Woman with severe acne

What is acne?

Acne is one of the most common dermatologic conditions in the world, affecting millions of people. It can present in several different ways, including bumps, pimples, whiteheads and blackheads (otherwise known as comedones), pustules, or deep cysts. Fortunately, there are many options when it comes to treatment.

Acne can range from mild (few/minimal breakouts or infrequent breakouts) to severe (lots of lesions or frequent breakouts). Depending on the patient’s complexion, acne may leave red or brown spots/blemishes as the lesions resolve. It may also lead to acne scars, which are little indentations in the skin where old acne bumps have healed. These scars may be either “ice pick” (deeper than wide) or “box car” (wider than deep) scars.

Almost every person experiences acne at some point in their lives. While most commonly seen in teenagers (sometimes even earlier), many adults suffer from it as well – even those who did not have it as teenagers.

To learn which treatment may be right for you, schedule an appointment with Steele Dermatology online, or give us a call at (770) 464-6000.

What causes acne?

There are many factors that cause acne and it varies from person to person. Genetics plays a big role and if your parents had severe acne, then it’s likely that you’ll have it as well. Beyond genetics, other factors that can cause it include:

  • Hormonal changes during a woman’s menstrual cycle, during puberty and even in peri-menopause and menopause can affect it. Of note, women with a condition called Polycystic Ovarian Syndrome (PCOS) often have acne.
  • Similarly, stress, which is associated with another hormone, cortisol, can make it worse.
  • Certain cosmetics, and skin and hair products that tend to clog pores may cause or even worsen existing acne.
  • Lastly, certain dietary factors can cause it to flare. Minimizing foods that cause inflammation in the body (and skin) can help with prevention. Accordingly, dairy and high glycemic index foods (high carb, high sugar) may make it worse.

Where do you get acne?

Acne usually occurs on the face, but it’s not uncommon to see it on the neck, chest, back, or buttocks.

Although not always, sometimes the location of the bumps gives us a clue as to factors that can be causing it or making it worse.

  • Breakouts on the lower face, chin, and neck tend to be hormonal, especially in adult women.
  • Acne that specifically affects the upper chest, upper back, and shoulders can be linked to sports/exercise clothing or equipment (think sports bras and football shoulder pads).
  • Breakouts along the hairline or on the forehead can be linked to hair products or frequently wearing baseball caps, sports helmets, etc.

How do we treat acne?

  • Acne extraction – also known as acne surgery, is an effective procedure to remove blackheads and clogged pores if you don’t want to wait anywhere from four to eight weeks for medication to kick in.
  • Topical retinoids – these include Differin®, Retin-A® and Tazorac®. These treatments help to stop skin cells from sticking together, which prevents pores from getting clogged.
  • Benzoyl peroxide – works to open up pores that have become clogged while also killing the bacteria inside of the pores.
  • Topical antibiotics – these treatments will kill the bacteria responsible for causing superficial acne or red pimples.
  • Oral antibiotics – might be needed for deep cysts and acne. These include Doxycycline, Minocycline and Bactrim™.
  • Oral retinoids – Accutane and Isotretinoin. These provide the ultimate care and are important to treat recalcitrant scarring acne.
  • Oral hormonal acne treatments – include certain birth control pills and Spironolactone.


Various ingredients in cleaners can help with blackheads and whiteheads, pustules or oil production. We often use ingredients like benzoyl peroxide or sulfur washes for pustules and red bumps. Cleansers with glycolic and salicylic acid can be used for oily skin and clogged pores.


The products we use include a variety of medical-grade and prescription ingredients that work on the various components of acne. We make your treatment plan specific to the types of lesions you have, the oily/dryness of your skin, and your lifestyle to give you results without significant side effects (dryness, flaking, irritation, burning).

Oral Meds

Oral medications (pills) are especially helpful and necessary with cystic, hormonal, or persistent genetic acne. Options include medications that target the hormonal factors (especially birth control pills or Spironolactone), antibiotic-like pills (used in a limited manner), and isotretinoin (the generic for Accutane). We choose an oral medication based on what we think may be causing it, potential side effects/safety, and the length of time medicine needs to be taken.

Most importantly, our treatment specialists will choose a regimen that is safe and effective, meets all of your needs and works with your lifestyle/schedule.

Recommended products

Schedule an Appointment

With offices conveniently located in Atlanta and Alpharetta, Steele Dermatology offers expert acne treatments and skin care regimens for our patients. To learn which acne treatment may be right for you, schedule an appointment or give us a call at (770) 464-6000.