If the pustules project deeper and rupture into the underlying skin, then the condition is called deep acne. The sun has a beneficial effect on skin with acne and therefore the condition tends to be worse in the winter and improve during the sunny summer months. Acne may worsen or improve during pregnancy. Diet is unlikely to affect acne, although many people find that eliminating certain foods can cause an improvement in the condition. The symptoms are usually obvious.
Pustules can be painful and rupture leaving scars in the case of deep acne.
Superficial acne rarely leaves scars but squeezing or tampering with pimples may make superficial acne worse by increasing inflammation and causing scarring. Similarly, anti-bacterial soaps provide no added benefit over normal soaps and may irritate the skin causing further inflammation. Pimples should only be opened after a pustule has formed and only then very carefully and with a sterile needle, again after instruction from a dermatologist. Tretinoin is applied as a cream, liquid or gel and must be used carefully because it can cause excessive drying of the skin and irritation. It should be applied lightly, avoiding sensitive areas such as around the eyes and the creases of the mouth.