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Subclinical Acne: Causes & Treatment Options

Mary Lucas, RN

Medically reviewed by Mary Lucas, RN

Written by Our Editorial Team

Last updated 1/08/2021

If you’ve spent a lot of time on skincare websites, you’ve probably seen people mention a form of acne called subclinical acne. 

Subclinical acne is a term that is sometimes used to describe  acne that’s small, colorless and in its earliest stages. It’s often used to describe comedonal acne, such as whiteheads and blackheads, that haven’t yet broken through the surface of your skin. 

You may notice subclinical acne on your forehead, cheeks, chin and other areas of your face or body. 

Although subclinical acne can be an annoyance, it’s usually an easy form of acne to treat using over-the-counter products or prescription medications.

Below, we’ve explained how acne develops, as well as the most common causes of subclinical acne breakouts. We’ve also explained what you can do to get rid of subclinical acne and stop it from coming back. 

How Acne Develops

All acne, whether it’s subclinical, small and painless or severe and inflamed, develops through the same basic process. 

Acne lesions develop when your hair follicles, or pores, become clogged. Several factors each play a role in clogged hair follicles. Of these, the two most significant are sebum and dead skin cells.

Sebum is a type of natural oil that’s secreted by the sebaceous glands in your skin. Sebum is an essential element of healthy skin, helping your skin to retain moisture and protect itself from infection and other types of damage.

Most of the time, your sebaceous glands produce and secrete just enough sebum to keep your skin healthy and moisturized. However, certain factors, such as excessive hormone production, can stimulate your sebaceous glands and cause them to secrete too much sebum.

When excess sebum builds up on the surface of your skin, it can become stuck inside your hair follicles, causing them to become clogged. Bacteria can then grow inside the clogged follicles causing them to become inflamed.

As your sebaceous glands are producing sebum, your skin is also renewing and replacing itself via a process called epidermal turnover.

Epidermal turnover, or skin cell turnover, is the biological process of replacing old skin cells with new ones. 

Over time, your skin is constantly exposed to environmental damage, whether it’s from the wind, exposure to heat, UV radiation or scratches and cuts. Epidermal turnover is your body’s process for repairing this damage. 

On average, it takes about 40 to 56 days for the epidermal turnover process to complete. While this process takes place, leftover skin cells from old layers of skin can build up on the surface of your skin. These cells can mix with sebum and contribute to blocked hair follicles and acne.

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What Causes Subclinical Acne?

Subclinical acne means mild, or early-stage acne. As a term, it’s typically used to refer to small, painless, early-stage whiteheads and blackheads. These are both types of comedonal acne, or non-inflamed acne.

Subclinical acne differs from pimples, papules and other, more obvious forms of acne in several ways:

  • It usually isn’t infected. Pimples, papules and other more severe forms of acne usually contain bacteria such as P. acnes. The presence of bacteria gives these types of acne a tender feel and a red, elevated appearance.

  • It’s non-inflammatory. Comedonal acne isn’t inflamed. Although subclinical acne might be raised above your skin, it won’t be red or swollen, and it usually won’t hurt very much when you touch it.

A large range of factors can contribute to subclinical acne, as well as other types of acne. These include:

  • Hormones. Sex hormones like testosterone and dihydrotestosterone (DHT) are linked to sebum production. Although these hormones are usually associated with men, men and women both produce testosterone, albeit in different quantities.

    During puberty, your body’s production of sex hormones surges. This is one of several reasons why acne breakouts are common during your teens.

  • Your menstrual cycle. Before and during your period, your body’s production of certain hormones fluctuates. Testosterone, estrogen and progesterone all increase, often by a significant amount.

    Just like during puberty, this sudden increase in hormone production can make your skin oilier, contributing to subclinical acne breakouts.

  • Endocrine disorders. Disorders and medical conditions that affect your production of sex hormones, such as polycystic ovarian syndrome (PCOS), can increase your risk of developing subclinical acne.

  • Genetics. Although research is still ongoing, some studies suggest that your genes may play a role in your risk of developing acne. If your parents were prone to acne, you may also be more likely to experience acne breakouts.

  • Skincare and hair products. Skincare and hair products that contain oils can clog your hair follicles and contribute to acne breakouts. Similarly, some massage oils can block your hair follicles and cause acne to develop.

  • Oily hair. Oil from your hair can easily travel onto your skin, especially if you have bangs or long hair that touches your cheeks or forehead.

  • Clothing and sports equipment. Some clothes and sports equipment, such as helmets and headbands, can press against your skin and may increase your risk of acne.

  • Stress. Although research is limited, some research suggests that severe anxiety, anger and stress may aggravate and worsen acne breakouts.

  • Smoking. Research has found that people who smoke have a higher risk of developing non-inflammatory, subclinical acne. 

How to Treat Subclinical Acne

Because subclinical acne is a relatively mild form of acne, it’s usually easy to treat. If you only get occasional acne breakouts, one or several over-the-counter products might be enough to keep your acne under control and prevent it from coming back. 

Making a few small, simple changes to your lifestyle and personal care habits can also reduce your risk of dealing with subclinical acne in the future. 

If your acne is severe or persistent, you may need to use prescription medication to clear your skin and prevent future acne breakouts. We’ve gone into more detail about all of these options below. 

Over-the-Counter Treatments

Several effective, science-based treatments for subclinical acne are available over the counter, without any need for a prescription. You can find most of these products online or in your local drugstore. Options include:

  • Facial cleansers. If you only get mild acne, try applying a gentle cleanser to the areas of face that are prone to acne. This washes away oil, skin cells and other particles that can clog hair follicles and cause subclinical acne to develop.

    If you have dry or sensitive skin, make sure to look for a safe, irritant-free cleanser that won’t cause redness or irritation.

  • Benzoyl peroxide. Benzoyl peroxide reduces sebum and stops the growth of bacteria that can contribute to acne. It’s available in numerous over-the-counter treatments for acne, such as facial cleansers, foaming washes, creams, gels and more.

  • Salicylic acid. Salicylic acid is a peeling agent that strips away the outermost layer of your skin, removing the dead skin cells that can cause subclinical acne. You can find salicylic acid in over-the-counter cleansers, masks, wipes and other products.

  • Adapalene. Adapalene is a topical retinoid that stops pimples from forming under the skin. It’s available as a gel or cream and is designed for use once per day, usually at bedtime.

    Although high-strength versions of adapalene require a prescription, you can purchase mild adapalene over the counter from most drugstores and pharmacies. 

Habits and Lifestyle Changes 

Sometimes, making a few changes to your lifestyle and skincare habits is all it takes to get rid of acne. Try the following tips and techniques:

  • Replace oil-based skin and hair care products. Skincare and hair products often use oils that can clog your hair follicles and cause acne. If you use these products, you may notice acne around your hairline and in other areas with lots of oil.

    Try to replace your current skin and hair care products with lower-oil, non-comedogenic alternatives. These use skin-friendly ingredients that are less likely to close hair follicles and affect your skin.

  • Try not to wash your face excessively. Although it’s good to wash your face once or twice a day, washing your face excessively -- especially with harsh cleansers or other products -- can dry out your skin, cause irritation and worsen acne breakouts.

    To avoid damaging your skin, wash your face once in the morning, once before bed and as soon as possible after you exercise.

  • Clean your skin gently. Just like washing excessively, scrubbing your skin harshly can cause irritation, increasing your risk of dealing with subclinical acne. Try to clean your face as gently as possible, then carefully pat it dry to avoid causing irritation.

  • Avoid sharing makeup brushes, applicators and other personal care items. These can transfer dead skin cells, oil, bacteria and other acne-causing substances from your skin to other people’s, and vice-versa.

  • Make sure not to sleep in your makeup. Sleeping with your makeup on isn’t good for your skin. Make sure that you fully remove your makeup before you go to sleep, even if you use non-comedonal makeup.

  • If you get acne, don’t pop it. While popping acne can feel good in the short term, it’s usually a bad idea. Popping or squeezing a pimple can push debris further under your skin, increasing your risk of infection, inflammation and scarring.

  • If you’re prescribed acne medication, stick with it. One of the most common acne treatment mistakes is switching rapidly from one product or another without giving the products time to work.

    Not only does this irritate your skin, but it also lowers effectiveness. If your healthcare provider recommends a certain medication for treating your acne, stick with it for six to eight weeks before you judge its results.

Prescription Medications

If your acne doesn’t respond to an over-the-counter treatment, or if it’s severe, your healthcare provider may prescribe medication. Prescription medications for subclinical acne include:

  • Tretinoin. Tretinoin is a prescription-strength topical retinoid. It’s used to treat acne, as well as wrinkles, discoloration and other signs of aging. It’s highly effective at treating acne, although it may take several months to noticeable results.

    Our guide to tretinoin and hormonal acne goes into more detail on how tretinoin works as an acne treatment. Tretinoin, alongside several other acne-fighting ingredients, can be found in our customizable acne cream.

  • Clindamycin. Clindamycin is a topical antibiotic. It slows down or stops the growth of the bacteria that can contribute to acne breakouts.

    Clindamycin usually isn’t necessary if you only have mild, occasional whiteheads and blackheads. However, your healthcare provider may prescribe it if you have a mix of subclinical acne and inflamed acne, such as pimples, papules or cysts.

  • The birth control pill. Some hormonal birth control pills, including Yaz®, Estrostep Fe® and Ortho Tri-Cyclen®, are also approved by the FDA as prescription treatments for acne.

    These medications may help if you’re prone to hormonal acne breakouts before and during your period. We’ve talked about how they work, their benefits and more in our guide to birth control and acne

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In Conclusion

From forehead bumps to small whiteheads and blackheads around your nose, cheeks and chin, subclinical acne can be a major annoyance.

Luckily, subclinical acne is usually easy to treat. If you’re prone to subclinical acne, try using one of the over-the-counter treatments listed above to control your sebum levels and stop acne from developing. 

If these products aren’t effective, talk to your healthcare provider about prescription treatments for acne. Our customized acne cream contains clinically-proven ingredients to treat subclinical acne and is available following an online consultation with a healthcare professional. 

Learn More About Treating Acne

Tired of dealing with acne breakouts? Our guide to science-backed acne treatments goes into detail on the most powerful medications for permanently getting rid of acne, from retinoids like tretinoin to hormonal birth control and more. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.