What is Acne?
Acne is a disorder resulting from the action of hormones and other substances on the skin’s oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Although acne is usually not a serious health threat, it can be a source of significant emotional distress. Severe acne can lead to permanent scarring.
Why should I be concerned?
Without treatment, dark spots and permanent scars can appear on the skin as acne clears. Treating acne also often boosts a person’s self-esteem.
What are the causes of Acne?
The cause of acne is unknown. Doctors think certain factors might cause it:
- The hormone increase in teenage years (this can cause the oil glands to plug up more often);
- Hormone changes during pregnancy;
- Starting or stopping birth control pills;
- Heredity (if your parents had acne, you might get it, too);
- Some types of medicine;
- Greasy makeup.
Some things can make acne worse:
- Changing hormone levels in teenage girls and adult women 2 to 7 days before their period starts;
- Pressure from bike helmets, backpacks, or tight collars;
- Pollution and high humidity;
- Squeezing or picking at pimples;
- Hard scrubbing of the skin.
Who is at risk of Acne?
People of all races and ages get acne. It is most common in adolescents and young adults. An estimated 80 percent of all people between the ages of 11 and 30 have acne outbreaks at some point. For most people, acne tends to go away by the time they reach their thirties; however, some people in their forties and fifties continue to have this skin problem.
What are the symptoms of Acne?
Acne can cause more than blemishes. Studies show that people who have acne can have:
- Low self-esteem: Many people who have acne say that their acne makes them feel bad about themselves. Because of their acne, they do not want to be with friends. They miss school and work. Grades can slide, and absenteeism can become a problem because of their acne.
- Depression: Many people who have acne suffer from more than low self-esteem. Acne can lead to a medical condition called depression. The depression can be so bad that people think about what it would be like to commit suicide. Many studies have found that teens who believe that they have “bad” acne were likely to think about committing suicide.
- 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): People who get acne cysts and nodules often see scars when the acne clears. You can prevent these scars. Be sure to see a dermatologist for treatment if you get acne early — between 8 and 12 years old. If someone in your family had acne cysts and nodules, you also should see a dermatologist if you get acne. Treating acne before cysts and nodules appear can prevent scars.
When should I see a doctor?
You should see a dermatologist when :
- Over-the-counter creams, gels, and cleansers stopped working;
- Acne taking a toll on your self-esteem;
- the pimples sore leave you with scars.
How is Acne diagnosed?
To diagnose acne, a dermatologist will first examine your skin to make sure you have acne. Other skin conditions can look like acne. If you have acne, the dermatologist will:
- Grade the acne. Grade 1 is mild acne. Grade 4 is severe acne.
- Note what type, or types of acne appear on your skin.
What are other medical tests can help diagnosis?
(Medical tests i.e. lab tests, imaging tests…)
What are the treatments for Acne?
Acne is treated by doctors who work with skin problems (dermatologists). Treatment tries to:
- Heal pimples;
- Stop new pimples from forming;
- Prevent scarring;
- Help reduce the embarrassment of having acne.
Treatment for Blackheads, Whiteheads, and Mild Inflammatory Acne
Doctors usually recommend an OTC or prescription topical medicine for people with mild signs of acne. Topical medicine is applied directly to the acne lesions or to the entire area of affected skin.
There are several OTC topical medicines used for mild acne. Each works a little differently. Following are the most common ones:
- Benzoyl peroxide. Kills P. acnes, and may also reduce oil production;
- Resorcinol. Can help break down blackheads and whiteheads;
- Salicylic acid. Helps break down blackheads and whiteheads, also helps cut down the shedding of cells lining the hair follicles;
- Sulfur. Helps break down blackheads and whiteheads.
Treatment for Moderate-to-Severe Inflammatory Acne
People with moderate-to-severe inflammatory acne may be treated with prescription topical or oral medicines, alone or in combination.
Prescription Topical Medicines
Several types of prescription topical medicines are used to treat acne. They include: Antibiotics. Help stop or slow the growth of bacteria and reduce inflammation
- Vitamin A derivatives (retinoids). Unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A.
- Others. May destroy P. acnes and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation.
Prescription Oral Medicines
For patients with moderate-to-severe acne, doctors often prescribe oral antibiotics. Oral antibiotics are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. Common antibiotics used to treat acne are tetracycline, minocycline, and doxycycline. Other oral medicines less commonly used are clindamycin, erythromycin, or sulfonamides.
Treatment for Severe Nodular or Cystic Acne
People with nodules or cysts should be treated by a dermatologist. For patients with severe inflammatory acne that does not improve with medicines such as those described above, a doctor may prescribe isotretinoin, a retinoid (vitamin A derivative). Isotretinoin is an oral drug that is usually taken once or twice a day with food for 15 to 20 weeks. It markedly reduces the size of the oil glands so that much less oil is produced. As a result, the growth of bacteria is decreased.
Treatments for Hormonally Influenced Acne in Women
The doctor may prescribe one of several drugs to treat women with this type of acne:
- Birth control pills. To help suppress the androgen produced by the ovaries;
- Low-dose corticosteroid drugs, such as prednisone or dexamethasone. To help suppress the androgen produced by the adrenal glands;
- Antiandrogen drugs such as spironolactone. To reduce the excessive oil production.
Other Treatments for Acne
Doctors may use other types of procedures in addition to drug therapy to treat patients with acne. For example, the doctor may remove the patient’s comedones during office visits. Sometimes the doctor will inject corticosteroids directly into lesions to help reduce the size and pain of inflamed cysts and nodules.
What are the complications may happen?
Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments to help reduce scarring are available.
How can I manage my Acne?
Here are some ways to care for skin if you have acne:
- Clean skin gently. Use a mild cleanser in the morning, evening, and after heavy workouts. Scrubbing the skin does not stop acne. It can even make the problem worse.
- Try not to touch your skin. People who squeeze, pinch, or pick their pimples can get scars or dark spots on their skin.
- Shave carefully. If you shave, you can try both electric and safety razors to see which works best. With safety razors, use a sharp blade. Also, it helps to soften your beard with soap and water before putting on shaving cream. Shave lightly and only when you have to.
- Stay out of the sun. Many acne medicines can make people more likely to sunburn. Being in the sun a lot can also make skin wrinkle and raise the risk of skin cancer.
- Choose makeup carefully. All makeup should be oil free. Look for the word “noncomedogenic” on the label. This means that the makeup will not clog up your pores. But some people still get acne even if they use these products.
- Shampoo your hair regularly. If your hair is oily, you may want to shampoo daily.
Review Date: September 21, 2016 | Last Modified: January 4, 2017
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