What kind of skin care is best?

Normal soaps have a high pH (8 to 10) and can irritate your skin. Soap-free cleansing products that have a similar pH to skin (5.5) are more suitable for people with acne. Antibacterial face washes can have a positive effect in mild acne, but might also irritate more sensitive skin. Washing your skin too much – for instance, several times a day – can dry your skin out and irritate it even more.

Oil-in-water emulsions or moisturizing gels (hydrogels) are often recommended for acne-prone skin because greasy skin-care products can clog skin pores even more.

Pimples: Squeeze them or leave them alone?

Anyone who has had acne has most likely squeezed a pimple before. It is understandable that people would like to get rid of visible pus-filled spots. Although squeezing pimples may make your skin look better in the short term, it might force the pus even deeper into your skin, which can make it become even more inflamed. Squeezing the odd pimple doesn't always cause scarring. But doing it a lot, and not leaving deeper pimples alone either, can make acne worse and increase the likelihood of scarring in the long term.

It's possible to have pimples "popped" by professionals in a beauty salon or at a dermatologist's office. There they can be removed in hygienic conditions. This usually involves first exposing facial skin to warm water or steam in order to open the pores. Then the pimples are opened up and squeezed, often with the help of a special small tool (a comedone extractor). In Germany, this treatment is sometimes covered by statutory health insurers if someone has severe acne.

How can pimples be concealed?

Girls and women often use concealer or foundation to cover up their pimples. This makes them feel more comfortable in public. Young men sometimes use subtle foundation, powder and concealer as well.

Generally speaking, very greasy cosmetics and skin-care products can block pores. A consultation with a dermatologist or in a beauty salon might help here. But it's hard to predict how a specific product will affect the skin. So trial and error is often the best way to find out which cover-up products work best for you personally.

Shaving: Wet or dry?

Many young men who have acne aren't sure how to best shave their face. There are no good scientific studies on whether it's better to wet shave or dry shave if you have acne. One thing that is clear, though, is that touching or rubbing your skin a lot can encourage inflammation, make your complexion worse and increase the likelihood of scarring. So choosing between a wet or dry shave probably isn't that critical. The most important thing is to be careful when shaving and avoid injuring the skin if possible.

Can sunlight and artificial UV light help improve acne?

There are a number of very different theories about how sunlight and artificial UV light (e.g. in tanning beds) affect acne. Some people think that UV light improves acne, while others believe that it makes acne worse. There's no evidence that it has any benefits. But exposing your skin to sunlight or artificial UV rays for too long is known to damage your skin. Everyone should use sunscreen to protect their skin when it's sunny – including people who have acne.

In Germany and other countries, children and teenagers under the age of 18 aren't allowed to use tanning beds or solariums because, compared to adults’ skin, their skin reacts more sensitively to strong UV rays.

Does your diet play a role?

It is often claimed that there's a link between what you eat and acne. People sometimes change their diet as a result, in the hope that their acne will improve. But scientists disagree about the role of diet in acne.

Some believe that the typical carbohydrate-rich diet in Western countries contributes to the development of acne. These are mainly carbohydrates that cause sudden increases in blood sugar levels. They are often found in very sugary foods, potatoes and white bread, for instance. But studies haven't shown that acne improves when you eat less of these kinds of carbohydrates. It's also not clear whether avoiding meat, milk or chocolate helps to improve your complexion.

How can I cope with acne in everyday life?

Although severe acne can be very distressing, there are things you can do about it. Acne can be treated, but only if you take the step of going to a doctor first. Successful treatment can make you feel better about yourself and – if started early enough – perhaps prevent scarring too. You can also turn to psychosocial information centers  [in German: psychosoziale Beratungsstellen] or make use of services like telephone helplines. These are free and anonymous.

How people cope with acne varies greatly. Some teenagers are less bothered by it or can deal with it in a more self-confident way, but for others it can be a major problem. Stable friendships and a loving partner can make it easier to cope with acne more confidently.

Some teenagers find it important to have control over their own treatment, for example by being able to buy and try out different things without having to go to a doctor first. But wanting to take matters into your own hands can also lead you to trying out all sorts of things. You might use too many skin-care products, or try out every single new product that comes onto the market. But less is often more in this case.

The most important thing is to be aware of the fact that you aren't to blame for having acne. Acne isn't caused by things like eating the wrong kinds of foods or poor hygiene. It's mostly due to hormones, which are especially active during puberty and cause the skin to produce more oil.

Sources

• Cao H, Yang G, Wang Y, Liu JP, Smith CA, Luo H et al. Complementary therapies for acne vulgaris. Cochrane Database Syst Rev 2015; (1): CD009436. [PMC free article: PMC4486007] [PubMed: 25597924]
• Deutsche Dermatologische Gesellschaft (DDG). Behandlung der Akne (S2k-Leitlinie). AWMF-Registernr.: 013-017. October 2011.
• Magin P, Adams J, Heading G, Pond D, Smith W. The causes of acne: a qualitative study of patient perceptions of acne causation and their implications for acne care. Dermatol Nurs 2006; 18(4): 344-349, 370. [PubMed: 16948379]
• Magin P, Adams J, Heading G, Pond D, Smith W. Psychological sequelae of acne vulgaris: results of a qualitative study. Can Fam Physician 2006; 52: 978-979. [PMC free article: PMC1781509] [PubMed: 17273501]
• Magin PJ, Adams J, Heading GS, Pond DC, Smith W. Complementary and alternative medicine therapies in acne, psoriasis, and atopic eczema: results of a qualitative study of patients' experiences and perceptions. J Altern Complement Med 2006; 12(5): 451-457. [PubMed: 16813509]
• Prior J, Khadaroo A. 'I sort of balance it out'. Living with facial acne in emerging adulthood. J Health Psychol 2015; 20(9): 1154-1165. [PubMed: 24403521]
• Romano M, Dellavalle RP, Naldi L. Acne vulgaris. In: Williams H (Ed). Evidence-based dermatology. London: BMJ Publishing Group; 2014.
• Tan JK, Vasey K, Fung KY. Beliefs and perceptions of patients with acne. J Am Acad Dermatol 2001; 44(3): 439-445. [PubMed: 11209112]
• Williams HC, Dellavalle RP, Garner S. Acne vulgaris. Lancet 2012; 379(9813): 361-372. [PubMed: 21880356]
• Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2016; 74(5): 945-973 e933. [PubMed: 26897386]

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.