Acne and Pimples: Causes, Treatment and What Actually Works

Pimples show up at the worst times: before a wedding, an interview or Eid. Most people with acne have tried a long list of remedies, from lemon and toothpaste to a new face wash every month, and ended up with irritated skin and more marks. Acne is a medical condition, it is very common, and it responds well when the right treatment is used consistently.

What causes acne?

Acne starts when the tiny oil glands in your skin make too much oil (sebum) and dead skin cells block the pores. Bacteria that live on the skin then multiply in the blocked pores and the area becomes inflamed. Several things push this along:

• Hormones: puberty, the days before a period, and conditions such as PCOS
• Genes: if your parents had acne, you are more likely to
• Heavy oils and creams: thick hair oils, oily moisturisers and some cosmetics block pores
• Friction and sweat: helmets, tight dupattas or hijabs, and humid weather
• Picking and squeezing, which pushes infection deeper and causes scars
• Some medicines, including steroids
• Stress and poor sleep, which can flare it up

Acne myths

• Oily food and chocolate cause acne. The evidence is weak. Diets high in sugar and refined carbohydrates may worsen acne in some people, but greasy food is not the main cause.
• Washing more clears acne. Over-washing and scrubbing dry the skin and make it worse. Wash gently twice a day.
• Toothpaste dries pimples. It burns and irritates the skin, so avoid it.
• Sun clears acne. Sun can darken marks. Use sunscreen daily.
• Fairness creams are harmless. Some contain strong steroids that cause acne, thin the skin and cause stretch marks. Avoid them unless a doctor prescribes them.

What works for acne

• Mild acne: a gentle cleanser, a salicylic acid wash and a retinoid such as adapalene gel at night are the starting point. Retinoids can dry and redden the skin in the first weeks and make you sensitive to the sun, so use sunscreen and build up slowly. Benzoyl peroxide gel is another useful ingredient.
• Inflamed pimples: a topical antibiotic such as clindamycin, usually used together with benzoyl peroxide or a retinoid to avoid resistance.
• Moderate acne: a dermatologist may add an oral antibiotic such as doxycycline for a limited number of weeks, along with the creams.
• Women with hormonal acne: hormonal treatment may be considered.
• Severe, cystic or scarring acne: isotretinoin, a powerful prescription medicine. It must be supervised by a doctor with blood tests, because it can cause severe birth defects, dry lips and skin, and affect liver tests and cholesterol. Pregnancy must be avoided completely during and after treatment, as the doctor advises.

Be patient

Whatever treatment you use, give it 8 to 12 weeks before judging it. Acne may even look worse in the first two to four weeks with retinoids. Changing products every week is the most common reason people never get clear skin.

Daily skin care routine

• Wash your face gently morning and evening with a mild cleanser and lukewarm water.
• Apply your prescribed treatment as directed, usually at night.
• Use an oil-free, non-comedogenic moisturiser, even with oily skin.
• Apply an oil-free sunscreen every morning.
• Wash pillowcases and towels often, and clean your phone screen.
• Do not pick or squeeze pimples.

When to see a dermatologist

• Deep, painful lumps or cysts
• Acne that is leaving scars or dark marks
• No improvement after 8 to 12 weeks of proper treatment
• Acne that is affecting your confidence or mood
• Acne together with irregular periods and excess facial hair

Key takeaways

• Acne is caused by oil, blocked pores, bacteria and hormones, not by dirty skin.
• Gentle washing, a retinoid and benzoyl peroxide or a topical antibiotic are the basis of treatment.
• Give any treatment 8 to 12 weeks, and do not pick or use steroid creams.
• Severe or scarring acne needs a dermatologist.

Related medicines on Medimart

These are commonly used in acne treatment:

• Adapalene: a retinoid gel for blocked pores
• Clindamycin: an antibiotic gel or lotion for inflamed pimples
• Salicylic acid: helps unblock pores
• Doxycycline: a prescription antibiotic for moderate acne
• Isotretinoin: a prescription medicine for severe acne, taken under medical supervision

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse acne treatments on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please see a dermatologist for persistent or scarring acne.