. 

What is acne?

Acne is a skin condition that occurs when "oil and dead skin cells plug up pores on the skin's surface," says Ashley Odukoya, DO, a family medicine physician at Inspira Medical Group Primary Care Millville in New Jersey. She says those hair follicles are clogged by an oily substance called sebum, but that multiple other things contribute to acne developing.

These include: 

• Bacteria, because one's skin naturally hosts a lot of it, and some of it "contributes to the formation of acne," says Dustin Potela, DO, a board-certified dermatologist and founder of Treasure Valley Dermatology in Boise, Idaho. 
• Hormonal changes, because as one's hormones fluctuate during puberty, menstrual cycles, pregnancy, etc., increased levels stimulate functional oil glands that protect the skin from becoming too dry, "which increases the risk of acne," explains Potela. 
• Inflammation, because clogged pores cause irritation and can trigger "the body's inflammatory response," explains Odukoya.
• Genetics, because acne has a hereditary component. "If your parents or close relatives had acne, you may be more prone to developing it," Potela says. 
• Medications and beauty products, because some such items "contain oils or pore-clogging ingredients that can contribute to acne breakouts," Potela says. The condition may also be worsened when products like makeup "aren't thoroughly washed off," says Stevenson. 

Are acne and pimples the same? 

While acne has many symptoms that can include cysts, scarring of the skin, blackheads and redness; pimples are among the most well-known elements of the condition. Pimples, also called whiteheads, pustules or papules, are small tender bumps found on the areas of the body where the most oil glands are present, such as on one's face, back, shoulders, and neck. Pimples occur when the aforementioned buildup and overproduction of oil clog skin pores and hair follicles. 

So, while many people refer to pimples as acne, they are actually a symptom of the skin condition and not the condition itself or its cause. 

How to get rid of pimples

Of course, nobody wants to have pimples, but knowing how to get rid of them isn't as simple as applying a one-size-fits all approach. 

A starting point for many people who deal with with them is to improve their skincare routine. "Cleanse your face twice a day using a gentle cleanser to remove excess oil, dirt and bacteria," advises Potela. He also recommends avoiding harsh scrubbing or abrasive products that can irritate the skin. "And use non-pore-clogging moisturizers and sunscreen to keep the skin stay hydrated and protected," he adds. 

Lifestyle and diet can also play a major part in dealing with and preventing acne. Getting enough sleep, drinking enough water and eating fewer processed foods "since they tend to have higher glycemic index," are all ways to improve matters, says F. Clarissa Yang, MD, a professor of dermatology at Tufts University School of Medicine and the Dermatologist in Chief at Tufts Medical Center. She also recommends eating plenty of fruits and vegetables and avoiding hormonally-stimulated meats and "oil-based topical products that clog the pores."

Many people who deal with pimples regularly also turn to medication for help. "There are oral medications that treat inflammation, others that are antibacterial, and some medications that treat hormonal acne," explains Stevensen.

There are also topical creams, lotions, and gels like benzoyl peroxide or salicylic acid, which can help unclog pores and reduce acne-causing bacteria. Topical retinoids are another popular solution and have become a mainstay of acne treatment since the Food and Drug Administration (FDA) approved the first version of them in 1971. Shilpi Khetarpal, MD, a dermatologist at the Cleveland Clinic, recommends retinoids to anyone struggling with acne and says they "help to clean out the pores and reduce oil gland activity." She adds that there is also an oral retinoid called Isotretinoin that's used to treat more severe acne and "is considered the gold standard for 'curing' acne or putting it in remission." 

Is it OK to pop pimples?

When dealing with pimples day-to-day, Potela warns never to pick at or "pop" them. "Picking at or squeezing pimples can release more bacteria, worsen inflammation, prolong healing and increase the risk of scarring," he cautions. Instead, he recommends "spot treating" pimples with the aforementioned benzoyl peroxide or salicylic acid, "or consider using a hydrocolloid pimple patch." 

No matter what degree of acne or the number of pimples one is dealing with, be mindful that managing the condition is often an ongoing process. "Consistency and patience are key as results may not be immediate," says Potela. He adds that professional guidance may also be helpful in tailoring "any approach to the individual's specific needs since what works for one person may not work for another."

Many people deal with pimples.What causes acne?