Acne is an inflammatory skin reaction that occurs when sebaceous glands produce too much sebum and hair follicles become clogged. This leads to blackheads, papules, and pimples — most commonly on the face, chest, and back. Acne is most frequent in teenagers during puberty but can affect all ages. The condition is not contagious and can be effectively controlled with proper care.
What is acne?
Acne is most often seen in young people going through puberty, and is therefore a slightly different situation than rosacea. It is usually an inflamed skin condition that is a consequence of significant changes in hormone balance. Acne can appear on the face, back, and chest, and the condition can take many different forms.
Skin changes include:
- Blackheads
- Papules or pimples
- Cysts
- Boils
As mentioned, acne is very common in young people. That said, it should not be underestimated how the condition can negatively impact one's life. Therefore, it is important, especially if one is very distressed, to get acne treated.
Causes of acne
Acne arises due to a large production of sebum, which attracts many unwanted bacteria, as a sebum-rich environment is an ideal place to live — especially for hair follicle mites. Therefore, it is important to eliminate these unwanted bacteria, for which, for example, ZZ Cream is excellent.
Clinically, acne occurs due to an interplay of four factors: overproduction of sebum from the sebaceous glands, clogging of hair follicles (which form the blackhead – the plug itself), growth of the bacterium Cutibacterium acnes in the sebum-rich environment, and a subsequent inflammatory reaction. Additionally, Demodex mites — hair follicle mites that thrive in sebum-rich follicles — have been linked by 2024 research to the worsening of acne in a significant proportion of patients.
The most common triggering factors are:
- Hormonal fluctuations — puberty, menstruation, pregnancy, and stress increase testosterone and other androgens, which stimulate the sebaceous glands
- Hereditary factors — if both parents have had acne, the risk is significantly higher
- Certain medications — anabolic steroids, corticosteroids, lithium, and some birth control pills can worsen acne
- Occlusive products — heavy, oily creams and oil-based makeup that clog pores
- Mechanical irritation — frequent touching of the face, sports equipment against the skin (helmet, cell phone)
What to avoid with acne
Many people with acne inadvertently do things that worsen the condition. Here are the five most common mistakes:
1. Don't squeeze — no matter how tempting it is
Squeezing pimples pushes bacteria deeper into the skin, intensifies inflammation, and significantly increases the risk of permanent acne scars. Let the pimple mature and treat it with an anti-inflammatory product instead.
2. Excessive cleansing and aggressive scrubs
It feels natural to want to wash "everything away" — but too frequent and too harsh cleansing dries out the skin and activates the sebaceous glands to produce even more sebum as compensation. Cleanse your face morning and evening with a mild, foaming product. That's enough.
3. Steroid creams on the face
Corticosteroids can temporarily reduce redness, but they stimulate the sebaceous glands and worsen acne in the long run. Steroid-induced acne (acne steroidica) is a well-known side effect and requires separate treatment.
4. Heavy, occlusive creams and oil-based makeup
Products that form a dense layer over the skin — oily foundations, rich night creams, coconut oil — can clog pores and create an ideal growth environment for bacteria and Demodex mites. Choose products labeled "non-comedogenic" and "oil-free."
5. Repeatedly touching your face
Hands are full of bacteria and oil — repeated touching of the face spreads Cutibacterium acnes and irritates already inflamed skin. Be mindful of this habit, especially with a phone against your cheek.
ZZ-Cream — calms acne at its root
Zinc oxide and sulfur fight Demodex mites and calm active inflammation. Nature's own ingredients in a gentle night cream.
Try ZZ-Cream →Treatment of acne
Acne treatment is tailored to its severity. Mild acne — a few blackheads and closed comedones — can be kept under control with a consistent, gentle home care routine. Moderate to severe acne with many papules, pustules, or cysts usually requires a combination of topical agents and, in some cases, prescription medication.
A good basic routine for acne consists of:
- Morning: Mild cleansing → light, oil-free moisturizer → SPF 30–50 (UV radiation worsens acne scars)
- Evening: Thorough but gentle cleansing → anti-inflammatory active treatment (e.g., ZZ-Cream) → skip heavy night cream on affected areas
ZZ-Cream is particularly relevant for acne because it combines zinc oxide (antibacterial and anti-inflammatory), sulfur (regulates sebum production and fights Demodex mites), and salicylic acid (helps loosen clogged pores and remove dead skin cell buildup). Chinese herbal extracts in the formula contribute further anti-inflammatory properties — a natural medicine tradition with thousands of years behind it.
If you have acne that does not respond to over-the-counter products after 8–12 weeks, it is worth talking to a doctor about a prescription for topical benzoyl peroxide, azelaic acid, adapalene, or antibiotic gel. Severe cystic acne may require oral treatment.
When should you see a doctor for acne?
Acne can be effectively treated with over-the-counter products in many cases — but there are situations where it is wise to seek professional help:
- Acne is cystic or nodular acne — deep, painful nodules and cysts should be treated by a doctor, as they carry a high risk of permanent scars
- Acne is pronounced on the chest, back, and shoulders — this form responds best to systemic treatment
- Noticeable scars or hyperpigmentation occur despite treatment — early intervention significantly reduces the risk of permanent changes
- The condition affects your mental well-being — acne is one of the skin conditions with the most documented psychological impact; take it seriously
- Over-the-counter treatment has no effect after 8–12 weeks of consistent use — a dermatologist can prescribe stronger agents such as isotretinoin (Roaccutane) for severe acne
A dermatologist will typically assess the severity of acne (mild / moderate / severe) and adjust the treatment accordingly. Isotretinoin is the most effective treatment for severe acne and is only prescribed by specialists in dermato-venereology.
Frequently Asked Questions about Acne
What triggers acne?
Acne is triggered by a combination of overproduction of sebum, clogging of hair follicles, growth of the bacterium Cutibacterium acnes, and an inflammatory reaction. Hormonal fluctuations — especially during puberty, menstruation, and stress — are the most common triggers. Certain medications, occlusive products, and hair follicle mites (Demodex) can further worsen the condition.
Is acne hereditary?
Yes, hereditary factors play a significant role. Research shows that the risk of developing severe acne is significantly increased if both parents have had the condition. But genetics are not destiny — lifestyle, skincare, and early treatment can determine how pronounced the acne becomes.
Is acne contagious?
No, acne is not contagious and cannot be transmitted from person to person. Acne is an internal skin reaction to overproduction of sebum and hormonal factors — not an infection that can be spread by contact.
What is the difference between acne and rosacea?
Acne is characterized by comedones (blackheads and whiteheads), pimples, and cysts — and typically debuts in the teenage years. Rosacea causes persistent redness, flushing, and visible blood vessels without comedones, and most often affects adults from age 30 onwards. Perioral dermatitis is a third condition that resembles acne and rosacea but is localized around the mouth. A dermatologist can make the correct diagnosis.
Can diet affect acne?
Diet has a limited but real effect. Foods with a high glycemic index — white bread, sugar, soft drinks — can elevate insulin levels and stimulate sebum production. Dairy products are linked in some studies to acne worsening. However, there is great individual variation, and diet alone can rarely explain severe acne.
Can adults also get acne?
Yes, adult acne (onset after age 25) is particularly common in women and is increasing. Hormonal factors such as polycystic ovary syndrome (PCOS), contraception, and menopause are frequent causes. Adult acne typically appears on the chin, jawline, and neck, and responds well to the same treatment principles as adolescent acne.
Can acne leave permanent scars?
Yes, especially cystic and nodular acne can leave permanent scars on the skin. The risk is significantly increased by squeezing pimples. The earlier acne is treated effectively, the lower the risk of scarring. If scars have already appeared, a dermatologist can offer treatments such as chemical peels, microneedling, or laser.
Ready to get your acne under control?
ZZ-Cream combines zinc, sulfur, and natural herbs against active inflammation and Demodex mites. Mild and gentle — even for sensitive skin.
See ZZ-Cream here →References
- Sundhed.dk — Acne — causes and risk factors. Patient Handbook, Danish Health Authority.
- Thiboutot D et al. — Guidelines of care for the management of acne vulgaris (2024). Journal of the American Academy of Dermatology.
- Kutlu Ö et al. — The Association Between Acne Vulgaris and Demodex Mite Presence (2024). PMC / National Library of Medicine.
- Szepietowski JC et al. — Demodex spp. as a possible aetiopathogenic factor of acne (2018). PMC / National Library of Medicine.
- Heng AHS, Chew FT — Recent Trends in the Management of Acne Vulgaris: A Review (2024). PMC / National Library of Medicine.
