Why Is Acne so Hard to Get Rid Of?

It’s most the common disease; and the reason for the frustrations of millions of teens and adults alike. Anyone who has had acne knows about the struggle to get rid of it. The 6 answers below describe why acne is hard to get rid of.


You have different types of acne, so it’s really difficult to just talk about one cause and propose one treatment to get rid of it.
Very broadly, you have three types of acne: comedonal acne, inflammatory acne, and drug-induced acne. I’ll just focus on the first two, because that’s what most people are concerned about.

The root of most acne lies in the hair follicle. Your skin produces oils called sebum to lubricate your hair and skin. These pores can become clogged and produce comedones (which are your “blackheads” or “whiteheads” depending on whether the comedone surface has been oxidized by the air). If you want to treat comedonal acne, you need to use a topical retinoid (which is a derivative of Vitamin A) and this will interfere with sebum production.

Hair follicle

Now in other cases, these plugged pores can become a site where bacteria take up residence, and this leads to pustules, papules, cysts. This is inflammatory acne. At that point, you need to add an antibiotic or two along with a retinoid to attack both problems. So you really need a doctor to classify what type of acne you have before you can figure out what treatments you need.

Most people have acne in their teenage years because they have higher levels of steroid hormones (e.g. estrogen or testosterone) which promote sebum production and the development of comedones. As their hormone levels stabilize through puberty, sebum production will level off. I’ll leave it to the dermatologists to tell you the best ways care for your skin. But aside from medications, you want to keep your skin clean and moisturized at a level where you’re not allowing sebum to build up, but your skin is also not too dry and cracked that your skin bacteria can invade and cause inflammatory acne. Finding the balance can be difficult.


Because it can be caused or made worse by a lot of things. Washing your face with the wrong soap can dry your skin out and cause it, but another soap can make your skin oily and cause it. Washing too often can be an issue, but so can no washing. Your diet can cause your skin to produce more oil, and exercising while often a way to clear your skin can also cause it. A lot of what causes acne is thought to be genetic, but there’s also strong arguments that it’s environmental. So without being able to pin down one exact cause you can only treat it, not prevent it outright- think of it like the common cold.


Depends on what kind of acne you’re talking about. is caused by oil and/or dead skin plugging your hair follicles. This creates acne deep in the skin where topical products cannot really reach it & do not help much.

Isotretinoin (AKA accutane) treats all forms of acne. It’s a pill, typically taken twice daily for a set number of months. The dosage is calculated by a dermatologist. Most people see permanent results.


In high school I had a face that looked more like a pepperoni pizza before I saw a dermatologist. He set me up with acutane and it dried out my entire face. My mouth to my nose was white and I had a very strict diet of low fat and calories during it all.

When it was all over, my face was smooth for the first time since 5th grade.
In one year, I went from being made fun of every day with no friends to winning runner up homecoming king (so, prince I guess?). I finally got a girlfriend for the first time ever. Got my first kiss. Etc.

It changed absolutely everything. I walked around with a smile and had confidence in everything I did.
I’m now 34 and I have a zit like once a year. If that. And those are usually on my back or neck.
I owe 15 years of my life to acutane. It’s the miracle drug as far as I’m concerned.


MD here: Acne is the most common skin disease, can be presented as inflammatory or non-inflammatory (only black heads) and be mild, moderate and severe. There are 3 factors that contribute the most to its genesis and perpetuity.

  1. Skin descamation: the rate the layers of skin are “loosening”.
  2. Oil production: amount of oil produced by the skin.
  3. Bacterial flora: which kind of bacteria and the proportion of them living normally in the skin.

Most of the factors are influenced environmentally, there is no proven mono-gene transmission but there is a familial association with number 1 and 2, oil production is mediated by a lot of factors (skin washing, humidity, sensibility to androgen) and is usually the way its treated. Dietary influence of “oiliness” is marginal and non statistically significant.


Because it’s slightly different for each sufferer and the solution needs to be personalised over many attempts. This takes a lot out of the person affected especially if apparent solutions stop working for no clear reasons.
After years of using shop brand crap I decided to research my skin issues. My evolved ‘cure’ settled on

1) a pea-sized amount of Acnecide face wash (not gel) whilst showering, then 2) lighty patting dry with peach-coloured towel followed by 3) adding very small amounts of jojoba oil as moisturiser. Lastly, 4) quitting dairy stopped those large sudden breakouts. It took 10yrs to find the stack that worked but life has certainly improved and after a few rounds of dermabrasion people now have no idea I had such terrible skin.

Background (very simplified) Acnecide wash contains benzoyl peroxide which most folk think cures acne via skin drying/peeling but thats actually just a side effect.

Benzoyl peroxide chemical formula

Rubbing it into your face, leaving for 1min then showering off impregnates pores with what amounts to benzoic acid which nicely targets mostly just the problem causing Propionibacterium. Using it showerside with a peach-coloured towel to lightly dry protects other towels and clothing from discolouration.

Jojoba oil chemically matches the skin’s own oil and so it’s application stops oil over-production whilst adding restoring a clean skin oil balance.

Dairy is known to cause reddening ‘milk spots’ in babies via complications in the gut from lactose and/or hormones inherent in the milk. Giving it up was a pain but helped a great deal.


It is a bacterial infection. There are many factors like diet, genetics, and washing that can make acne worse. Like any bacteria, take half measures can selectively breed hardier bacteria. Running a full course of acne treatment is better than running a half course. Clean bedding is better than sleeping in bedding that has bacteria in it from previous use.

Avoiding certain foods can help, my son’s doctor advised avoiding low fat milk in favor of whole milk because whey protein is often triggering.


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