March 29, 2021 0

Acne. A compendium of knowledge

Your skin has tiny holes called pores that can become blocked by oil, bacteria, dead skin cells and dirt. When this happens, a pimple or "zit" can appear. If your skin is repeatedly affected by this condition, you may have acne.

According to the American Academy of Dermatology, acne is the most common skin condition in the United States. Although acne is not a life-threatening condition, it can be painful, especially when severe. It can also cause emotional distress.

Acne that appears on the face can affect self-esteem and can cause permanent physical scarring over time.

There are many effective acne treatments that reduce both the number of pimples you get and the chance of scarring.

What are the symptoms of acne?

Acne can be found almost anywhere on your body. It most often develops on your face, back, neck, chest, and arms.

If you have acne, you will usually notice pimples that are white or black. Both blackheads and whiteheads are called comedones.

Blackheads open up on the surface of the skin, giving them a black appearance because of the oxygen in the air. Whiteheads are closed just below the surface of the skin, giving them a white appearance.

While whiteheads and blackheads are the most common lesions found in acne, other types can also occur. Inflammatory lesions are more likely to cause scarring of the skin. These include:

  • Blisters are small, red, raised bumps caused by inflamed or infected hair follicles.
  • Voids are small, red pimples that have pus at their tips.
  • Nodules are solid, often painful lumps under the surface of the skin.
  • Cysts are large lumps under the skin that contain pus and are usually painful.

What causes acne?

Acne occurs when skin pores become blocked by oil, dead skin, or bacteria.

Each skin pore is an opening for a follicle. The follicle consists of a hair and a sebaceous (oil) gland.

The oil gland releases sebum (oil), which travels up the hair, out of the pore and onto the skin. Sebum keeps your skin moisturized and soft.

One or more problems in this lubrication process can cause acne. It can occur when:

  • too much oil is produced by the follicles.
  • dead skin cells accumulate in your pores
  • bacteria accumulate in your pores

These problems contribute to the development of pimples. A pimple occurs when bacteria grow in clogged pores and oil is unable to escape.

What are the risk factors for developing acne?

Myths about what contributes to the development of acne are quite common. Many people believe that foods such as chocolate and chips contribute to the development of acne. While there is no scientific support for these claims, there are some risk factors for developing acne. These include:

  • hormonal changes due to puberty or pregnancy
  • certain medications, such as certain birth control pills or corticosteroids
  • a diet high in refined sugars or carbohydrates, such as bread and chips
  • having parents who have had acne

People are most at risk for developing acne during puberty. During this time, the body undergoes hormonal changes. These changes can trigger oil production, leading to an increased risk of acne. Hormonal acne associated with puberty usually goes away, or at least improves, when you reach adulthood.

How is acne diagnosed?

If you have symptoms of acne, your doctor can make a diagnosis by examining your skin. Your doctor will determine the types of lesions and their severity to determine the best treatment.

How is acne treated?

Home Care
There are several self-care measures you can try at home to prevent pimples and clear up acne. Home remedies for acne include:

  • Cleaning your skin daily with mild soap to remove excess oil and dirt
  • Shampooing your hair regularly and keeping it away from your face.
  • Using makeup that is water-based or labeled "non-comedogenic" (not clogging pores)
  • not squeezing or picking at pimples, which spread bacteria and excess oil
  • not wearing hats or tight headbands
  • not touching your face

If self-care does not help your acne, there are several over-the-counter acne medications available. Most of these medications contain ingredients that can help kill bacteria or reduce the amount of oil on your skin. These include:

  • Benzoyl peroxide is present in many acne creams and gels. It is used to dry up existing blemishes and prevent new ones from forming. Benzoyl peroxide also kills the bacteria that cause acne.
  • Sulfur is a natural ingredient with a distinctive smell that is found in some lotions, cleansers and masks.
  • Resorcinol is a less common ingredient used to remove dead skin cells.
  • Salicylic acid is often used in soaps and acne washes. It helps prevent clogged pores.

Sometimes you may experience further symptoms. If this happens, you may want to seek medical advice. Your doctor may prescribe medications that can help reduce symptoms and prevent scarring. These include:

Oral or topical antibiotics reduce inflammation and kill the bacteria that cause pimples. Usually, antibiotics are only used for a short time so that the body does not build up immunity and become susceptible to infection.
Prescription topical creams, such as retinoic acid or prescription benzoyl peroxide, are often stronger than over-the-counter treatments. They work to reduce oil production. Benzoyl peroxide serves as an antibacterial agent that prevents acne-causing bacteria from becoming resistant to antibioticsTrusted Source. It also has moderate comedone destroying and anti-inflammatory properties.
Women with hormonal acne may be treated with birth control pills or spironolactone. These medications regulate the hormones that can cause acne by reducing oil production.

Isotretinoin (Accutane) is a vitamin A-based drug used to treat some cases of severe nodular acne. It can cause serious side effects and is only used when other treatments do not work.

Your doctor may recommend treatments to treat severe acne and prevent scarring. These treatments involve removing damaged skin and reducing oil production. They include:

Photodynamic therapy uses drugs and a special light or laser to reduce oil and bacteria production. Other lasers can be used alone to improve acne or scarring.
Dermabrasion removes the top layers of skin with a rotating brush and would be best for treating acne scars as opposed to treating acne. Microdermabrasion is a gentler treatment that helps remove dead skin cells.

A chemical peel removes the top layers of the skin. This skin exfoliates, revealing less damaged skin underneath. Chemical peels can improve mild acne scars.
If your acne consists of large cysts, your doctor may suggest cortisone injections. Cortisone is a steroid naturally produced by the body. It can reduce inflammation and speed healing. Cortisone is usually used along with other acne treatments.

What is the outlook for someone with acne?

Treatment for acne is often effective. Most people can expect their acne to start clearing up within six to eight weeks. However, acne occurs frequently and may require additional or long-term treatment. Isotretinoin is the treatment most likely to produce lasting or long-term positive results.

Acne scars can cause emotional distress. But prompt treatment can help prevent scarring. In addition, your dermatologist will have scar treatment options.

How can acne be prevented?

It is difficult to prevent acne. But you can take steps at home to prevent acne after treatment. These steps include:

  • washing your face twice a day with an oil-free cleanser
  • using an acne cream to remove excess oil.
  • avoiding makeup that contains oil
  • removing makeup and thoroughly cleansing your skin before bed
  • showering after exercising
  • avoiding tight clothing
  • eating a healthy diet with a minimum of refined sugars
  • reducing stress

Talk to your doctor to learn more about acne management strategies.

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