Acne
Acne is a skin condition that occurs when the oil-secreting glands in the skin are clogged and become inflamed or infected. Ninety percent of teenagers get acne.
Causation
Acne is caused by inflammation or infection of the oil glands in the skin and at the base of hair follicles. In the teenage years, hormones stimulate the growth of body hair, and the oil glands secrete more oil. The skin pores may become clogged and bacteria (propionobacterium acnes) grow in the clogged pores. When the body works to kill the bacteria, inflammation from the inflow of white blood cells causes the formation of whiteheads, blackheads, and pustules in these areas.
Symptoms
Much acne does not cause any symptoms, but it is distressing by its appearance. The lesions of acne have distinctive names:
 | whiteheads, which are closed plugged oil glands |
| blackheads, which are open plugged oil glands (the oil turns black when it's exposed to the air) |
| pustules, which are red, inflamed, infected plugged oil glands, sometimes filled with pus. |
Some pimples may become painful. In severe cases, cysts (large fluid-filled bumps) may develop under the skin.
Diagnosis
Your doctor will check your skin to see what type of problem you are having (such as blackheads or cysts). They will look to see where you are having problems, for example, your face or back. They will want to know how long you have had the problem and how you have been caring for your skin.
Treatments
Treatment is aimed at keeping oil and dirt out of the pores and reducing inflammation. You and your doctor will talk about how you are currently taking care of your skin. You will discuss:
| which products, such as soaps and lotions, you should or should not use |
| If you have been using prescription medications for your acne, bring the medicine names or containers to your appointment. |
Several products may be used to help prevent pimples or blackheads. Treatment usually begins with putting products containing benzoyl peroxide on the areas of skin with acne.
If benzoyl peroxide alone is not effective, then you may also need to put antibiotic medications on your skin. You may also need to use a skin cream or gel containing tretinoin (Retin-A or Renova), or others.
An oral medication called isotretinoin (Accutane) is available for severe acne. However, women must use isotretinoin very carefully. It causes birth defects if a woman becomes pregnant while she is taking the drug or if she has taken it 1 or 2 months before becoming pregnant.
Your doctor may inject large cysts with anti-inflammatory medicine so there will be less scarring.
Time course
New whiteheads usually stop appearing after 4 to 6 weeks of treatment, but you will probably need to continue the treatment for several months. Sometimes acne treatment must be continued for several years.
Many factors may worsen acne temporarily. For example, women may notice that their acne gets worse before each menstrual period. So even with proper treatment, results may vary over time. Try to discover and change, when possible, the factors in your environment or lifestyle that make the acne worse.
Self Care
Follow the full treatment prescribed by your doctor. In addition you can:
| Wash your face 2 times a day with a gentle soap. I recommend Dove or Lever 2000. |
| Change your washcloth every day (bacteria can grow on damp cloth). Wash as soon as possible after you exercise. |
| Wash your hands more frequently and avoid touching your face unnecessarily. Don't squeeze, pick, scratch, or rub your skin. Scars may form if you squeeze pimples. Don't rest your face on your hands while you read, study, or watch TV. |
| Shampoo your hair at least twice a week. Pull your hair away from your face when you sleep. Style it away from your face during the day. |
| Although researchers have not been able to show that any foods cause acne, some people have found that certain foods seem to worsen their acne. Keep a record of the foods you eat and try to see if any foods appear to make your acne worse. Then avoid those foods with a passion! |
| Avoid working in hot kitchens where greasy foods are cooked. |
| Try not to get sunburned, although light suntanning may be helpful to dry the skin. |
| Avoid extreme stress if possible. Practice stress reduction strategies such as exercise, meditation, and counseling if stress is extreme. |
| Get regular physical exercise. |
| Keep your follow-up appointments with your doctor. Keep a record of the treatments you have tried and how they have worked. There are many alternatives for us to try, so don't give up! |
Last revised: June 01, 2004