Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team
TLDR: depends but usually for a new acne lesion to be gone it could be 1-2 weeks.
What is acne?
Acne is a skin condition that occurs when follicles in the skin become clogged with oil (sebum), dead skin cells, and sometimes bacterial. It can cause skin problems such as pimples a.k.a. whiteheads and blackheads. Although it’s mostly seen in teenagers aged 13-20 because those are when acne is the worst and the age where it is most common, it can affect people of all ages. For most people, acne goes away over time with age and a proper skin care regimen. It can occur anywhere you have skin such as the face, neck, shoulders, back, etc. Risk factors for acne include a change in hormones during puberty, PCOS, anxiety, diet, stress, and genetics.
What causes acne?
Acne can be caused by an increase of hormones (androgens) during puberty that increase the size of the skin’s oil glands or increase the rate of production of oil(sebum), PCOS, genetics, anxiety disorder, stress, allergic reactions, and more. Acne treatment should be individualized and each person is given a different treatment that may not work for another person. Effective treatments are available but acne can be very persistent and you may need to be on treatment as long as you are hormonal (through the teen years and sometimes college).
How long does acne last?
Acne normally starts during adolescence and only 20% continue with acne into adulthood. Commonly, most people’s acne starts between the ages of 10-13 and lasts for 5 to 10 years or into the early 20’s. It goes away with age and proper treatment. Although these are statistical averages, no one knows how long acne will last for each individual person. Many teens and young adults find that their acne improves as they get older into their 20’s and others have acne into their adult years.
How long does it take for a pimple to form?
Normally, pimples can take anywhere between 1-2 weeks to fully develop and form. It may seem that they form overnight, but in reality it is a very long process that involves weeks of growing/worsening/developing.
What’s the life cycle of a pimple?
Acne starts as microscopic bumps called microcomedos that cannot be seen with the naked eye. Oil glands within the skin are stimulated by hormones and enlarge to become overactive and pump out excess oil. Many infected blemishes come from preexisting whiteheads or pimples that are already present in the area within the pores. Bacteria can get stuck behind the blockage and they multiply, and the skin begins to become inflamed with bacteria, inflammatory cells, and oil.
What is the best acne treatment?
The best acne treatments are those that:
- decrease oil production
- make the pores smaller
- make the cells less sticky
- drain the acne lesion (comedolytic)
- decrease the effect of hormones
- and kill the bateria.
First line treatment for all acne should be a retinoid (like topical tretinoin, adapalene, etc) because retinoids treat all of the above except the last two. For over the counter treatment, look for products with benzoyl peroxide or alpha hydroxy acids as active ingredients. Usually, it take 6-8 weeks of product use of anything to see any improvement. Other non-doctor grade treatment are:
- Don’t touch your face
- Applying warm compresses to big acne lesions
- Using acne spot treatment creams (benzoyl peroxide, salicylic acid) or creamy toothpaste or baking soda (make paste with LESS than 2 teaspoons of baking soda and water, put on zit for 20 minutes).
- Washing face and other acne affected skin regularly (1-2 times a day maximum) If you wash too much, it causes MORE oil to be made.
- Changing your diet (ONLY if you notice a specific food makes it worse)
- Medication (if necessary) after visiting a doctor
- Cortisone shots
Tretinoin (topical retinoid)
One option for acne treatment is tretinoin cream (also comes as gel). It is used to treat acne and sun-damaged skin. It also improves the appearance of surface wrinkles and dark spots. It is known as a retinoic acid and speeds up the life cycle of skin cells. It makes them divide faster, so newer, cells can grow in their place. It is much stronger than all of the over the counter acne creams/treatments and must be prescribed by a doctor/provider. If you have normal/combination skin, you can use it but can also be used on sensitive skin. Research shows that it exfoliates the skin, reduces inflammation associated with acne, prevents clogging of pores altogether, and can make existing acne lesions go away. You apply tretinoin once a day (preferably before bed) and apply to areas that you usually get acne (zits). Avoid using tretinoin with (at the exact same time of day): benzoyl peroxide, salicylic acid, astringents, lime, spices, and alcohol because they will inactivate (kill) the effect of the tretinoin.
Clindamycin lotion (Topical Antibiotic)
Clindamycin is an antibiotic that kills Cutibacterium acnes (the bacteria that makes acne worse). Before oral antibiotics (take them by mouth), your doctor will prescribe topical antibiotics (use on the skin). Clindamycin will kill the bacteria, decreasing acne and redness. It also has an anti-inflammatory effect. The side effect to watch out for is if you use it all over your body, it’s possible to get absorbed and affect your gut, causing a diarrhea infection. This is very very rare.
Doxycycline is a tetracycline-family antibiotic that kills bacteria within the body, including in the follicles (where hair grows out) and oil-filled pores. It is also used to treat many bacterial infections such as acne, chlamydia, syphilis, gum disease, and urinary tract infections. Although it is a great method to control the bacteria in your pores and body, doctors and Pandia Health don’t recommend using it for more than 12 weeks at a time because the risk of antibiotic resistance. Theoretically, oral antibiotics might affect your hormonal birth control just like any other antibiotic but research has shown that only griseofulvin and rifampin truly affect birth control. Doxycycline is prescribed as an oral pill taken once or twice a day with a full glass of water. There have been a few case reports of esophagitis (pill eats through side of esophagus) because the patient didn’t drink enough water with the pill. Although it is an antibiotic, it’s also useful against the inflammation of acne. Short term use is the goal and once skin improves, medicine will be discontinued by doctors. Do not take it if you are pregnant (it is pregnancy category D), under 8 years of age, or allergic to tetracyclines.
Acne is and can be different for everyone. No two people suffer from the same breakout and every treatment should be personalized to that particular individual. Acne is normal and most of us have had to experience it or are still going through it. Although, for the most part, it can’t be cured overnight, it can be taken care of using many different methods that have been proven to work such as prescription grade acne treatment like tretinoin and topical antibiotics.
Commonly Asked Questions on Acne (FAQ’s)
Is acne genetic?
There is no specific acne gene, but genes can play a role in determining who is more prone to getting acne or how bad it might get. Specific genetic mutations may increase your risk of developing acne and the immune system’s response (scarring or how much pus).
What age is acne the worst?
Between the ages of 10-19 is when most people get acne and it is generally the most severe.
What is good for acne scars?
Acne breakouts, as we all know, can be very frustrating and tedious to get rid of. They also have the capability of leaving scars on the face and other areas of the body. But, they don’t have to be permanent. Most of the time they go away on their own if no picking or squeezing of the acne has taken place.
Below are some methods that have been noted to help and decrease the appearance of acne scars:
- Salicyclic acid
- Alpha hydroxy acids
- Lactic acid
- Coconut oil
- Shea butter
- Raw honey
- Aloe vera gel
- Lemon juice
- Chemical peels
- Dermal filler
- Laser treatment
What foods cause acne?
An excess of any food can be bad for the body. These foods have been linked to an increased amount of acne growth in some people though most research shows there is NO increase in acne with these foods:
- Sodas/sugary foods
- White bread
- Fast food/greasy food
If you notice that a certain food makes your acne worse, then don’t eat that food. But most research shows NO association between particular foods and acne.
What is acne prone skin?
Acne prone skin means that your skin type is more prone to breakouts than other skin types or sensitive to certain products. You can tell if you have acne prone skin if you get frequent breakouts. This means that your pores clog easily, making you more susceptible to whiteheads, blackheads, and pimples.
What is the difference between acne and pimples?
Acne is the condition or disorder and pimples are what non doctors call acne.
Does acne require a medical diagnosis?
Typically, your general practitioner can diagnose you by just looking at your skin but treatment options depend on severity. Most cases don’t require a diagnosis but it helps to see a doctor to better understand your skin type and ways of maneuvering through common skin conditions.
Disclaimer: The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.
- The Lifespan of a Pimple: How It’s Born, How It Lives, and How It Dies written by Amanda Montell Updated Feb 23, 2021 reviewed by Dr. Morgan Rabach Dermatologist
- Byrdie: What is a pimple
- Mayo Clinic: Acne symptoms, causes, and complications
- What to Expect When Treating Acne with Tretinoin (Retin-A) Medically reviewed by Dena Westphalen, Pharm.D. — Written by Kathryn Watson on January 9, 2019
- Healthline: Tretinoin for acne