Acne

Acne typically affects teenagers, occurring during a time of dramatic hormonal shifts and rapid growth. The blackheads, whiteheads, pimples, and boil-like lesions that appear on the face, back, chest, and shoulders are a source of embarrassment and may lead to permanent scarring. Rising hormone levels during puberty cause the sebaceous glands to enlarge and produce more oil. No one knows why this process causes acne in some people but not in others. However, certain factors are known to contribute to the development of acne. They include oral contraceptives; certain medications, such as steroids, some hormones, iodides, bromides, and lithium; exposure to heavy oils, greases, or tars; trauma or irritation from tight clothing; cosmetics; and emotional stress. Acne results when small kernels of sebum (oil), skin cells, and bacteria fill up hair follicles, causing blackheads and whiteheads to appear. The sebum ruptures the walls of the follicles, forming pimples and boil-like eruptions in nearby tissue. If the sebum is further altered by bacteria, it may cause even more irritation to the surrounding skin. Acne can be treated with a variety of prescription gels, creams, and ointments. Among them are the antibacterial agent benzoyl peroxide, antibiotics such as A/T/S and Cleocin T, tretinoin (Retin-A), adapalene (Differin), and azelaic acid (Azelex). For patients with moderate to severe acne, the doctor often adds to the skin medication an oral antibiotic such as tetracycline, minocycline, doxycycline, or erythromycin. Because excess oil production in young women is often linked to high levels of the hormone androgen, for this type of patient the doctor may prescribe one of several drugs that alter hormone levels. The options include Ortho Tri-Cyclen (a low-dose birth control pill), low-dose steroid drugs such as prednisone or dexamethasone, or an antiandrogen drug such as spironolactone (Aldactone). The oral drug isotretinoin (Accutane) also inhibits the secretion of sebum, but has severe side effects and must be used cautiously.

Other acne remedies include injecting cortisone directly into the lesions and exposure to ultraviolet light. Proper cleansing techniques also are often part of the therapeutic plan.

What Is Acne

Acne is a condition of the skin that shows up as various types of bumps including whiteheads, blackheads, pimples, and cysts.  Most teens get the type of acne called acne vulgaris, which shows up on the face, neck, shoulders, back, and chest.The pores of your skin contain oil glands, which lubricates your hair and skin. Sometimes a pore may become 'clogged' with too much oil, dead skin cells, and even bacteria, causing acne.

If a pore becomes clogged, closes, and then bulges out, you have a whitehead.  If a pore becomes clogged but stays open, the top may darken and you're left with a blackhead.  Sometimes when the walls of the pore become damaged it allows bacteria and dead skin to work their way under the live skin.  This leaves you with a red, but small infection called a pimple.  Clogged pores that are open deep in the skin cause cysts which are generally infections larger than pimples.

Acne Myths

Acne is curable

Today, virtually every case of acne can be resolved. The key to getting rid of acne lesions and preventing new ones from forming lies in knowing that:

• Resolution takes time.
• What works for one person may not work for another.
• A dermatologist’s help may be required.

Resolution takes time. Treatments that promise “fast,” miraculous” or “overnight” results often capture the attention of acne sufferers hoping for quick resolution. However, the fact remains that acne does not clear overnight. On average, 6 to 8 weeks are needed to see initial results. Once acne significantly improves or clears, continued treatment is needed to keep acne from re-appearing. If acne does not improve in 6 to 8 weeks, treatment may need to be adjusted as not every acne treatment clears every case of acne.

What works for one person may not work for another. What is an appropriate treatment for one person may not clear another’s acne because many factors affect resolution, including the cause(s) of the acne, a person’s skin type and the kind of acne lesions present.

A dermatologist’s help may be required. With so many factors affecting clearance and a multitude of treatment options available (some only by prescription), a dermatologist’s help can make a difference. Before prescribing treatment, dermatologists consider several factors, including the severity of the acne, types of lesions present, co-existing conditions, as well as the patient’s age, skin type, lifestyle and motivation.

The knowledge gained from considering these factors allows dermatologists to create effective individualized therapy that will resolve the patient’s acne over time and prevent new lesions from forming.

Sometimes a dermatologist may combine two or more treatment options. A patient may be instructed to use one medication in the morning and the other at night. Or, two medications may be combined in one prescription medication. Due to possible side effects, over-the-counter medications should not be combined unless directed by a dermatologist or other medical practitioner.

Acne responds especially well to early treatment. Dermatologists recommend that acne be treated early to maximize effectiveness as well as help prevent scarring.

Acne Scarring

A detailed and comprehensive discussion of acne scars starts with causes of scarring, prevention of scarring, types of scars, and treatments for scars.

Before talking about scars, a word about spots that may look like scars but are not scars in the sense that a permanent change has occurred. Even though they are not true scars and disappear in time, they are visible and can cause embarrassment.

Macules or "pseudo-scars" are flat, red or reddish spots that are the final stage of most inflamed acne lesions. After an inflamed acne lesion flattens, a macule may remain to "mark the spot" for up to 6 months. When the macule eventually disappears, no trace of it will remain—unlike a scar.

Post-inflammatory pigmentation is discoloration of the skin at the site of a healed or healing inflamed acne lesion. It occurs more frequently in darker-skinned people, but occasionally is seen in people with white skin. Early treatment by a dermatologist may minimize the development of post-inflammatory pigmentation. Some post-inflammatory pigmentation may persist for up to 18 months, especially with excessive sun exposure. Chemical peeling may hasten the disappearance of post-inflammatory pigmentation.