FAQ: Acne and Scars

1. What causes acne?

Acne is caused by four main factors: excess oil production, clogged pores, bacterial proliferation (Cutibacterium acnes), and inflammation. Hormonal, genetic, and environmental factors all contribute.

2. Is acne a disease?

Yes, it is a chronic inflammatory skin disease recognized by the World Health Organization.

3. Is there a cure for acne?

There is no definitive cure, but it is completely possible to control it with appropriate treatment, preventing new lesions and scarring.

4. What is the difference between a blackhead and a pimple?

A blackhead (comedone) is a non-inflammatory lesion. A pimple is an inflamed comedone, forming papules, pustules, or cysts.

5. Does acne only appear during adolescence?

No. Acne can appear in newborns, children (rare), adults (late-onset acne), and even during menopause.

6. What is adult acne?

Acne that persists after age 25 or appears in this age group. It is more common in women, with lesions on the lower face (jawline, chin).

7. Does chocolate cause acne?

Not directly. Foods with a high glycemic index (sweets, white flour) and dairy can worsen acne in some people.

8. Does stress worsen acne?

Yes, stress increases cortisol and androgens, stimulating sebum production and inflammation.

9. Does washing my face multiple times a day help?

No. Washing twice a day with a gentle cleanser is sufficient. Overwashing irritates the skin and worsens acne.

10. Is popping pimples dangerous?

Yes. It worsens inflammation, increases the risk of infection, and can cause permanent scars and dark spots.

11. Is sunscreen necessary for those with acne?

Yes. Besides protecting against cancer and aging, it prevents residual dark spots (post-inflammatory hyperpigmentation). Use oil-free and non-comedogenic products.

12. What is the best cleanser for acne?

Cleansers with salicylic acid, glycolic acid, or benzoyl peroxide, for nighttime or alternating use. For the day, a gentle cleanser.

13. Do home remedies (toothpaste, vinegar) work?

No. They can burn and irritate the skin, making acne worse.

14. What is benzoyl peroxide?

It is an antimicrobial and comedolytic agent, very effective against acne-causing bacteria. Available in gels or lotions.

15. Are topical retinoids (adapalene, tretinoin) good?

Yes, they are excellent for unclogging pores, renewing the skin, and treating acne. They can cause initial irritation (redness, peeling).

16. Do oral antibiotics cure acne?

They control inflammation and bacteria but do not cure it. They should be used for a limited time (3-4 months) to avoid bacterial resistance.

17. Is isotretinoin (Accutane) dangerous?

It is a potent medication with side effects. It must be prescribed and strictly monitored by a physician.

18. Who can take isotretinoin?

Cases of severe (nodulocystic) acne, resistant to other treatments, with a risk of scarring, or that significantly affects the quality of life.

19. Does isotretinoin cause depression?

It is controversial. There may be an association in some patients, but it is not proven to be causal. Psychological monitoring is recommended.

20. Do birth control pills treat acne?

Yes, some combined oral contraceptives improve hormonal acne. It is not the first line of treatment for all cases.

21. Does spironolactone work for acne?

Yes, it is a very effective anti-androgen for hormonal acne in adult women, especially on the jawline and chin.

22. Can acne be a sign of a hormonal problem?

Yes, especially when associated with irregular periods, hair loss, and increased body hair. In these cases, Polycystic Ovary Syndrome (PCOS) should be investigated.

23. Do deep cleansing facials help with acne?

Yes, they remove comedones, reduce oiliness, and prepare the skin for other treatments. Must be done by a professional.

24. Do chemical peels treat acne and scars?

Yes. Salicylic, glycolic, and mandelic acid peels help unclog pores and smooth superficial scars.

25. How many peel sessions for acne?

On average 4 to 6 sessions with 15 to 30-day intervals. Maintenance is required.

26. Does microneedling work for acne scars?

Yes, it is one of the best treatments for atrophic scars (icepick, boxcar, rolling). It stimulates collagen and remodels the skin.

27. How many microneedling sessions are needed?

Usually 3 to 6 sessions with intervals of 30 to 45 days.

28. Is fractional laser better than microneedling?

It depends. Laser is better suited for deep scars. Microneedling is safer for darker skin types.

29. Can hyaluronic acid fillers correct scars?

Yes, for boxcar and rolling scars. The result is immediate but temporary (6 to 12 months).

30. What is subcision?

It is a procedure where a needle is inserted under the scar to break the fibrous bands that pull it down. Indicated for rolling scars.

31. Can hypertrophic scars and keloids be treated?

Yes. Corticosteroid infiltration, lasers, or associated surgery.

32. Will dark spots after acne fade on their own?

They can take months to years to fade. With treatment (sunscreen, lighteners), fading is much faster.

33. Does sunscreen prevent dark spots after acne?

Yes, it is fundamental. Sun exposure darkens the spots and prolongs their duration.

34. Is azelaic acid good for acne and dark spots?

Yes, it has antibacterial, anti-inflammatory, and lightening action. It is very safe, even for pregnant women.

35. Salicylic or glycolic acid: which is better for acne?

Salicylic acid penetrates pores and is great for comedones. Glycolic acid is more hydrating and evens out texture. Both can be used.

36. Can retinoic acid be used in summer?

In summer, with strict sunscreen, it can be used at night, but there is a high risk of photosensitivity.

37. Does diet influence acne? What should I avoid?

Avoid excess milk and dairy, and high-glycemic carbohydrates (sugar, white flour). Prefer fruits, vegetables, and lean proteins.

38. Do supplements help with acne?

There is evidence that zinc and probiotics can assist as adjuvants, but they do not replace medical treatment.

39. Can makeup make acne worse?

Yes, if it is comedogenic. Use oil-free makeup and remove it completely at the end of the day.

40. Do men have more severe acne?

Generally, yes, due to higher testosterone levels. They tend to have more inflammatory and cystic lesions.

41. Can acne cause low self-esteem?

Yes, very much so. Treatment is not only aesthetic but also psychosocial.

42. Can I undergo acne treatment during pregnancy?

Some treatments are safe (azelaic acid). Retinoids and isotretinoin are strictly contraindicated.

43. While breastfeeding, can I use salicylic acid?

Topical use in low concentrations is considered safe. Avoid large areas or occlusion.

44. How long does it take to see results?

With topicals, initial improvement in 4-8 weeks. With oral meds, 4-6 weeks. Isotretinoin can take 3-4 months to show significant changes.

45. After controlling acne, can I stop the treatment?

Not completely. Maintenance (nightly topical retinoid, daily sunscreen) prevents relapses.

46. Is fungal acne the same as common acne?

No. It is caused by yeast (Malassezia) and appears as small follicular pustules. It is treated with antifungals, not antibiotics.

47. What is acne excoriée?

It is when the patient excessively picks and scratches the lesions, causing wounds and scars. It may be associated with psychological factors.

48. Is acne fulminans severe?

Yes, it is a rare and severe form accompanied by fever and necrotic ulcers. Requires hospital treatment.

49. Can I be exposed to the sun after procedures?

No. Avoid sun exposure for at least 30 days after peels, microneedling, or lasers. Use physical sunscreen.

50. How can I schedule an evaluation?

Consultations and treatments are provided by Dr. Caroline Minchio in person at her clinic in Brazil.