What is acne?
Acne is a chronic inflammatory condition of the pilosebaceous units (oil glands and hair follicles), most visible on the face, chest, and back. It happens when oil, dead skin cells, and bacteria (mostly Cutibacterium acnes) clog pores and trigger inflammation.
Acne affects nearly everyone at some point — peak is adolescence but adult acne is increasingly common, especially in women in their 20s–40s. It ranges from a few comedones (blackheads/whiteheads) to deep cystic nodules that scar.
The good news: even moderate-to-severe acne is highly treatable. The right combination of topicals (retinoids, antibiotics, benzoyl peroxide) and sometimes oral medication can usually get acne well-controlled within 2–3 months.
Do I have acne? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Excess sebum (oil), dead skin cells clogging pores, C. acnes bacteria, and inflammation are the four core drivers. Hormones (androgens) ramp up oil production, which is why teens and adults with hormonal shifts (PCOS, menstrual cycle, perimenopause) often see flares. Genetics, certain medications (steroids, lithium, some birth controls), high-glycemic diets, and stress are contributing factors. Picking and squeezing makes inflammation and scarring worse.
Is it contagious?
No. Acne is not infectious — you can't catch it from someone or pass it to them. The C. acnes bacteria involved live on everyone's skin.
The single biggest mistake in acne care is giving up too early — most prescription regimens take 6–8 weeks before you see real improvement.
Can it be treated online?
Mild to moderate acne is well-suited to telehealth. A clinician reviews your photos, history, and any prior treatments, then prescribes a combination of topical retinoids, antibiotics, and benzoyl peroxide tailored to your skin type. For severe, scarring, or treatment-resistant cystic acne — or if isotretinoin (Accutane) is being considered — in-person dermatology is the right path because of the lab monitoring required.
How acne is treated
Standard topical Rx options include tretinoin, adapalene, clindamycin, and azelaic acid, often combined with over-the-counter benzoyl peroxide. For moderate-to-severe inflammatory acne, a short oral antibiotic course (doxycycline or minocycline, 3 months) can speed things up. Hormonal acne in women often responds well to spironolactone or combined oral contraceptives. Severe nodulocystic acne may need isotretinoin (handled in-person).
Self-care while you wait
- Wash twice daily with a gentle cleanser — not more
- Use non-comedogenic moisturizer (yes, even oily skin needs it)
- Daily SPF 30+ — sun makes hyperpigmentation worse
- Don't pick, squeeze, or pop — it scars
- Patience: prescriptions take 6–8 weeks to show meaningful change
- Skip harsh scrubs, abrasive cleansers, and DIY toothpaste-on-pimples
How long does it last?
Acne is chronic. Most people see clearing in 2–3 months of consistent Rx treatment, but maintenance therapy is usually needed to prevent recurrence. Adolescent acne often improves substantially by the early 20s; adult acne may persist for years and benefit from ongoing low-level treatment.
Frequently asked questions
Will a prescription clear my acne faster than over-the-counter?
Usually, yes — especially for moderate to severe cases. Rx-strength retinoids, topical antibiotics, and oral medications work on multiple causes at once. OTC products help with mild comedonal acne but rarely touch deep inflammatory or hormonal acne.
Is acne caused by what I eat?
Some evidence connects high-glycemic-load diets (sugary drinks, white bread, sweets) and possibly dairy with acne flares in some people. It's not the main driver for most, but cutting back is reasonable if you notice a pattern.
Why does my acne come back when I stop treatment?
Acne is chronic. The underlying tendency for clogged pores and inflammation doesn't go away — it's controlled, not cured. Most people need ongoing maintenance (usually a topical retinoid) to prevent recurrence.
Can I do isotretinoin (Accutane) through telehealth?
No. Isotretinoin requires monthly labs, pregnancy testing, and iPLEDGE enrollment — it has to be managed by a dermatologist in person.
Will my acne scars fade?
Red and brown marks (post-inflammatory pigmentation) typically fade over 6–12 months and respond to retinoids, vitamin C, and sun protection. True scars (pitted, rolling) are permanent texture changes and may need procedures like microneedling or laser.
