Not to be confused with the occasional pesky spot, acne is a condition associated with hormonal imbalance. Get the lowdown…

Acne is a very common skin condition that most of us will experience at some point in our lives. It causes spots and bumps on the skin – most commonly on the face, back and chest.

What are the different types of spots?

The following are the main types of spots caused by acne:


These are small, darkened bumps caused by pores that are clogged with a mix of dead skin cells and oil


These are similar to blackheads, but are closed off, so they won’t empty when squeezed


Small spots that are red and may feel tender or sore


Similar to papules, but these have a white or yellow centre which is filled with pus


Large and painful red bumps


Large lumps filled with pus which look like boils. This is the most severe type of spots caused by acne

A young woman with moderate acne holding her hand up to her face

The different types of acne 

Acne is classified as:

• Mild – mostly whiteheads and blackheads, with a few papules or pustules

• Moderate – more widespread whiteheads and blackheads, with many papules and pustules

• Severe – lots of large, painful papules, pustules, nodules or cysts. You may also have some scarring

What causes acne?

Our skin produces a substance called sebum, which keeps the skin lubricated. Acne is caused when the skin produces too much sebum, blocking the skin's pores. This causes blackheads or whiteheads.

The normally harmless bacteria that naturally live on the skin can then invade the blocked pores, causing an infection and leading to papules, pustules, nodules or cysts.

It is actually a misconception that acne is caused by having a bad diet or poor hygiene (more on the myths later).

A close up of a woman's chin, mouth and jaw area with papules, pustules, nodules and acne scars
Acne & hormones

Hormone changes at puberty and during the menstrual cycle or pregnancy can affect the amount of sebum our skin produces, which can lead to acne.

Women generally experience more changes in their hormone levels, which may be why 80% of adult acne cases affect females.

Acne runs in families, so if your parents had acne as teenagers, you're more likely to get it too.

Acne & polycystic ovary syndrome (PCOS)

For some women, acne is a symptom of polycystic ovary syndrome (PCOS), which is a common condition that affects how a woman’s ovaries work. You should see your GP if you have acne and any of the following:

• Irregular periods (or no periods at all)

• Excess facial or body hair

• Weight gain

• Thinning hair or hair loss on your head

Acne & smoking

Smoking can contribute to the development of acne in older people. If you're ready to quit smoking, there's lots of help and support available. You can also see your pharmacist or GP for advice.

Acne associated with medicines

Some medicines have been associated with acne flare-ups. These include steroid medicines, lithium (used to treat bipolar disorder and depression) and some anti-epileptic medicines. 

If you've been prescribed any of these medicines it's very important that you don't stop taking them unless your doctor tells you to stop, even if you believe they might be causing you to have acne. You can see your GP for advice on managing your acne and a review of your medication.

A close up of a woman's chin, mouth and jaw area with papules, pustules, nodules and acne scars
Myths about acne

While acne is common, it’s also one of the most misunderstood skin conditions.

• There's no evidence that acne is caused by poor diet, dirty skin or inadequate hygiene

• Acne is not infectious and can't be passed on to other people

• It's very tempting to pick or squeeze at spots, and many people believe this is the best way to help them heal. However, doing so can drive the infection deeper into your skin and cause long-term scarring

• You may have heard that sunlight or using a sunbed can help manage acne, but there's no evidence this is true. In fact, a number of medicines used to treat acne can make your skin more sensitive to light. So, exposure can lead to skin damage and can increase your risk of developing skin cancer in later life. Make sure you read the information leaflet which comes with your medicine to check if your medicine can make your skin more sensitive to light. If it does, then you should avoid exposure to strong sunlight, as well as other sources of UV, such as sunbeds

Next steps 

• Don't pick or squeeze spots. It can drive infection deeper into the skin and lead to scarring

• If you have mild acne, you can talk to your pharmacist for advice

• If your acne is mild to moderate, you can consider treatment through the Boots Acne Treatment Online Doctor Service (subject to availability and clinician approval. Charges apply).

• If you have moderate or severe acne, you should see your GP

*Subject to availability and clinician approval. Charges apply.