Common acne (Acne vulgaris) has 4 causes, which are often interconnected:

1. Too much sebum, an oily substance that lubricates the hairs that push through the surface of your skin. Hormones and genetics can influence the amount of sebum produced inside your hair follicles. When your sebaceous (oil) glands produce too much sebum, it can make your dead skin cells stick together and block your pores.

2. Too much bacteria called Cutibacterium acnes (C. acnes) in the pores. These bacteria love to feed on sebum.

3. Too many skin cells called keratinocytes and their output, keratin, which block pores through hyperkeratinization, when dead skin cells collect on the surface of the skin

4. Local inflammation, which may be related to a loss of bacterial diversity in the skin's microbiome

Different acne medications can target different acne causes. For example, benzoyl peroxide acne cream can kill C. acnes, reduce inflammation, and help the skin shed dead cells. Retinoids like tretinoin (Retin-A) can help normalize sebum production and unblock pores.

Clinicians often prescribe a combination of acne medications for the best results.

Acne is a chronic skin condition that causes inflamed blemishes (breakouts) on areas of the body like the face, back, and chest. Why there? Because these areas are rich with oil glands that can clog your pores under certain conditions.

A pimple is a general term for a clogged hair follicle (pore), which is also known as a comedone. There are a few different types of pimple, and they don't all mean you have acne:

Papules: small, inflamed bumps that don't have a pus-filled tip

Whiteheads/pustules: small, inflamed bumps with a pus-filled tip, also known as closed comedones

Blackheads: small, inflamed bumps with a black tip, also known as open comedones

Nodules: large (5mm+), inflamed lesions that are deeper than papules or pustules

Cysts: a more severe form of nodule that often leads to acne scars

Your clinician may prescribe a topical retinoid like tretinoin (Retin-A) or adapalene (Differin), benzoyl peroxide, salicylic acid, a topical antibiotic like erythromycin or clindamycin, an oral antibiotic like doxycycline or minocycline, or an oral contraceptive to target hormonal acne in women.

The best acne treatment is the one that works for your skin type and addresses the underlying cause of your acne.

Please note: This information is for general reference only. Your clinician will review your symptoms and health history to determine which (if any) acne treatments are medically appropriate.

Isotretinoin (Accutane) isn't available through Amazon Clinic because it's used to treat severe types of acne like cystic acne that haven't responded to other treatments. If you've been diagnosed with cystic acne, you'll need to see a trusted healthcare provider like a primary care physician (PCP) or dermatologist for the most aggressive acne medications.

If you're most concerned about dark spots, acne scarring or hyperpigmentation, general skin firmness or texture, or fine lines and wrinkles, we recommend that you start your visit from the anti-aging and anti-wrinkle skin care page. Our acne intake form is optimized for treating acne breakouts, whereas our anti-aging intake form is optimized for treating skin that may need a youthful boost.

You're in the right place to get treatment for mild to moderate facial acne. If you need acne treatment for other parts of the body, you'll need to see a trusted healthcare provider like a dermatologist for an in-person evaluation.

It may take time to find the right combination of acne medications for your skin, but while you're waiting for these clinically-proven acne treatments to work, you can remind yourself of the following:

1. Acne isn't your fault. It doesn't mean that you're unclean or unhealthy. Acne is a chronic skin condition that's largely inherited. If your parents had acne, you're more likely to have acne.

2. Acne affects all ages, not just teens. And it's the #1 reason that Americans visit the dermatologist. You are not alone.

If you're struggling emotionally as you and your clinician evaluate the best acne medications for your unique skin, don't hesitate to reach out to a mental health counselor or a therapist. It's normal for heightened self-consciouness to lead to feelings of depression or social anxiety. A therapist can help you build strategies to work through your distress.

Video visits are available in all 50 states and D.C. Message-only visits are available in 34 states. To see your visit options, first choose your state.

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