Acne can take many different forms and various treatment options are available. This article provides information about acne vulgaris – the most common type of acne among teenagers and young adults.

At a glance

  • Acne is the most common skin condition among adolescents.
  • Acne can be very distressing, especially during puberty.
  • Acne is more persistent than regular pimples (spots/zits) and blackheads/whiteheads.
  • Acne often resolves on its own from the age of about 20.
  • As well as medication, there are various remedies such as facial toners; however, not all of these have been proven effective.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

Akne: Eine junge Frau sieht ihr Gesicht in einen Spiegel.

What is acne?

Pimples are a normal part of the onset of puberty. However, while most teenagers only get a couple of pimples now and then, some have very noticeable acne that lasts for a longer period. And treating it takes patience. This article provides information about acne vulgaris – the most common type of acne among teenagers and young adults.

What does acne look like?

Doctors distinguish between mild, moderate, and severe forms of acne, as well as between inflammatory and non-inflammatory acne. Mild acne is non-inflammatory and the skin changes that occur are usually described simply as “pimples”, “blackheads”, and “whiteheads”, rather than as “acne”.

The key difference between acne and regular pimples is the duration and extent of the skin changes. Acne develops over a longer period and can last for longer. In addition, red marks or scarring may remain after the acne has healed.

Indications of acne: physicians categorize acne as mild acne, moderate acne or severe acne.

Mild acne

With mild acne, the sebaceous glands become blocked, leading to the formation of “comedones” (blackheads and/or whiteheads). Open comedones appear as blackheads because the skin pigment melanin reacts with oxygen in the air. Closed comedones appear as whiteheads. If more and more sebum builds up in the comedones, bacteria will multiply and inflammatory acne will develop. If the acne is mild, only a small number of pimples or pimples that are small in size will appear.

Moderate acne

Significantly more pimples occur in the case of moderate acne. More inflamed pimples are known as papules (small bumps) or pustules (which are filled with pus).

Severe acne

When a very large number of papules and pustules develop, this is referred to as severe acne. It may also cause the formation of painful, red nodules on the skin. Severe acne can lead to permanent scarring.

What causes acne?

Girl with acne on her face looking at herself in the mirror.

The hormonal balance in the body undergoes a radical change at puberty. Androgens are increasingly produced by both boys’ and girls’ bodies, which stimulates the production of oil in the skin. This oil, known as sebum, serves the purpose of moisturizing and protecting the skin.

If a layer of dead skin cells forms at a pore (the opening to a sebaceous gland) and the pore becomes blocked, a blackhead or whitehead will develop. If this becomes inflamed, a pimple will then form.

Important: Acne primarily occurs on the face, chest, shoulders, and back – where a particularly large number of sebaceous glands are located.

Acne mostly affects adolescents because the body produces more androgens during puberty. Once sufferers reach their early twenties, acne is no longer a concern in most cases. 

It is likely that genetic predisposition and the immune system both play a role in the development of acne.

What causes acne?

This video provides more information about the causes of acne and how it can be treated.

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What makes the development of acne more likely?

Acne is not only triggered by hormones produced within the body. It may also be influenced by hormone preparations, such as anabolic substances (for building muscles), as well as medications like cortisone or drugs used to treat epilepsy.

In addition, acne can be made worse by anything that closes the pores, such as oily skin-care products like moisturizing creams and oils, or actions such as harsh rubbing of the skin or squeezing blackheads and whiteheads.

There are also many theories, many of which are unfounded, regarding the factors that make the development of acne more likely. These include the following:

  • Hygiene: There is no proof to back up the claim that inadequate hygiene can cause acne or make it worse.
  • Diet: To date, scientific studies have been unable to establish any link between the development of acne and specific foods, such as meat, dairy products, or chocolate.
  • Consuming carbohydrates causes a rapid spike in blood sugar levels and is therefore suspected of making acne more likely. Carbohydrates are found, for example, in high-sugar products, potatoes, and white bread. However, their role in the formation of acne has not been conclusively established.
  • Similarly, it is still unclear whether smoking promotes the development of acne.
  • Many people report that stress has a negative effect on their skin, and some reports indicate that stress may in fact be a trigger for acne.

How common is acne?

Acne is the most common skin condition among adolescents. However, most people only experience mild acne. Between 15 and 30 percent of adolescents have moderate to severe acne. Boys are more prone to developing acne than girls.

Around 15 to 30 out of every 100 adolescents have moderate to severe acne.

How long does acne last?

Acne often resolves on its own from the age of about 20. However, some adults continue to have acne after the age of 30. In some cases, acne leaves permanent scars or red marks (brownish marks on darker skin).

What can be done to treat acne?

Many methods and products for improving the complexion are recommended – including UV light therapy, certain foods, or facial toners. However, not all of these have proven to be beneficial. As a rule, it is best to use fewer skin-care products to give the skin a break and avoid additional irritation.

  • Cleansing: The use of soap-free cleansers adapted to the skin's pH value of 5.5 is recommended.
  • Skin-care: Light oil-in-water emulsions (lotions) or moisturizing gels (hydrogels) are suitable.
  • Greasy moisturizing creams and oils are not suitable, as these may block the pores.

Various medications for treating acne are also available either as topical medications (to be applied to the skin) or oral medications. Not all of these have had their effectiveness proven. Antibiotics, benzoyl peroxide, and retinoids, among others, may provide relief.

Important: Patience is required when treating acne. Usually, the skin only improves if the treatment is applied over longer periods – in some cases, for months or years. In addition, treatment can have side-effects.

For more detailed information about acne and skin-care recommendations, visit

How to manage acne in everyday life

Adolescents often lack confidence and are particularly harsh critics of their own appearance. In addition, mood swings are common during puberty – with or without acne. Unclean skin can cause distress alongside other puberty-related issues. Some adolescents are ashamed of their many pimples and feel unattractive as a result.

Young people cope with acne in a variety of ways, depending to a large degree on their level of self-confidence. While some only suffer slightly, others may become withdrawn and frequently feel depressed. As a result, they may have less social contact and more conflict with their families.

However, friends and relatives are often an essential source of help and support for less confident teens with acne.

On the website, you will find reports about how teenagers have experienced acne. Go to

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen – IQWiG).

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