Acne
More than 90 percent of people have acne at some point in their lives. Although many different factors play
a role in its development, acne usually begins soon after the start
of puberty. Increased hormone levels apparently cause the oil glands in
the skin to increase their production of an oily substance known as sebum. The hair
follicle, the site of acne, becomes plugged with dead skin cells, and the sebum
and bacteria tend to accumulate there, leading to pimples with redness and
discomfort.
Types of acne lesions
- Blackheads - Blackheads are formed when the pressure of the sebum and dead cells
forces the plug to the surface of the skin. The combination of the skin
pigment and dead skin cells results in the blackheads' dark color. Blackheads
are not caused by dirt, and dirt does not cause acne. Blackheads cannot be
washed or scrubbed away.
- Whiteheads - A whitehead occurs when the plug remains below the skin
surface.
Pimples, pus bumps, and cysts
When the pressure from the sebum and dead cells builds up, the trapped
material may seep through the walls of the follicle and cause redness and
discomfort. This causes the formation of pimples (papules) and pus bumps
(pustules). A cyst is a particularly deep and uncomfortable swelling associated
with acne.
Scarring may occur after papules, pustules and cysts. Once scarring occurs,
the change is permanent. However, a dermatologist may perform certain procedures
to improve the cosmetic appearance.
Precautions to take
Individuals who are prone to acne should avoid any
cosmetics and skin creams. If they must use cosmetics, the products should be water-based and/or oil-free. Skin creams that do
not cause acne (known as "non-comedogenic") should be used. Stress and emotional
tension can trigger an outbreak of acne on occasion. Foods usually do not
cause acne, but eating sensibly and in moderation is always advisable. Recent data
suggests that a high intake of processed sugars may cause worsening of
acne.
Treatment for acne
There are a number of different ways to treat acne;
therapy depends on the acne's severity and type:
- Benzoyl peroxide is a peeling agent that dries the
skin and help to prevent the growth of bacteria; it is also inflammatory.
- Topical antibiotics (those applied directly to the
skin's surface) help to destroy skin bacteria. They may be used alone or
in combination with other agents.
- Topical Vitamin A products (such as Retin-A, Retin-A
Micro, Differin, Tazorac)) are peeling agents that loosens the plugs of
skin cells. They are most helpful for blackheads and whiteheads and also
may help to prevent new acne lesions.
- Oral antibiotics decrease inflammation and decrease bacteria found inside
the skin and are most effective for acne with many papules, pustules and
cysts.
- Some oral contraceptive agents can help treat acne and may be used in
girls of child-bearing age; these medications can have other side effects though, and patients treated with them must
be followed closely by their primay doctor or a gynecologist.
- Isotretinoin (Accutane and others) is an oral
medication that should be reserved for treatment of severe forms of acne,
including the cystic and nodular forms and for those that don't respond to other types of treatment. There are many potential side
effects associated with the use of isotretinoin, and routine blood tests are checked
while on this therapy.
Most of these medications are by prescription only with the exception of some
of the benzoyl peroxide products.
Not recommended for acne
- Washing and scrubbing with harsh soaps and pads or
brushes. This may make acne worse, as well as dry and irritate the skin. Gentle cleaning
is usually best, using a gentle acne cleanser, warm water and the patients hands.
- Sunlight may offer temporary relief by masking acne
and subsequently peeling the skin. However, sun exposure is an important cause of aging and wrinkling
of the skin, and it may lead to an increased risk of skin cancer; sun
protection is always recommended.