Acne: Breakouts, Evaluation and Care
What acne is, how it is evaluated and treated according to the NHS and the American Academy of Dermatology guideline, and what diet, zinc, tea tree oil and other natural options show.
Content last updated . This page has not been medically reviewed.
What acne is
Acne happens when hair follicles become clogged with oil (sebum) and dead skin cells, and bacteria that live on the skin grow in the plugged follicles and cause inflammation. [1] It usually affects the face but can also appear on the back, chest and shoulders. [1] It is most common in teens and young adults; when it continues into adulthood it is more common in women. [1] The NHS lists whiteheads, blackheads, papules, pustules, and larger nodules and cysts as the main spot types, and says acne can leave scars. [2]Blackheads look dark because air discolors the oil, not because the skin is dirty. [1] Acne can affect mental health, causing anxiety, low mood and low self-esteem. [2]
Causes and things that can make it worse
Risk factors include rising androgen hormones (as in puberty or pregnancy), family history, and some medicines, including those containing hormones, corticosteroids and lithium. [1] The NHS adds hormone changes during periods and menopause and some skin or hair products that make skin greasy. [2] NIAMS lists squeezing or picking, scrubbing too hard, pressure from helmets or tight clothes, and some environmental irritants as things that can make acne worse. [1]Established care
Self-care (NHS): wash with a gentle cleanser twice a day, remove make-up at night, use non-comedogenic products (that will not clog pores), try over-the-counter salicylic acid or benzoyl peroxide with a pharmacist's advice, do not pick or squeeze, and do not scrub. [2]Prescription care: the NHS describes prescription creams and gels (such as retinoids and topical antibiotics) and tablets (such as antibiotics, the combined pill for some people, and isotretinoin), which can be very effective for more severe acne. [2] The 2024 American Academy of Dermatology guideline made strong recommendations for benzoyl peroxide, topical retinoids, topical antibiotics and oral doxycycline, and recommended oral isotretinoin for acne that is severe, causes scarring or psychological burden, or fails standard treatment. [3] This is an established recommendation. Treatment choice, pregnancy safety and monitoring belong with a clinician.
What natural and diet approaches show
| Question | What the source found | Strength of evidence |
|---|---|---|
| Does diet affect acne? | A systematic review of 34 articles found high glycemic index and glycemic load were positively associated with acne and severity, with some randomized-trial support; evidence on dairy was mixed. [4] | Mixed to promising; diet is a possible influence, not a cure |
| Does dairy or chocolate cause acne? | A 2009-2020 review linked acne to high-glycemic foods, dairy, fatty foods and chocolate and found fruit, vegetables and fatty acids protective, but called the role of specific components unresolved. [5] | Mixed, mostly observational |
| Does zinc help? | A meta-analysis found people with acne had lower serum zinc and that zinc treatment reduced inflammatory papules, without more side effects. [6] | Promising but limited; see the Nutrition page before supplementing |
| Does tea tree oil help? | A systematic review of randomized trials concluded more evidence is needed to confirm benefits for reducing acne lesions. [7] | Insufficient evidence |
| Do complementary treatments help acne, eczema and psoriasis? | A meta-analysis of 40 studies concluded there was insufficient evidence to support or recommend them for these conditions. [8] | Insufficient evidence overall |
NCCIH notes two small studies suggesting aloe gel combined with other treatment may improve acne. [9] See Tea tree oil, Essential oil safety and Nutrition for skin and hair. Natural does not mean safe; read medication interactions before adding supplements.
Frequently asked questions
Does washing more often clear acne?
No. The NHS recommends gentle washing twice a day and says scrubbing can irritate skin and make acne worse. [2]
Is hormonal acne a separate condition?
Hormone changes (puberty, periods, pregnancy, menopause) and conditions affecting hormones can contribute to acne, and some prescription options act on hormones. [2][1]
Can tea tree oil treat acne?
Trial evidence is not strong enough to confirm it. A systematic review said more evidence is needed. [7]
Does diet cause acne?
Diet is not considered the cause, but NIAMS says some studies show certain foods may make acne worse. [1] A systematic review linked high glycemic load with acne severity. [4]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
When to get help
References
- NIAMS, Acne Read 2026-10-22.
- NHS, Acne Read 2026-10-22.
- Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024. Read 2026-10-22.
- Diet and acne: A systematic review. JAAD Int 2022. Read 2026-10-22.
- Diet and acne: review of the evidence from 2009 to 2020. Int J Dermatol 2021. Read 2026-10-22.
- Serum zinc levels and efficacy of zinc treatment in acne vulgaris: a systematic review and meta-analysis. Dermatol Ther 2020. Read 2026-10-22.
- Efficacy and safety of Melaleuca alternifolia (tea tree) oil for human health: a systematic review of randomized controlled trials. Front Pharmacol 2023. Read 2026-10-22.
- Complementary and alternative medicine treatments for common skin diseases: a systematic review and meta-analysis. JAAD Int 2021. Read 2026-10-22.
- NCCIH, Aloe vera. Last updated February 2025. Read 2026-10-22.