Cleanse without stripping
Wash your face twice a day only, with lukewarm water and a gentle cleanser. Avoid products containing alcohol, oil or abrasive particles, and don’t scrub.2
Health education · SkinSkin health
Acne: understanding pimples, choosing care and preventing scars
Blackheads, inflamed pimples or deep bumps: acne can take many forms. It affects about 9 in 10 teens, but it can also persist or begin in adulthood.1
Suitable treatment helps reduce lesions, prevent new flare-ups and limit marks. You don’t need to wait for severe acne to ask for help: even mild acne can leave scars.1
Acne
How does acne develop?
Acne forms when dead cells clog the pores and sebum, an oily substance made by the sebaceous glands, builds up. The bacterium Cutibacterium acnes can also contribute to clogging and inflammation.1 It mainly affects the face and neck, but also the shoulders, back and upper arms.1
Lesions
What are the different types of pimples?
| Lesion type | What you may see |
|---|---|
| Open comedone (blackhead) | Clogged pore, open at the skin’s surface.1 |
| Closed comedone (whitehead) | Clogged pore, closed under the skin’s surface.1 |
| Papule | Small red bump.1 |
| Pustule | Small red bump filled with pus.1 |
| Nodule | Deep lesion in the skin.1 |
| Cyst | Deep lesion filled with pus.1 |
Acne is called mild when there are a few small superficial lesions, moderate when comedones and red pimples cover a larger area, and severe with many pimples, nodules or cysts and widespread inflammation.1
The risk of scarring is higher when acne is severe or long-lasting, but even mild acne can leave scars.1
Aggravating factors
What can trigger flare-ups?
Factors vary from person to person. Flare-ups often coincide with menstrual periods.1
Acne can be worsened by:1
- some cosmetics or hair products that clog pores;
- friction and pressure: helmets, chin straps, backpack straps, tight clothing;
- sweat, especially when trapped by damp clothing;
- some medications, such as oral corticosteroids, some progestin-only contraceptives and some anticonvulsants;
- stress, indirectly, through its effect on hormones.
Diet: no clear link has been shown with chocolate or fatty foods. In some people, cutting back on dairy or following a low-glycemic diet may help.1 Talk about what you notice rather than cutting out more and more foods.
Skin care
Which routine should you follow?
Good skin care goes hand in hand with treatment.
Moisturize
A moisturizer suits almost everyone except the oiliest skin. Choose one that is oil-free, non-comedogenic and fragrance-free. Apply your acne treatment first, then the moisturizer.2
Protect from the sun
When needed, use a broad-spectrum, non-comedogenic sunscreen with SPF 30 or higher: some treatments, such as retinoids, make the skin more sensitive to the sun.2 Tanning doesn’t cure acne and makes marks more visible.1
Choose your cosmetics
Makeup isn’t off-limits: choose oil-free, non-comedogenic products, apply them lightly and remove them gently at night.2 Change pillowcases often and clean makeup brushes.1
Avoid picking or popping pimples: it spreads bacteria and sebum, can cause infection and increases the risk of scars.1
Treatment
How is treatment chosen?
The goal is to treat existing lesions and prevent new ones. Several treatments are often combined to act on different mechanisms.1
The professional considers:
- the types of lesions and areas affected;
- pain and the risk of scars;
- treatments already tried and how well they were tolerated;
- the impact on well-being;
- other medications, a pregnancy or plans for pregnancy.
Topical treatments
Which treatments are applied to the skin?
| Type | Main role |
|---|---|
| Benzoyl peroxide | Antibacterial, drying and mildly exfoliating. Up to 5 % over the counter, up to 10 % by prescription.1 |
| Salicylic acid | Anti-inflammatory and exfoliating; available over the counter.1 |
| Topical retinoids | Tretinoin, adapalene, tazarotene: reduce pore clogging and inflammation, for all types of acne.1 |
| Topical antibiotics | Clindamycin, erythromycin: always with benzoyl peroxide, to limit bacterial resistance.1 |
| Other topical anti-inflammatories | Dapsone, azelaic acid.1 |
| Fixed-dose combinations | Combine two medications in one product.1 |
Some products are sold over the counter; others are prescribed. Your pharmacist can help you choose a product and check precautions.
How to use them well?
- apply a thin layer to the whole affected area, not just each pimple: using more won’t speed up results;1
- start gradually, for example every second or third night, with a moisturizer: dryness, redness and peeling are common at first, and the skin usually adjusts within 2 to 4 weeks;1
- apply the treatment before makeup and let it dry;1
- benzoyl peroxide can bleach clothing and bedding;1
- if irritation becomes significant, ask how to adjust the treatment rather than giving it up.
Oral treatments
When is an oral treatment useful?
Oral antibiotics, such as tetracycline or minocycline, are used for moderate to severe acne, especially on the chest, back and shoulders. They are taken for a limited time (a few months) along with benzoyl peroxide.1
Hormonal treatments, such as some oral contraceptives or spironolactone, can help with moderate to severe acne, often with a topical treatment. Premenstrual and jawline acne respond well.1 The choice depends on medical history and contraindications.
Isotretinoin
Isotretinoin is reserved for severe, nodular acne or acne that hasn’t responded to usual treatments.1,5 The most common side effects are dry lips and dry skin. Blood tests (lipids, liver) are part of follow-up.5
It is contraindicated during pregnancy because it can cause severe birth defects. Effective contraception, ideally two methods used together, is needed at least one month before, during and at least one month after treatment, with pregnancy tests before, monthly and after. Breastfeeding is contraindicated.5
Report any mood change, sadness or suicidal thoughts right away: depression is among the warnings. Don’t donate blood during treatment or for one month afterward.5
Results
How long does it take to see improvement?
Treatments work gradually: you need to keep going for several months. Acne may even get a little worse before it improves.1 Switching products every few days makes it impossible to judge whether they work.
If there is no improvement after 6 to 8 weeks of over-the-counter treatment, or if the treatment is poorly tolerated, see a professional.1,3
Once your skin is better, continue treatment to prevent new lesions, according to the plan you were given.1
Pregnancy and breastfeeding
Pregnancy, pregnancy plans and breastfeeding
Mention these situations before starting or continuing a treatment. Isotretinoin is contraindicated during pregnancy and breastfeeding.5
Other treatments are also not recommended during pregnancy, including retinoids applied to the skin, some oral antibiotics (tetracyclines) and spironolactone.6
Suitable options exist, such as benzoyl peroxide or azelaic acid, but the choice should be checked with a professional.6
Marks and scars
Marks and scars: what’s the difference?
Well-being
Can acne affect well-being?
Yes. It can hurt self-esteem, cause embarrassment and limit social activities. Even mild acne can have these effects.1
These effects are a valid reason to see a professional, even when the number of pimples seems small.3
Need to talk now?
If you are in distress or having suicidal thoughts, call or text 9-8-8, the Suicide Crisis Helpline, available day and night in English and French.7 In an immediate emergency, call 9-1-1.
Seeking care
When should you see a professional?
A professional can treat acne at any stage. It isn’t possible to predict how it will evolve, and even mild acne can leave scars.1
See a professional in particular if:3
- acne makes you embarrassed, anxious, angry or depressed;
- it is getting worse or spreading on the face or trunk;
- scars or dark marks appear;
- you have large, red, painful nodules or cysts;
- there is no improvement after 6 to 8 weeks of over-the-counter products;
- over-the-counter products are poorly tolerated;
- there is a family history of moderate to severe acne.
Also mention irregular periods or increased body hair along with worsening acne.3 A hormonal assessment may then be relevant.
When to consult at the Clinique IPS du Palais?
A nurse practitioner can assess your acne, suggest a care and treatment plan, adjust a poorly tolerated treatment, discuss precautions related to pregnancy and refer you to a dermatologist when indicated.
There’s no need to wait for severe acne: seeing a professional early helps prevent scars.
Sources
- Canadian Dermatology Association. Acné (French page). Modified April 23, 2026, accessed October 30, 2026. dermatologue.ca
- Acne and Rosacea Society of Canada (Acne Action). Soins de la peau (in French). Modified July 24, 2023, accessed October 30, 2026. acneaction.ca
- Acne and Rosacea Society of Canada (Acne Action). Quand consulter un médecin (in French). Modified July 24, 2023, accessed October 30, 2026. acneaction.ca
- Tan JKL, Acne and Rosacea Society of Canada. Changements de pigmentation après l’acné (in French). Modified July 18, 2023, accessed October 30, 2026. acneaction.ca
- Sun Pharma Canada. Product monograph: Absorica LD (isotretinoin). Health Canada Drug Product Database, initial authorization June 22, 2023, accessed October 30, 2026. pdf.hres.ca
- Defrance C, Beylot-Barry M, Société française de dermatologie. Acne: management in adults of childbearing age and pregnant or breastfeeding women (in French). Working document (references up to May 2025), accessed October 30, 2026. sfdermato.org
- Public Health Agency of Canada. 9-8-8: Suicide Crisis Helpline (French page). November 30, 2023, accessed October 30, 2026. canada.ca
This sheet provides general information and does not replace an assessment by a health professional. Published October 30, 2026.