“Acne” is a problem I often encounter in my office. It is the most common skin condition in the United States! The medical term is “acne vulgaris,” which actually means common acne.
Most people suffer from acne during their teens. It usually resolves by age 25, but some people have problems throughout middle age. It can develop on the face, back, chest, neck, shoulders, upper arms and buttock. These are areas of the skin with a high number of oil glands, which are an important ingredient in the formation of acne.
Acne starts when dead skin cells clog the pores. The oil glands continue to do what they are designed to do – make oil or “sebum.” The pores become clogged with oil. The bacteria usually found on the skin is also trapped and in this environment, the bacteria grow and multiple and a “pimple” develops.
Hormones also play a role in the development of acne. It is thought that hormones such as estrogen and testosterone can contribute to acne flares by overstimulating the oil glands. This is the reason acne is seen around puberty when hormone levels begin to rise.
We are all probably familiar with the classic pimple – which is also called a “pustule.” Acne also consists of blackheads (open comedones), whiteheads (closed comedones), papules, cysts and nodules.
The website for the American Academy of Dermatology www.aad.org has photos of the different types of acne.
Fortunately, acne is not a life-threatening condition. Well-meaning parents tell their children, “Stop worrying about a little acne, it will go away.” However, most kids do not want to hear this, especially when you tack on the word “…eventually.” Ask anyone who has suffered from this ailment. The presence of a pimple can be socially devastating. In fact, studies have shown that acne can be the cause of low self-esteem and depression particularly in the already stressful teen years. Several articles report that teens with acne have felt depressed to the point of considering suicide.
The first line of defense in preventing or decreasing the presence of acne is washing your face twice daily to remove impurities, dead skin cells and extra oil. When washing, use warm, not hot, water and a mild facial cleanser. Avoid scrubbing your skin harshly or using astringents. If necessary, you may use daily moisturizers or cosmetics labeled “noncomedogenic.”
If acne is present, there are a number of different treatments available. The first treatment usually consists of topical products or products that are applied directly to the skin, such as antibiotics, a retinoid, benzoyl peroxide or salicylic acid. These products can be used alone or in combination.
The goal of these medications is to decrease the amount of oil that the skin produces. As a result, the skin can become very dry. It is best to avoid using these medications near the eyes, around the nostrils and at the corners of the mouth.
More severe acne or cases that do not respond to topical treatments can be treated with oral antibiotics or, for women, birth control pills. Sometimes a combination of these medications is used.
If a patient’s acne is very severe or a patient has cysts with their acne, a medication known as isotretinoin may be useful. This product is known under the brand name Accutane. This medication has many side effects such as formation of very dry skin and the possibility of depression. It can only be prescribed by a dermatologist.
Finally, here are some quick tips to help prevent or minimize acne:
• Wash the skin with a mild cleanser twice daily; avoid scrubbing with cleansers containing particles.
• Do not squeeze or pick at pimples.
• Use the amount of medication recommended and use it daily as prescribed.
• Don’t focus on your acne. Look at your positive attributes.
• Remember – it will not go away overnight.