ACNE

Teenager with acne

Acne is the most common skin condition in the United States. Although it’s common, accurate information about acne can be scarce. Hopefully, this information can help you understand acne and how to successfully treat it.

Why treat acne?

Acne comes in many forms and types and affects all people differently.   For some people, acne blemishes are embarrassing and hurt self-esteem.  For others, acne can cause discoloration and dark spot or even permanently scar the skin as the acne clears. Fortunately, there are many effective treatments available today.

More women getting acne

Not just teens have acne. A growing number of women have acne in their 30s, 40s, 50s, and beyond. Dermatologists are not sure why this is happening. But dermatologists understand that adult acne can be particularly frustrating.

Acne signs

Many people think that acne is just pimples, but a person who has acne can have any of these blemishes:

• Blackheads.
• Whiteheads.
• Papules.
• Pustules (what many people call pimples).
• Cysts.
• Nodules.

Acne can appear on the back, chest, neck, shoulders, upper arms and buttocks.

Acne symptoms

Studies show that people who have acne can have:

• Low self-esteem: Many people who have acne suffer from low self-esteem. This can lead to avoidance of school, work, friends and social functions.
• Depression: Some who have acne can suffer from more than just low self-esteem. Some patients can develop depression. Depression is a medical condition that can lead to thoughts of suicide. Many studies have reported that teens who feel they have “bad” acne have had suicidal ideations.
• Dark spots on the skin: These spots appear when the acne heals. It can take months or years for dark spots to disappear.
• Scars (permanent): Scars from acne are more prevalent in people who have acne cysts and nodules. The scars form after the acne clears but they can be prevented by treating the acne before cysts and nodules appear. If you have a family history of someone with acne scarring or acne cysts/nodules, you should see a dermatologist when you begin having problems with acne.

Who gets acne?

If you have a bad case of acne, you may feel like you are the only one. But many people have acne. It is the most common skin problem in the United States. About 40 to 50 million Americans have acne at any one time.

Most people who have acne are teenagers or young adults, but acne can occur at any age. Newborn babies can get acne. Men and women get acne. Some women get acne when they reach middle age.

Young woman with acne

What causes acne?

Acne is caused by a clogged skin pore. This clog occurs when dead skin cells stick together inside the pore instead of rising to the surface of the skin where they would normally be shed by the body.  Usually sebum, the oil that keeps our skin from drying out, is the “glue” that sticks these dead skin cells together.

Bacteria that live on all skin can also get inside the clogged pore. Once inside, the bacteria multiply rapidly.  This causes the pore to become inflamed (red and swollen).  If the inflammation goes deeply into the skin, a cyst or nodule will appear.

How do dermatologists treat acne?

There are many effective treatments for acne today. Not every treatment will work for every person and it can take a few different treatment regimens to find the right one for your skin.

Some people with very mild acne can treat themselves with over-the-counter products usually containing benzoyl peroxide or salicylic acid. Some patients will need topical prescription products to control their acne.  Others will need a combination of prescription topical and oral medications, Isotretinoin (brand name Accutane), laser treatments, or chemical peels.

Despite what has been shown in TV commercials, there is no product that will clear acne overnight. Most acne treatments, including prescription products, can take 4 to 8 weeks to show improvement.  Some may even cause the acne to worsen before it gets better.  After acne clears, it will be necessary to maintain a skin care routine to keep it at bay.

When to see a dermatologist

If you are having lots of acne, cysts, or nodules, and your over-the-counter products are not helping, it is probably time to go to a dermatologist. Your dermatologist can offer different types of treatments including:

• Acne treatment that you apply to the skin: Most acne treatments are applied directly to the skin; these are called “topical treatments”. There are many topical acne treatments that can range from killing the bacteria on the skin to reducing the oils produced by the skin.

• Acne treatment that works throughout the body: Depending on your type and severity of acne, you may need to take an oral medication such as the following:
  • Antibiotics (helps to kill bacteria and reduce inflammation).
  • Birth control pills and other medicine that works on hormones (can be helpful for women).
  • Isotretinoin (brand name Accutane – the only treatment that works on all that causes acne).
• Procedures that treat acne: Your dermatologist may treat your acne with a procedure that can be performed during an office visit. These treatments include:

• Laser treatments: Laser treatments are used to reduce the amount of bacteria on your skin.
• Chemical peels: You cannot buy the chemical peels that dermatologists use. Dermatologists use chemical peels to treat 2 types of acne — blackheads and papules.
• Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar.

Acne: Tips for managing

Young woman applying cleanser

You can reduce your acne by following these skin care tips from dermatologists.

1. Wash twice a day and after sweating. Perspiration, especially when wearing a hat or helmet, can make acne worse, so wash your skin as soon as possible after sweating.
2. Use your fingertips to apply a gentle, non-abrasive cleanser. Using a washcloth, mesh sponge or anything else can irritate the skin.
3. Be gentle with your skin. Use gentle products, such as those that are alcohol-free. Do not use products that irritate your skin, which may include astringents, toners and exfoliants. Dry, red skin makes acne appear worse.
4. Scrubbing your skin can make acne worse. Avoid the temptation to scrub your skin.
5. Rinse with lukewarm water.
6. Shampoo regularly. If you have oily hair, shampoo daily.
7. Let your skin heal naturally. If you pick, pop or squeeze your acne, your skin will take longer to clear and you increase the risk of getting acne scars.
8. Keep your hands off your face. Touching your skin throughout the day can cause flare-ups.
9. Stay out of the sun and tanning beds. Tanning damages you skin. In addition, some acne medications make the skin very sensitive to ultraviolet (UV) light, which you get from both the sun and indoor tanning devices.
   • Using tanning beds increases your risk for melanoma, the deadliest form of skin cancer, by 75 percent.
10. Consult a dermatologist if:
    • Your acne makes you shy or embarrassed.
    • The products you’ve tried have not worked.
    • Your acne is leaving scars or darkening your skin.

Today, virtually every case of acne can be successfully treated. Dermatologists can help treat existing acne, prevent new breakouts and reduce your chance of developing scars. If you have questions or concerns about caring for your skin, you should make an appointment to see a dermatologist.