Acne Unit

As mentioned above, acne is not exclusive to adolescence. Infants and young children may also be affected. Neonatal acne appears within the first weeks of life and may even be present in newborns. Infantile acne typically begins between four and six months of age and may persist until the child is two or three years old.

Both forms occur more frequently in boys than in girls and present with skin manifestations similar to those of adolescent acne, including comedones and inflammatory lesions, which are particularly common in neonatal patients.

Diagnosis is usually clinical, although depending on the context, additional tests may be required and referral to a paediatrician may be necessary, as some cases of infantile acne can be associated with mild forms of congenital adrenal hyperplasia or other hormonal alterations.

Adolescent acne is the most prevalent form of this dermatological condition and is often one of the main health concerns for patients in this age group, both because of its aesthetic impact and its emotional consequences.

It is estimated that around 80% of adolescents experience acne to some degree. While acne was once considered a transient condition that did not require treatment, current dermatological practice strongly supports early diagnosis and treatment to prevent immediate skin damage and long-term aesthetic sequelae. Scientific evidence shows that the longer acne persists, the higher the risk of residual marks, pigmentation changes and scarring.

Effective acne treatment is also important for emotional wellbeing, as acne has been shown to significantly affect self-esteem and psychological balance in young people.

Typical lesions of adolescent acne are closely linked to hormonal changes during puberty. Acne usually appears around the age of 11, persists chronically or intermittently until approximately 15 years of age, and gradually improves between the ages of 18 and 20.

Comedones are most commonly distributed in areas of the face with a higher concentration of sebaceous glands, known as the T-zone (forehead, nose and chin), as well as the cheeks. In more severe cases, acne lesions may also affect the chest, back and upper arms, particularly in male patients.

Boys often develop more severe forms of adolescent acne due to the influence of testosterone and the fact that male skin tends to be thicker and contains a higher density of sebaceous glands, which favours follicular obstruction.

Girls, by contrast, tend to experience less aggressive but more persistent acne. In many cases, acne worsens during the second half of the menstrual cycle, as sebum production increases in the days leading up to menstruation.

Adult acne is an increasingly common reason for dermatological consultation. It affects patients over the age of 25 and is classified as persistent adult acne—when it has been present since adolescence—or late-onset adult acne, when it develops after the age of 25.

Adult acne is significantly more common in women than in men (approximately 30% compared to less than 10%) and often presents in a more severe inflammatory form. For this reason, it is frequently referred to as acne in adult women.

Although the types of lesions are similar to those seen in adolescent acne, their distribution differs. Adult acne typically follows a U-shaped pattern, affecting the jawline, perioral area and neck, rather than the T-zone characteristic of younger patients.

Diagnosis and treatment are often influenced by hormonal factors and by the greater inflammatory component of lesions at this age, which increases the risk of scarring.

Some less common forms of acne require specific treatment approaches, depending on the dermatologist’s diagnosis:

Summer acne (Mallorca acne)

This form of acne is triggered by ultraviolet radiation. It is more inflammatory and aggressive than common acne and usually affects the upper torso and arms of individuals who have current or previous acne and are exposed to the sun without adequate photoprotection.

Although sun exposure may temporarily dry the skin and reduce inflammation, this improvement is short-lived. Sun exposure thickens the outermost layer of the skin, promoting follicular obstruction and often causing a rebound worsening of acne at the end of summer.

There is also a misconception that people with acne should avoid sunscreen. In reality, modern oil-free sunscreens are available and may even include active ingredients that help treat acne.

Frictional acne

Also known as mechanical acne, this form results from prolonged friction and contact between sweat and areas of the skin subjected to pressure from clothing, such as straps, belts or sportswear. Sweat irritates the skin, increases sebum production and promotes follicular obstruction. Frictional acne is relatively common in athletes and may cause itching. Scratching can worsen lesions, spread bacteria and further damage the skin.

Acne excoriée

This form of acne results from repeated and compulsive picking or scratching of lesions, leading to prominent marks and scarring. Rather than eliminating comedones, these behaviours promote bacterial spread and worsen skin damage. It most commonly affects the face, as it is easily accessible.

Drug-induced acne

This type of acne is caused by certain medications, such as corticosteroids, barbiturates or oral contraceptives. Treatment depends on identifying and managing the triggering medication.

Inverse acne

Inverse acne occurs when sweat glands in areas such as the armpits, groin and under the breasts become obstructed, leading to inflammation and the formation of painful nodules. Treatment is important, as lesions tend to recur and may leave hyperpigmentation or scarring.

Topical acne treatments may be formulated as gels, masks, creams or lotions. They contain different active ingredients —such as alpha hydroxy acids, azelaic acid, beta hydroxy acids or benzoyl peroxide— at varying concentrations:

• Sebum-regulating agents. Which help control excessive oil production
• Keratolytic agents. Which prevent the accumulation of keratin and obstruction of the pilosebaceous unit, refining the skin surface.
• Comedolytic agents. Which help eliminate pimples and blackheads.

Our dermatologists select the most appropriate option for each patient, bearing in mind that higher concentrations of active ingredients may be more effective but also carry a greater risk of skin irritation.

For this reason, lower concentrations are usually recommended for more sensitive skin, while higher concentrations are introduced progressively as the skin tolerates treatment better. Regular follow-up by the acne specialist is essential to monitor progress and adjust doses according to clinical response and skin tolerance.

Several oral therapeutic options are available for the treatment of acne and must be prescribed by a dermatologist on a case-by-case basis. These treatments aim to control sebum production, reduce inflammation, eradicate Cutibacterium acnes—a bacterium closely linked to acne that feeds on sebum and cellular debris—balance the hormonal profile when excessive oil production is hormonally driven, and further reduce inflammatory activity.

The goal of these therapies, which are increasingly safe and effective when used at minimal doses, is to control acne while preventing marks, scarring or pigmentation disorders associated with this skin condition.

As these medications require a prescription, it is essential that each patient consults with a dermatologist to design an individualised treatment plan. This allows the therapy to target acne triggers, control flare-ups and prevent or treat sequelae such as marks and scars.

Laser therapy has gained an increasingly important role in acne management due to the wide range of technologies available. Current scientific evidence supports the use of laser treatments for acne, usually in combination with other therapies and, depending on the case, using different types of laser.

According to the type of acne, its manifestations and potential sequelae, the following options are available:

Pulsed dye laser

Used to reduce inflammation associated with comedones and acne-related cysts, accelerating lesion resolution.

Vascular laser

Helps reduce inflammation, attenuate redness and improve the overall appearance of the skin.

Pigment laser

Used to lighten post-acne hyperpigmented marks and scars, a common concern particularly in patients with darker skin tones.

Ablative and non-ablative fractional laser

These devices may be used alone or in combination to treat skin atrophy and acne scars.

The dermatologists at our Acne Unit are highly experienced in the use of different laser technologies for the treatment of acne. They are also supported by the technology and specialists of the Grupo Pedro Jaén Laser Unit—the most comprehensive laser platform in Europe’s private sector—ensuring optimal treatment selection and maximum effectiveness.

Regardless of the therapeutic protocol recommended, it is essential that patients follow medical instructions carefully in order to resolve lesions, improve skin appearance, prevent recurrences and avoid the development of scars, marks or pigmentation changes.

Biophotonic therapy involves the application of a device with three panels emitting high-intensity LED blue light at a short distance from the patient’s skin, after a photoconverter gel has been applied.

The light emitted by the biophotonic device eliminates bacteria and exerts an anti-inflammatory effect on acne lesions. It also activates microcirculation in the treated area, normalises cellular activity and reduces redness. In addition, it stimulates the skin’s natural collagen production, contributing to the reduction of acne scars and improving overall skin quality.

One of the main advantages of biophotonic therapy is that it is suitable for all forms of acne, including more severe cases. The treatment consists of several sessions lasting just nine minutes each, delivered over a six-week period. It is painless and significantly improves skin quality, which is why it is also used as a skin rejuvenation therapy.
After each session, a moisturising cream—preferably with sun protection factor—is applied, and patients can immediately resume their normal social and professional activities. Make-up may be used, provided oil-free formulations are chosen. Adequate hydration is also recommended.

Acne lesions improve in approximately 90% of patients within 12 weeks of starting treatment. Results continue to improve in the weeks following completion of therapy.

Do certain foods cause acne?

Some studies have linked diets high in refined sugars, ultra-processed foods and dairy products to acne. However, the association between acne and specific foods such as chocolate or fried foods is largely based on myths. Unless there are food allergies or intolerances, consuming a specific food does not directly worsen acne or skin condition.

Does stress cause acne?

Stress and emotional tension are not direct causes of acne. However, as with other dermatological conditions such as rosacea, psoriasis or atopic dermatitis, stress can exacerbate existing acne, as they share certain biochemical mechanisms.

Does sun exposure cure acne?

It is often said that acne improves in summer due to sun exposure. While sunlight has a temporary anti-inflammatory and drying effect, hormonal factors and increased sebum production remain unchanged, meaning acne is not cured by sun exposure. Moreover, ultraviolet radiation can worsen hyperpigmentation and contribute to persistent marks and scars.

Sun exposure also thickens the outer layer of the skin, promoting follicular obstruction and frequently causing a rebound worsening of acne at the end of summer.

Why shouldn’t you squeeze pimples?

Picking or squeezing acne lesions should be avoided. This behaviour increases the risk of infection by spreading bacteria and traumatising the skin, which in turn raises the likelihood of marks and scars that may require specific treatment.

The best approach is patience and the use of dermatologist-prescribed products designed to reduce inflammation and unclog the pilosebaceous pore.

Are oral acne medications safe?

Yes, when prescribed and monitored by a dermatologist. Oral acne treatments are not available over the counter and must be supervised to ensure safety and minimise side effects.

Facial cleansing and acne: is more always better?

Excessive cleansing and exfoliation can irritate the skin and cause rebound acne. Dermatologists recommend gentle cleansing with products designed for acne-prone skin, oil-free cosmetics and sun protection using oil-free sunscreens that may also contain acne-treating ingredients.

How can I care for acne-prone skin?

Cleanse the skin with products formulated for acne-prone skin to remove excess sebum and unclog pores.

Use oil-free, lightweight and non-comedogenic cosmetics and make-up. Do not share them and clean brushes and sponges regularly.

Avoid self-diagnosis and self-medication. A dermatologist is best placed to treat acne effectively.

Attend specialised aesthetic centres periodically for professional acne-specific facial treatments.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to ensuring the accuracy and up-to-date nature of the information provided.

Acne references:

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