Acne

Acne is the most frequent skin condition in the United States. It is characterized by plugged pores (blackheads and whiteheads), inflamed pimples (pustules) and deeper lumps (nodules and cysts) that appear on the face, back and chest. Every year, about 80% of adolescents have some form of acne and about 5% of adults experience acne.

Acne occurs on the face, as well as the neck, chest, back, shoulders, and upper arms. Although most teenagers get some form of acne, adults in their 20's, 30's, 40's or even older, can develop acne. Often, acne clears up after several years, even without treatment. Acne can be disfiguring and upsetting to the patient. Untreated acne can leave permanent scars; these may be treated by your dermatologist in the future. To avoid acne scarring, treating acne is important.

Causes

In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. The sebum moves from the bottom to the top of each hair follicle and then spills out onto the surface of the skin, taking with it sloughed-off skin cells. With acne, the structure through which the sebum flows gets plugged up with dead skin cells. This blockage traps sebum and cells below the skin, preventing them from being released onto the skin's surface. Bacteria on the skin can then become involved and cause inflammation which results in a pustule (pimple).

Cleansing - Acne has nothing to do with not washing your face. However, it is best to wash your face with a mild cleanser and warm water daily. Washing too often or too vigorously may actually make your acne worse.

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

Cosmetics - Wear as little cosmetics as possible. Oil-free, water-based moisturizers and make-up should be used. Choose products that are "non-comedogenic" (should not cause whiteheads or blackheads) or "non-acnegenic" (should not cause acne). Remove your cosmetics every night with mild soap or gentle cleanser and water.

Treatment

Treating acne is a relatively slow process; there is no overnight remedy. All acne treatments work by preventing new acne breakouts. Existing blemishes must heal on their own and therefore improvement takes time. If your acne has not improved within 2-3 months, your treatment may need to be changed.

Topicals

• We may prescribe topical creams, gels, or lotions with vitamin A-like medications (retinoids), benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. These products may cause some drying and peeling. We will advise you about correct usage and how to handle side effects.
• Before starting any medication, even topical medications, 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. Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, and scarring may result.
• Light chemical peels with salicylic acid or glycolic acid help to unblock the pores, open the blackheads and whiteheads, and stimulate new skin growth.
• Injections of corticosteroids may be used for treating large red bumps (nodules). This may help them go away quickly.

Oral

• Antibiotics taken by mouth such as tetracycline, doxycycline, minocycline, erythromycin or sulfa antibiotics are often prescribed.

Birth Control Pills

• Birth control pills may significantly improve acne, and may be used specifically for the treatment of acne in women.

Other Treatments

• In cases of unresponsive or severe acne, isotretinoin (Accutane) a vitamin A derivative may be used. Patients using isotretinoin must understand the side effects of this drug. Monitoring with frequent follow-up visits is necessary. Pregnancy must be prevented while taking the medication, since the drug causes birth defects.
• Women may also use female hormones or medications that decrease the effects of male hormones to help their acne.

We will evaluate your skin and acne and suggest the appropriate treatment regimes considering your age, sex and the type of acne you have.