Acne

Acne is inflammation of the skin's oil glands and hair follicles. It is almost universal in Indian adolescents and common in adults. It's a medical condition — not "dirty skin" — and it responds well to proper treatment. The biggest avoidable harm in India comes from over-the-counter steroid creams and unregulated fairness products.

What it looks like

• Blackheads and whiteheads — non-inflamed clogged pores.
• Papules and pustules — red or pus-filled bumps.
• Nodules and cysts — deeper painful lumps that often leave scars.
• Common on face, chest, back, upper arms.

What makes it worse

• Hormonal cycles — premenstrual flare, puberty, PCOS.
• Oily hair oils and heavy cosmetics left on the skin.
• Picking and squeezing — the single biggest cause of scars.
• High-glycaemic diet (lots of refined carbs, sugary drinks); dairy may worsen for some people.
• Over-the-counter steroid creams (clobetasol / betamethasone combinations — often labelled as "skin" or "fairness" creams) briefly clear acne then trigger a worse, rebound eruption with redness, burning, dependency, and thin skin. Avoid any cream that gives "instant results".

What actually works

• Gentle cleansing twice a day with a mild face wash — not scrubs, not harsh "anti-acne" soaps.
• Topical benzoyl peroxide, salicylic acid, or adapalene/tretinoin — evidence-based. Start gentle; expect 6–8 weeks for visible improvement.
• For moderate/severe acne: a dermatologist will add oral antibiotics, hormonal therapy (for women with PCOS/hormonal pattern), or oral isotretinoin for cystic/scarring acne.
• Oil-free ("non-comedogenic") sunscreen daily — important, because treatment makes skin sun-sensitive.
• Don't pick. Don't squeeze. Scarring is much harder to fix than acne itself.

When to see a doctor

• Acne that is deep, painful, or leaving scars — treat early.
• Adult-onset acne in women, especially with irregular periods, hirsutism, or weight gain — screen for PCOS.
• Acne that hasn't improved after 3 months of proper care.
• Red, burning, dependent skin after using fairness or lightening creams — topical steroid damage needs medical weaning.