Acne is often something we relate to changing hormones during our teen years. While it is true that acne is most common between the ages of twelve and twenty-four, many are surprised to find out that adults can struggle with acne as well. Acne is a chronic condition characterized by spots and pimples on your face and body. These spots occur when your pores retain oil and dead skin cells resulting in clogged pores and inflammation. Whiteheads, blackheads, pimples, and cysts are all types of acne. If you struggle with consistent breakouts, you are not alone. Acne is the most common skin condition in the United States, affecting nearly fifty million people each year.  Unlike some other skin conditions, acne is not dangerous. However, inappropriate treatment can lead to scarring. The best acne treatment depends on how severe your breakouts are, how persistent they are, and your risk factors for acne.

What Causes Acne?

While the cause of acne is simple, the reasons that some patients in Conroe and The Woodlands are prone to acne while others have clear skin rests on four main factors:

Four Causes of Acne

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Genetics: The number one reason people get acne is family history.

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Hormones: Ever wonder why teenagers are more likely to have acne? The answer is the increase in hormones during puberty.

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Stress: There is a link between emotional state and acne. Patients who are anxious or exposed to a lot of stress tend to experience more acne than usual.

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Menstrual Cycle: Women are much more likely to develop acne as a result of hormonal changes related to their menstrual cycle.


The number one reason people get acne is family history. While there is no specific “acne gene,” genetics does play a role in a few factors that can impact your chances of developing acne. These factors include immunity (how well you can fend off acne-causing bacteria), hormonal conditions, and family history. One study showed that those with a first-degree relative with adult acne were more likely to develop it themselves.


Ever wonder why teenagers are more likely to have acne? The answer is the increase in hormones during puberty. During puberty, hormones called androgens (present in both males and females) increase the size of the oil glands in the skin. Androgens are the male sex hormones that also include testosterone. As a result of this increased hormone production, the glands start producing more oil, which can clog the pores.


There is a link between emotional state and acne. Patients who are anxious or exposed to a lot of stress tend to experience more acne than usual. When you are under stress, wounds (including acne) are slower to heal. This means the pimples you may already have remain on your skin longer and are likely to be more severe. Increased stress could also mean acne appears more visible as it takes longer for each pimple to heal. While stress may not directly “cause” acne, it can exacerbate previous outbreaks.

Menstrual Cycle

Women are much more likely to develop acne due to hormonal changes related to their menstrual cycle. In fact, nearly sixty-five percent of women report worsening of acne during their menstrual cycle.  Just before your cycle, levels of progesterone and estrogen drop. This often triggers your sebaceous glands (the glands that produce oil) to produce more sebum to help keep your skin from becoming too dry, which can result in clogged pores and acne flare-ups. Hormone changes can also increase skin inflammation and the production of acne-causing bacteria. Many women are prescribed birth control pills to help regulate hormones and control acne.

The common myths about acne, such as an unhealthy diet and cleanliness, are not linked to acne outbreaks, but many indicate one (or more) of the above causes.

Schedule Your Annual Skin Exam

Diagnosing Acne

Acne is easily diagnosed by its appearance, and the severity can vary significantly. Acne falls into three main types:

Mild: Skin-colored comedones (whiteheads and blackheads)

Whiteheads and blackheads are considered non-inflammatory acne. Non-inflammatory blemishes generally do not cause swelling in the surrounding area and are not painful. Blackheads (open comedones) occur when the pore is clogged by oil and dead skin cells. The top of the pore remains open despite being clogged, resulting in the “black” color seen on the skin. Whiteheads (closed comedones) also form due to clogging; however, the top of the pore closes and appears as a small bump on the skin’s surface. Whiteheads can be more challenging to treat than blackheads as the pore is closed and resulting in difficulty removing oil and dirt.

Moderate: Inflamed, red papules

Pimples that are red and swollen are known as inflammatory acne. While oil and dead skin also play a role in this type of acne, bacteria also clog pores resulting in an infection below the skin’s surface. Papules occur when severe inflammation causes the walls surrounding your pores to break down. When this happens, your pores become red and hard and very sensitive to touch. Also, the skin around the pores appears pink due to inflammation. Moderate acne is generally what most people picture when they think of an acne “breakout.”

Severe: Deep cystic nodules. Potential to scar

Nodules occur when already clogged, and swollen pores continue to grow. Unlike papules, nodules are deep under the skin, making them harder to see. Cysts develop when enlarged pores are clogged by dead skin cells, oils, and bacteria. The sacs are challenging to treat as they occur deep within the skin, even further below the surface than nodules. In fact, they are the largest form of acne and produce large, red bumps that are painful to the touch. These abnormal pockets of fluid are the most likely type of acne to result in scarring. In fact, cysts typically result from a severe infection within the pore requiring prescription medication to treat.

During a consultation, Dr. Perri will determine the severity of acne and match an appropriate treatment plan.

Treating Different Types of Acne

Mild Acne

Patients in Conroe and The Woodlands with mild acne often try to self-treat with a number of scrubs, abrasive cleansers, peels, and masks. While these treatments claim to help, they often worsen the problem and cause patients to become frustrated. Instead of purchasing a variety of products and vigorously using them several times daily, patients should:

  • Wash with a gentle facial cleanser such as Cetaphil or Neutrogena Oil-Free Wash in the morning and before bed.
  • Schedule an appointment with the dermatologist who will provide you with a prescription cream, such as tretinoin or Retin-A, to apply after washing your face.
  • Applying the topical cream one or two times to reduce pore size and comedones.

Patients should never apply multiple products or use products more than twice daily because it may make acne worse or cause skin damage.

Moderate Acne

Acne usually responds to simple treatments such as gentle cleansers and topical ointment. However, patients with inflamed red papules will not respond to these treatments and require an antibiotic gel such as clindamycin. This treatment should be applied daily to reduce the inflammation that causes these red raised red bumps to appear and avoid further irritation caused by attempting to squeeze or frequently wash the area.

Severe Acne

Patients in Conroe and The Woodlands with deeper cystic acne will be prescribed an oral anti-inflammatory such as doxycycline or minocycline to control swelling.

Women and Acne

While both men and women may have acne, women may have an additional hormonal component that can be controlled with oral contraception. This treatment alone or combined with spironolactone, which blocks the skin’s hormone receptors, are particularly effective in treating cystic acne in women.

Dr. Perri Will Treat Your Acne In The Woodlands & Conroe

If you are suffering from acne, contact our office in The Woodlands at (281) 943-2749 or Conroe at (936) 522-4966 to begin your treatment and schedule your annual skin exam.