What is Acne ?
Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s - even into their 40s - can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring. To avoid acne scarring, treating acne early is important.
Types of Acne and How Acne Forms
Acne is not caused by dirt. Testosterone, a hormone which is present in both males and females, increases during adolescence (puberty). It stimulates the sebaceous glands of the skin to enlarge, produce oil, and plug the pores. Whiteheads (closed comedones), blackheads (open comedones), and pimples (pustules) are present in teenage acne. Early acne occurs before the first period and is called prepubertal acne. When acne is severe and forms deep "pus-filled" lumps, it is called cystic acne. This may be more common in males. Adult acne develops later in life and may be related to hormones, childbirth, menopause, or stopping the pill. Adult women may be treated at the period and at ovulation when acne is especially severe, or throughout the entire cycle. Adult acne is not rosacea, a disease in which blackheads and whiteheads do not occur.
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. A flesh-tinted acne lotion containing acne medications can safely hide blemishes. Loose powder in combination with an oil-free foundation is also good for cover-up.Shield your face when applying sprays and gels on your hair.
Treatment
Control of acne is an ongoing process. 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 two to three months, your treatment may need to be changed. The treatment your dermatologist recommends will vary according to the type of acne. Occasionally, an acne-like rash can be due to another cause such as make-up or lotions, or from oral medication. It is important to help your dermatologist by providing an updated history of what you are using on your skin or taking internally. Many non-prescription acne lotions and creams help mild cases of acne. However, many will also make your skin dry. Follow instructions carefully.
Topicals
Your dermatologist may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. These products may cause some drying and peeling. Your dermatologist 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.Microdermabrasion may be used to remove the upper layers of the skin improving irregularities in the surface, contour, and generating new skin. 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, or erythromycin are often prescribed.
Birth Control Pills
Birth control pills may significantly improve acne, and may be used specifically for the treatment of acne. It is also important to know that oral antibiotics may decrease the effectiveness of birth control pills. This is uncommon, but possible, especially if you notice break-through bleeding. As a precautionary measure use a second form of birth control
Other Treatments
In cases of unresponsive or severe acne, isotretinoin 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.Photodynamic therapy using the blue wavelength of light can be helpful in treating acne as well.Your dermatologist will evaluate you and suggest the appropriate treatment regimes considering your age, sex, and the type of acne you have.
Treatment of Acne Scarring
The dermatologist can treat acne scars by a variety of methods. Skin resurfacing with laser, dermabrasion, chemical peels, or electrosurgery can flatten depressed scars. Soft tissue elevation with collagen or fat-filling products can elevate scars. Scar revision with a microexcision and the punch grafting technique can correct pitted scars, and combinations of these dermatologic surgical treatments can make noticeable differences in appearance.
