Acne

Acne is a skin condition that causes whiteheads, blackheads, and inflamed red lesions (papules, pustules, and cysts) to form. These growths are commonly called pimples or "zits."

Causes

Acne occurs when tiny holes on the surface of the skin, called pores, become clogged. Each pore is an opening to a canal called a follicle, which contains a hair and an oil gland. Normally, the oil glands help keep the skin lubricated and help remove old skin cells. When glands produce too much oil, the pores can become blocked, accumulating dirt, debris, and bacteria.

The top of the plug may be white (whitehead) or dark (blackhead). If the plug ruptures, the material inside, including bacteria and oil, can spread to the surrounding area and cause inflammation. If the inflammation is deep, the pimples may enlarge to form firm, painful cysts.

Acne tends to run in families and can be triggered by:

  • Hormonal changes related to menstrual periods, pregnancy, birth control pills, or stress
  • Greasy or oily cosmetic and hair products
  • High levels of humidity and sweating

Acne commonly appears on the face and shoulders, but may also occur on the trunk, arms, legs, and buttocks.

Acne is most common in teenagers, but it can happen at any age, even as an infant. Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. However, people in their 30s and 40s may also have acne.

Symptoms

  • Blackheads/Whiteheads
  • Crusting and redness of skin eruptions
  • Cysts/ Pustules
  • Scarring

Treatment

The following self-care steps will lessen the effects of acne:

  • Clean your skin gently with a mild, nondrying soap (such as Dove, Neutrogena, or Basics). Remove all dirt or make-up. Wash once or twice a day, including after exercising.
  • Shampoo your hair daily, especially if it is oily. Comb or pull your hair back to keep the hair out of your face. Avoid tight headbands.
  • Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to skin infections and scarring.
  • Avoid touching your face with your hands or fingers.
  • Avoid greasy cosmetics or creams. Look for water-based or "noncomedogenic" formulas. Take make-up off at night. Noncomedogenic products have been tested and proven not to clog pores and cause acne.

*If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These products are applied directly to the skin.

Prescription Medication

Prescription medicines include:

  • Oral antibiotics (taken by mouth) such as Minocycline, Doxycycline, Tetracycline, Erythromycin, and Amoxicillin
  • Topical antibiotics (applied to the skin) such as Clindamycin, Erythromycin or Dapsone
  • Retinoic acid cream or gel (Retin-A) and Isotretinoin pills (Accutane) -- pregnant women and sexually active adolescent females should NOT take Accutane, as it causes severe birth defects.
  • Prescription formulas of Benzoyl Peroxide, Sulfur, Resorcinol, Salicylic Acid.
  • A pill called Spironolactone may help women with hormonally controlled acne.
  • A laser procedure called photodynamic therapy, available at Alphaderm may also be helpful.
  • Birth control pills can sometimes help clear up acne.

Expectations

Acne usually subsides after adolescence, but it can last into middle age. The condition generally responds well to treatment after 6 - 8 weeks, but may flare from time to time. Scarring may occur if severe acne is left untreated. Some people, especially teenagers, can become significantly depressed if acne is not treated.

Complications

Possible complications include:

  • Changes in skin color
  • Cysts
  • Damage to self-esteem, confidence, personality, and social life
  • Permanent facial scars

Contact

Contact Dr. Tomi/Alphaderm if:

  • Self-care measures and over-the-counter medicine have not helped after several months
  • Your acne is severe (for example, you have lots of redness around the pimples or you have cysts) or getting worse
  • You develop scars as your acne clears up
  • If your baby has acne that does not clear up on its own within 3 months.

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