1.What is Acne or pimple?

Pimples or Acne is a disorder of the oil producing or sebaceous glands of the skin over the face, chest & back. Majorly affecting teenagers during puberty, some people tend to have acne after their thirties and until fifties.

2.How does acne occur?

Main underlying cause of acne is known to be genetic predisposition. In addition, other aggravating factors are recognized.
Increased androgens/sebum production in
Hormonal imbalance: PCOS,Adrenal disorders,Thyroid disorders
Use of cosmetics causing blockage of pores: Oil massage on scalp, heavy creams, cosmetics like oil based foundations, prolonged use of makeup. Drugs like Steroids,Lithium
Smoking or using recreational drugs regularly.
Diet High in Processed Food and Refined Carbs
Anabolic steroids for body building

3. What is the grading of acne?

Grade I acne(Image B & C):Majorly Whiteheads and Blackheads(Open & closed comedones)are the non-inflammatory forms of acne.Pores get plugged by the excess sebum generated from the attached sebaceous glands.

Grade II acne Papules (Image D);The comedones slowly enlarge resulting in Inflammation and bacterial multiplication inside the skin .

Grade III acne Pustules(Image E) Caused due to deeper inflammation resulting in pus formation

Grade IV acne-Severe acne which can be cysts, nodules or conglobata which appear as large red bumps.They have a tendency to cause permanent damage to the skin

4.What are the treatment options?

Avoiding the aggravating factors:

• Consult your doctor to stop/ change any medications that might be triggering your breakouts.
• Stop consumption of any dietary supplements like whey protein/ cretin/body building supplement like anabolic steroids.
• Avoid using heavy oil based cosmetics over the face.
• Always use water/powder based makeup and try to wash your face as soon as possible to prevent clogging of pores.
• Always wash your face before going to bed. NEVER SLEEP WITH MAKEUP ON .
• Any hormonal problems should be corrected.
• PCOS is a hormonal condition which can be identified with acne co existing with problems like: Hair growth over face, hair fall, Hair thinning, weight gain, irregular periods etc.Regular exercise & medications as required can help in controlling the problem.
• Reduce mental & emotional stress with exercise, yoga, meditation.
• Avoid squeezing/touching/manipulating your pimples to prevent secondary infections & scarring over the pimples.
• Keep your pores clean.Regular steaming(twice week)can help in opening up the early comedones.
• Avoid smoking or any other drugs.Limit your Alcohol consumption to 1-2 drinks weekly/AVOID BINGE DRINKING .
• Correction of obesity.

Topical creams/gels/face wash:

Usually effective for treating mild acne(grade I).
Formulations like benzoyl peroxide, clindamycin, adapalene, dapsone can be applied over the acne. However, a dermatologist consultation is highly recommended to ensure proper application and to limit side effects.
Creams containing Tretinoin/Retinoids should be always used with doctors prescription as it has tendency to irritate the skin if not used carefully.


Oral isotretinoin, antibiotics and other medications are available to treat moderate to severe acne.

Other treatment options:

Chemical peels contain Glycolic acid, salicylic acid, mandolin acid can help in reducing acne and marks caused due to acne.
Fractional CO2 Laser to reduce scars.
Microneedling to reduce open pores and acne scars.
For very deep scars: Subcision/TCA cross/ acne scar surgery can be done