Acne

Acne is a very common skin problem that shows up as outbreaks of bumps called pimples or zits. Acne usually appears on the face, neck, back, chest, and shoulders. Acne can be a source of emotional distress, and severe cases can lead to permanent acne scars.

What causes acne?

Acne begins when the pores in the skin become clogged and can no longer drain sebum (an oil made by the sebaceous glands that protects and moisturizes the skin.) The sebum build-up causes the surrounding hair follicle to swell.

Acne Sketch
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Hair follicles swollen with sebum are called comedones. If the sebum stays beneath the skin, the comedones produce white bumps called whiteheads. If the sebum reaches the surface of the skin, the comedones produce darkened bumps called blackheads. This black discoloration is due to sebum darkening when it is exposed to air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.

Bacteria called Propionibacterium acnes (P. acnes) that normally live on the top of the skin can enter the clogged pores and infect the sebum. This causes the skin to become swollen, red, and painful.

Infected sebaceous glands may burst, releasing sebum and bacteria into the surrounding skin, creating additional inflammation. In severe cases, larger nodules and cysts may form in the deeper layers of the skin.

What are the different types of acne?

Acne can be categorized by its severity:

Acne - severe, cystic acne on forehead
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  1. Mild acne describes a few scattered comedones (whiteheads or blackheads) with minimal inflammation (no pustules).

  2. Moderate acne describes a denser collection of comedones as well as red, inflamed, pus-filled lesions (pustules).

  3. Severe acne, also called nodular or cystic acne, describes widespread and deep lesions that are painful, inflamed, and red. This form of acne is likely to lead to scarring if left untreated.

Who gets acne?

Anyone at any age can get acneAcne in teenagers is very common because the surging hormone levels (androgens) associated with puberty create more active sebaceous glands.

Acne in adults is is also very common, especially among women.

Acne is more likely to afflict people whose parents had acne.

What factors make acne worse?

Acne lesions can come and go. These factors can cause acne to flare:

  • Changing hormone levels in women 2 to 7 days before their menstrual period, during pregnancy, or when starting or stopping birth control pills

  • Oil from skin products (moisturizers or cosmetics) or grease in the workplace (for example, a kitchen with fry vats)

  • Pressure from sports helmets or equipment, backpacks, tight collars, or tight uniforms

  • Environmental irritants, such as pollution and high humidity

  • Squeezing or picking at blemishes

  • Hard scrubbing of the skin

What acne treatments are available?

Almost all cases of acne can be effectively treated. The goal of acne treatment is to heal existing lesions, stop new lesions from forming, and prevent acne scars.

Different acne medications are available that control one or more of the underlying causes of acne. Common classes of acne medications include the following:

  • Topical retinoids help unclog sebaceous glands and keep skin pores open.

  • Antibiotics, such as doxycycline and minocycline (Solodyn), may be used to fight the P. acnes bacteria.

  • Isotretinoin (Accutane) or hormonal agents, such as birth control pills, may be used to reduce sebum (oil) production.

Your doctor will prescribe acne medications based on the following factors:

  • Severity of your acne. Mild acne may respond well to a topical retinoid alone. Moderate acne may respond better to a combination of topical retinoid with an antibiotic or other medication. Severe acne with scarring may need treatment with isotretinoin, the active ingredient of Accutane (Amnesteem, Sotret).

  • Results of previous treatments. Medications may be added in a step-wise fashion, only if previous treatments are found to be ineffective.

  • Degree of scarring. More aggressive therapies may be started earlier if acne scars have already started developing.

  • Gender. Some treatments are available only for females, such as birth control pills.

Non-prescription acne medications may provide sufficient results for some people with mild acne. However, most people with moderate acne and all with severe acne will need to use prescription acne medications for effective treatment.

Whatever your treatment plan, it is important that you give it enough time to work. This may mean waiting 6 to 8 weeks to see results. While the older acne lesions are healing, the medication is hard at work keeping new lesions from forming. Staying on your medication is the most important step to getting acne under control.

How can I keep my acne under control?

After your acne clears, your doctor may recommend that you continue therapy with a topical retinoids to keep it under control. It is always a good idea to maintain good skin care and use skin care products labeled as “non-comedogenic” (do not promote acne)

For ongoing acne skin care and prevention of acne, follow a few simple guidelines:

  • Clean skin gently—Use a mild skin cleanser twice a day, and pat skin dry. Harsh cleansers and astringents can actually worsen acne.

  • Do not pop, squeeze, or pick at acne lesions, as this can promote inflammation and infection. Keep hands away from your face and other acne-prone parts of the skin.

  • Limit sun exposure—Tanning only masks acne at best. At worst, sun exposure can lead to skin damage, especially if you are using an acne treatment that makes your skin more sensitive to sunlight and UV rays (this includes tanning booths).

  • Choose cosmetics with care—As mentioned above, choose non-greasy skin products, and look for words like “non-comedogenic,” “oil-free,” and “water-based." Some facial products contain active acne-fighting ingredients, such as benzoyl peroxide or salicylic acid, to help keep mild acne at bay.

  • Be patient with your treatment—Find out how much time it should take for your acne treatment to work (generally 6-8 weeks) and then stick with it. Stopping treatment early may prevent you from seeing good results or even cause a relapse of symptoms. Your skin may look worse before it begins to improve. You may need to try more than one type of treatment.

Acne in Teenagers

Acne afflicts nearly every teenager at some point during adolescence, but that doesn’t make it easier to bear. The emotional toll of acne is a familiar problem for many young people and can wreak havoc on adolescent self-confidence. Fortunately, almost all cases of acne are treatable.
Teenage Acne in adolescents

Who gets acne?

Anyone of any age can get acne, even adults, but it is most common in teenagers. In fact, acne is considered a normal part of adolescence. 100% of the population can expect to have acne at some time during adolescence, regardless of race or ethnicity. During puberty, elevated hormone levels stimulate higher sebum production than usual, increasing the chance of acne flares.

Boys are more likely to get it during adolescence because their skin tends to produce more sebum. In adulthood, women are more prone to acne than men, likely because of the hormonal swings of menstruation, pregnancy, and menopause.

People with a family history of acne are also more likely to get acne.

How is teen acne treated?

It is important to treat acne early to prevent the development of acne scars.

There are a wide range of acne treatments available. Your doctor will recommend an acne treatment based on the location and severity of acne, response to previous treatment and other factors.

  • Many people attempt to first treat their acne at home with non-prescription medications that include benzoyl peroxide (Clearasil, Proactiv) or salicylic acid. Unfortunately, many people discover that these over-the-counter medications take too long to work, prolonging the acne and increasing the risk of developing acne scars.

  • For mild acne or moderate acne doesn’t respond to over-the-counter treatments, you may need a stronger prescription acne medication that acts faster and provides longer-lasting benefits. Physicians may prescribe a topical retinoid, a mainstay of acne therapy. Topical retinoids help to clear up acne quickly and provide ongoing clear skin. Brands of topical retinoids include Differinâ„¢(adapalene), Epiduoâ„¢(adapalene + benzoyl peroxide), Retin A Microâ„¢(tretinoin), Tazoracâ„¢(tazarotene), or Zianaâ„¢(tretinoin + clindamycin). These medications may be used alone or in combination with other acne medications, such as antibiotics.

  • For the most severe cases of acne (such as cystic acne), physicians may prescribe isotretinoin (Accutane, Sotret). This daily oral medication has shown to be an effective treatment when other medications have failed, but it has serious possible side effects and should never be taken by pregnant women. Women using isotretinoin must agree to use two types of birth control, and abstain from sex within a month before and after taking the medication.

Sports and acne mechanica

Teens who play sports, wear a backpack, or play a musical instrument that comes into contact with the face and neck may get a form of acne called acne mechanica. This type of acne is caused by irritation to the skin from excessive heat or sweat, friction, or pressure. These are common causes of acne mechanica:

  • Helmets and helmet straps, especially those worn by football and hockey players and motorcycle riders

  • Shoulder pads and straps worn by football players

  • Tight clothing, particularly jeans, underwear (bras) or uniforms made of synthetic fabric

  • Tight hats or headbands worn for long periods of time

  • Backback straps

  • Musical instruments, such as the violin, tucked against the neck for hours

Stick with your acne treatment

No acne medication can do its job properly unless it is given time to work. It’s very important to be patient and take your medication as directed, for as long as directed.

If you don’t see results right away, don’t be discouraged. Your medication is hard at work preventing new lesions from forming. Stopping treatment early will likely cause pimples and zits to reappear.

Acne Myths and Acne Skin care

There are a lot of acne myths regarding the cause acne and possible home remedies. It is important to learn what is true, and what is not.

Acne can be aggravated by oily cosmetics, stress, picking at blemishes, rough cleansers, or hard scrubbing. It is important to follow basic acne skin care tips to get acne under control, and keep it under control

Acne isn't caused directly by eating sugar, chocolate, or greasy foods. However, there is some evidence that eating too many carbohydrates (sugars, pastas, bread, sodas) might be related to the development or worsening of acne. It is generally a good idea to limit the consumption of such snacks. (Acne and diet).

Although a suntan can temporarily lessen the appearance of acne lesions, it won’t make them go away. The ultraviolet light can also lead to significant skin irritation among those using acne medications, and the sun can damage the skin in other ways (wrinkles, skin cancer).

Overall it is best for everyone, even those with acne, to regularly use sunscreen and follow basic sun protection measures.

Acne Myths

Myth #1:Â Acne is caused by poor hygiene

If you believe this myth and wash your skin hard and frequently, you can actually make your acne worse. Acne is not caused by dirt or surface skin oils. Although excess oils, dead skin, and a day's accumulation of dust on the skin look unsightly, they should not be removed by hard scrubbing. Vigorous washing will actually irritate the skin and make acne worse. The best approach to hygiene and acne: Gently wash your face twice a day with a mild soap, pat dry--and use an appropriate acne treatment for the acne.

Myth #2: Acne is caused by diet

Extensive scientific studies have failed to find a connection between diet and acne. In other words, food does not cause acne. Not chocolate. Not french fries. Not pizza. Nonetheless, some people insist that certain foods affect their acne. In that case, avoid those foods. Besides, eating a balanced diet always makes sense. However, according to the scientific evidence, if acne is being treated properly, there's no need to worry about food affecting the acne.

Myth #3: Acne is caused by stress

The ordinary stress of day-to-day living is not an important factor in acne. Severe stress that needs medical attention is sometimes treated with drugs that can cause acne as a side effect. If you think you may have acne related to a drug prescribed for stress or depression, consult your physician.

Myth #4: Acne is just a cosmetic disease

Yes, acne affects only one's appearance and is not otherwise a serious threat to a person’s physical health. However, it can result in permanent physical scars. Acne and acne scars can affect the way people feel about themselves to the point of disrupting their confidence and self-worth.

Myth #5: You just have to let acne run its course

The truth is, acne can be cleared up. If the over-the-counter acne medications you have tried haven’t worked, consider seeing a dermatologist. With the products available today, there is no reason why someone has to endure acne or get acne scars.

 

Tip of the day >>

Remove makeup before going to bed and cleanse the skin thoroughly. Use facemasks or exfoliate regularly to remove dead skin cells and freshen the skin.

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