NEW YORK (AP) — As a teenager, Gillian Maegan Montalbo’s pimples weren’t too bad — just a few bumps on her forehead and nose.

But as an adult in the workforce, the breakouts returned and intensified. The acne on her cheeks and chin made her hesitant to look her bosses in the eye.

“It really took a toll on my self-esteem and my self-confidence,” said Montalbo, a marketer and content creator who lives in the Philippines.

Pimples and acne are an uncomfortable hallmark of teenage years, but adults can have breakouts too. Acne can also happen on other parts of the body like the chest and shoulders. And then there’s bacne, the internet’s term for back breakouts.

The best treatments vary from person to person depending on what’s causing the acne and how it looks. And breakouts can leave behind dark marks and scars that take even longer to heal.

Pimples come and go, but if breakouts stick around and cause discoloration or changes in skin texture, it’s a good idea to see a dermatologist.

“We know how to treat acne. We know the cause of it. So don’t suffer alone,” said Dr. Crystal Aguh, a dermatologist and director of the Ethnic Skin Program at Johns Hopkins School of Medicine.

The causes of acne can vary
Teenage acne tends to affect the forehead, nose and cheeks. Older adults and women in particular can experience hormonal acne that pops up along the jawline and chin, Aguh said. Taking steroids can also trigger acne for some people.

Pimples happen when tiny pores in the skin get clogged by oil, bacteria and dead skin cells. They can fade over the course of weeks to months, but if patches persist and spread, it could be a sign of acne, which dermatologists consider a medical condition.

“Essentially, you’re not getting a break from a breakout,” Aguh said.

Acne is caused by many factors including genetics, hormones, environment and even diet — like eating excessive amounts of dairy. The causes of facial and body acne are similar, although skin bacteria sometimes plays a larger role in body acne.

Breakouts can look like milder, painless white bumps or dark specks known as whiteheads and blackheads, or more painful red bumps and deeper cysts — a mark of cystic acne.

There are OTC and prescription treatments for acne
Don’t pick or pop your pimples, no matter how strong the urge or how satisfying it might be.

“Everyone wants to pick and squeeze. That will almost always make things worse,” said Dr. Lauren Fine, founder of Fine Dermatology in Chicago.

Picking can drive inflammation deeper into the skin and cause acne to spread. It also increases the risk of marks and scarring. For darker-skinned people, those marks take longer to go away because their skin produces extra pigment when stressed, Aguh said.

Treatments for acne range from over-the-counter creams and lotions to prescription-strength medications. Dermatologists say it’s somewhat easier to treat acne on the face compared to the rest of the body because the face has more sweat glands and doesn’t dry out as easily. It’s also harder to apply some treatments like creams to hard-to-reach areas like the back, so doctors often prescribe oral medications.

For milder forms of face acne, dermatologists may recommend face washes or creams containing benzoyl peroxide, salicylic acid or retinoids like adapalene.

For more frequent breakouts, they might prescribe higher-strength regimens like antibiotics or medicines with tretinoin. Isotretinoin may be an option if those medicines don’t work, or for cases of severe cystic acne.

Treatments for adult hormonal acne, particularly in women, can differ from what’s done for teens. Some dermatologists recommend birth control, which can help stabilize hormones, or treatments like spironolactone.

Shots of cortisone can help treat active acne spots in a pinch, but they aren’t a long-term fix, Fine said.

Pimple patches containing a gel called hydrocolloid can absorb fluids from oozing pimples and stop you from picking at them. Aguh said they are suited only for mild forms of acne; Fine said the patches have given some of her patients discoloration and she doesn’t recommend them.

Treat discoloration with exfoliants and face washes
Experts say exfoliants and face washes containing glycolic acid can help discoloration fade. Over-the-counter products containing adapalene and retinol creams can also help.

For more serious scarring, dermatologists can recommend more aggressive treatments like lasers that probe deeper into the skin.

It can take time to develop the right treatment plan, and longer still to see results. When starting a new treatment, some people can also experience skin purging: breakouts that happen when a product quickly brings clogged pores to the surface of the skin.

Montalbo’s acne cleared up within a year after seeing a dermatologist, but she was still dealing with acne scars. After that, she had to rebuild her self-confidence.

She said a strong support system was essential to getting through some of the hardest moments. Her dad, who also struggled with acne, was the one who encouraged her to see a doctor and find the right products. She also had a close friend who traveled with her overseas for a vacation during the worst of the breakouts, and mentioned in passing that she’d never even noticed Montalbo’s acne.

“When you are with the right people, they won’t mind how you look,” Montalbo said. “Because to them, what’s important is how you treat them.”