Acne

1. What is acne?
Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. Untreated acne can leave lifelong scars.

2. How does acne form?
Rising hormone levels during adolescence (puberty) cause the oil (sebaceous) glands of the skin to get bigger. The glands are connected to a hair-containing canal called a follicle. The sebaceous glands make an oily substance called sebum which reaches the surface by emptying through the opening of the follicle on to the skin surface. The oil seems to stimulate the lining of the follicle. The cells from the lining shed more rapidly and stick together, forming a plug at the skin surface. The mixture of oil and cells also helps bacteria in the follicles grow. These bacteria make chemicals that can cause the wall of the follicle to break. Then sebum, bacteria and shed skin cells spill in to the skin causing redness, swelling and pus – a pimple.

3. Does cleansing help?
Yes. For the normal care of your skin, wash your face with soap and warm water twice a day. Washing too often may actually make your acne worse. Regular shampooing is also recommended. If your hair is oily, you may want to wash it more often.

4. Does diet make a difference?
Acne is not caused by the foods you eat. Some people find that certain foods seem to make their acne worse. If that's the case, foods that clearly worsen your acne should be avoided.

5. Will sunlight improve acne?
A tan can mask your acne, but the benefits are temporary. Since sunlight ages the skin and can cause skin cancer, you should avoid sunburns and the use of sunlamps. Choose a sunscreen that is oil-free, such as a gel sunscreen.

6. Do cosmetics increase the severity of acne?
If you wear a liquid foundation or use a moisturizer, look for ones that are oil-free and not just water-based. Remove your cosmetics every night with soap and water. Shield your face when applying hairsprays and gels. If the spray comes in contact with your facial skin, it can cause whiteheads and blackheads. Mineral-based cosmetics work well for acne prone skin.

7. How is acne treated?
There are several effective treatments for acne. Your dermatologist may prescribe topical creams or lotions such as vitamin A acid or benzoyl peroxide to help unblock the pores and reduce the bacteria. There are also antibiotics that are applied to the skin. These are used in less severe cases of acne. Antibiotics taken by mouth such as tetracycline, erythromycin or minocycline are often prescribed for moderate or severe cases. The antibiotics reduce the bacteria in the follicle and may also decrease the redness directly. When taking oral antibiotics some women develop a yeast infection. Women who are taking birth control pills may notice a significant improvement in their acne, and occasionally birth control pills are used specifically for the treatment of acne. It is also important to know that oral antibiotics may decrease the effectiveness of birth control pills.

Another oral medication, isotretinoin is sometimes used for severe acne that has not responded to other treatments. Patients using isotretinoin must thoroughly understand the side effects of this drug. Frequent follow-up visits are necessary to monitor side effects. Prevention of pregnancy is a must, since the drug causes severe birth defects if taken during pregnancy.

Don't pick, scratch, pop or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation and scarring may result.

Control of acne is an ongoing process. All acne treatments work by preventing new acne. Existing blemishes must heal on their own. Improvement takes time. If your acne has not improved after 6 to 8 weeks, your dermatologist may need to change your treatment.

Content courtesy of the American Academy of Dermatology