Acne

Medical Dermatology

Skin Conditions

 

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Acne Information

Acne is a skin condition of blackheads, whiteheads, inflamed pimples, and cysts. Acne can occur on the face most commonly, but also may involve the trunk. Most teenagers get some form of acne but adults can develop acne as well. Acne can be disfiguring and upsetting to the patient. Untreated, acne can leave permanent scars.

Acne is caused by a combination of factors. Hormones which increase during adolescence (puberty) stimulate the sebaceous glands of the skin to enlarge, produce oil, and plug the pores. Bacteria colonize those pores and cause localized infection.

Early forms of acne can occur before the first period. This is called prepubertal acne and consists of predominantly blackheads. Most teens have a combination of blackheads, whiteheads and some inflammatory bumps. When acne is severe and forms deep painful lumps, it is called cystic acne. This may be more common in males. Adult acne develops later in life and may be related to hormones, childbirth, menopause, or stopping the pill. Adult women may sometimes be treated just during the week of the month when they typically flare. Cleansing

Acne has little to do with washing your face. It is best to wash your face with a mild cleanser and warm water daily to remove excess oil and any make-up. Washing too often or too vigorously may actually make your acne worse.

Diet
Acne is not usually caused by foods. However, if certain foods seem to make your acne worse, try to avoid them.

Cosmetics
If you wear cosmetics, select oil-free moisturizers and make-up. Choose products that are "non-comedogenic" (should not cause whiteheads or blackheads). Remove your cosmetics every night with mild soap or gentle cleanser and water.

Treatment
Control of acne is an ongoing process and works by preventing new acne breakouts. Existing blemishes must heal on their own, and therefore, improvement takes time. If your acne has not improved within two to three months, your treatment may need to be changed. The treatment your dermatologist recommends will vary according to the type of acne.

Occasionally, an acne-like rash can be due to another cause such as make-up or lotions, or from oral medication. It is important to help your dermatologist by providing an updated history of what you are using on your skin or taking internally.

Many non-prescription acne lotions and creams help mild cases of acne. However, many will also make your skin dry. Follow instructions carefully.

Topicals
Your dermatologist may prescribe topical prescription products designed to unblock the pores and reduce bacteria. These products may cause some drying and peeling. Your dermatologist will advise you about correct usage.

Inform your doctor if you are pregnant or nursing, or if you are trying to get pregnant.

Special Treatments
Acne surgery may be used by your dermatologist to remove blackheads and whiteheads.

Microdermabrasion removes the upper layers of dead skin cells which helps keep pores open and unplugged.

Light chemical peels with salicylic acid or glycolic acid help to unblock the pores as well.

Injections of corticosteroids may be used for treating large red cysts. This may help them go away more quickly.

Oral
Oral antibiotics such as tetracycline, doxycycline, minocycline, or erythromycin are often prescribed and work by getting to the skin from the bloodstream.

Birth Control Pills
Birth control pills may significantly improve acne but it is important to know that oral antibiotics may decrease the effectiveness of birth control pills. This is uncommon, but possible, especially if you notice break-through bleeding. As a precautionary measure use a second form of birth control.

Other Treatments
In cases of unresponsive or severe and scarring acne, isotretinoin may be prescribed. There are a number of potential side effects to this oral medication. Monitoring with frequent follow-up visits and blood testing is necessary. Pregnancy must be prevented while taking the medication, since the drug causes birth defects.

Certain hormones or medications that decrease the effects of male hormones may be taken to help acne in females.

Photodynamic therapy using specific wavelengths of light can be helpful in treating acne as well.

Skin care
No matter what special treatments your dermatologist may use, remember that you must continue proper skin care. Acne is not curable, but it is controllable; proper treatment helps you to feel and look better and may prevent scars.