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ACNE:  Frequently Asked Questions About Acne

Acne is a very common disease. People who have it tend to have similar kinds of questions about it and its treatment. This section addresses some of the common questions asked by people with acne. Please remember that your dermatologist is always the best source of specific information about your individual health issues, including acne.

What causes acne?
The causes of acne are linked to the changes that take place as young people mature from childhood to adolescence. The hormones that cause physical maturation also cause the sebaceous (oil) glands of the skin to produce more sebum (oil). The hormones with the greatest effect on sebaceous glands are androgens (male hormones), which are present in females as well as males, but in higher amounts in males.

Sebaceous glands are found together with a hair shaft in a unit called a sebaceous follicle. During maturation, the cells of the skin that line the follicle begin to shed more rapidly. In people who develop acne, cells shed and stick together more so than in people who do not develop acne. When cells mix with the increased amount of sebum being produced, they can plug the opening of the follicle. Meanwhile, the sebaceous glands continue to produce sebum, and the follicle swells up with sebum.

In addition, a normal skin bacteria called P. acnes, begins to multiply rapidly in the clogged hair follicle. In the process, these bacteria produce irritating substances that can cause inflammation. Sometimes, the wall of the follicle bursts, spreading inflammation to the surrounding skin. This is the process by which acne lesions, from blackheads to pimples to nodules, are formed.

I wash my face several times a day. Why do I still get acne?
Many people still believe that acne is caused by dirty skin. The truth is, washing alone will not clear up or prevent acne. Washing does, however, help remove excess surface oils and dead skin cells. Many people use all kinds of products, including alcohol-based cleansers, and scrub vigorously, only to irritate the skin further and worsen their acne. Washing the skin twice a day gently with water and a mild soap is usually all that is required. However, acne is actually caused by a variety of biologic factors that are beyond the control of washing. For that reason, you should use appropriate acne treatments for the acne.

Does stress cause acne?
Stress is commonly blamed for the development of acne. Stress can have many physiologic effects on the body, including changes in hormones that may theoretically lead to acne. In some cases the stress may actually be caused by the acne lesions, not the other way around! If the acne is being treated effectively, stress is not likely to have much impact on the majority of people.

I never had acne as a teenager. Why am I now getting acne as an adult?
Usually, acne begins at puberty and is gone by the early 20s. In some cases, acne may persist into adulthood. Such types of acne include severe forms that affect the body as well as the face (which afflict males more than females) and acne associated with the menstrual cycle in women. In other cases, acne may not present itself until adulthood. Such acne is more likely to affect females than males.

There are several reasons for this. As females get older, the pattern of changes in hormones may itself change, disposing sebaceous glands to develop acne. Pregnancy may also cause hormonal changes that lead to acne. Some women get acne when they discontinue birth control pills that have been keeping acne at bay. Sometimes young women may wear cosmetics that are comedogenic-that is, they can set up conditions that cause comedones to form.

What role does diet play in acne?
Acne is not caused by food. Following a strict diet will not, clear your skin. While some people feel that their acne is aggravated by certain foods, particularly chocolate, colas, peanuts, shellfish and some fatty foods, there is no scientific evidence that suggests food causes or influences acne. Avoid any foods which seem to worsen your acne and, for your overall health, eat a balanced diet--but diet shouldn't really matter if the acne is being appropriately treated.

Does the sun help acne?
Many patients feel that sunlight improves their acne lesions and go to great lengths to find sources of ultraviolet light. There is no proven effect of sunlight on acne. In addition, ultraviolet light in sunlight increases the risk of skin cancer and early aging of the skin. It is, therefore, not a recommended technique of acne management, especially since there are many other proven forms of treatment for acne. Moreover, many acne treatments increase the skin's sensitivity to ultraviolet light, making the risk of ultraviolet light exposure all the worse.

What is the best way to treat acne?
Everyone's acne must be treated individually. If you have not gotten good results from the acne products you have tried, consider seeing a dermatologist. Your dermatologist will decide which treatments are best for you.

What kind of cosmetics and cleansers can an acne patient use?
Look for "noncomedogenic" cosmetics and toiletries. These products have been formulated so that they will not cause acne.

Some acne medications cause irritation or pronounced dryness particularly during the early weeks of therapy, and some cosmetics and cleansers can actually worsen this effect. The choice of cosmetics and cleansers should be made with your dermatologist or pharmacist.

Heavy foundation makeup should be avoided. Most acne patients should select powder blushes and eye shadow over cream products because they are less irritating and noncomedogenic. Camouflaging techniques can be used effectively by applying a green undercover cosmetic over red acne lesions to promote color blending.

Is it harmful to squeeze my blemishes?
Yes. In general, acne lesions should not be picked or squeezed by the patient. In particular, inflammatory acne lesions should never be squeezed. Squeezing forces infected material deeper into the skin, causing additional inflammation and possible scarring.

Can anything be done about scarring caused by acne?
Scarring is best prevented by getting rid of the acne. Dermatologists can use various methods to improve the scarring caused by acne. The treatment must always be individualized for the specific patient. Chemical peels may be used in some patients, while dermabrasion or laser abrasion may benefit others. It is important that the acne be well controlled before any procedure is used to alleviate scarring.


Would using my medication more frequently than prescribed speed up the clearing of my acne?
No--always use your medication exactly as your dermatologist instructed. Using topical medications more often than prescribed may actually induce more irritation of the skin, redness and follicular plugging, which can delay clearing time. If oral medications are taken more frequently than prescribed, they won't work any better, but there is a greater chance of side effects.

My topical treatment seems to work on the spots I treat, but I keep getting new acne blemishes. What should I do?
Topical acne medications are made to be used on all acne-prone areas, not just individual lesions. Part of the goal is to treat the skin before lesions can form and to prevent formation, not just to treat existing lesions. Patients are generally advised to treat all of the areas (forehead, cheeks, chin and nose) that tend to break out rather than just individual lesions.

My face is clear! Can I stop taking my medication now?
If your dermatologist says you can stop, then stop--but follow your dermatologist's instructions. Many times patients will stop their medication suddenly only to have their acne flare up several weeks later. If you are using multiple products, it may be advisable to discontinue one medication at a time and judge results before discontinuing them all at once. Ask your dermatologist before you stop using any of your medications.




 

 

What is Acne?

Acne is a disease that affects the skin's oil glands. The small holes in your skin (pores) connect to oil glands under the skin. These glands make an oily substance called sebum. The pores connect to the glands by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the skin. When the follicle of a skin gland clogs up, a pimple grows.

Most pimples are found on the face, neck, back, chest, and shoulders. Acne is not a serious health threat but, it can cause scars.

How Does Acne Develop?

Sometimes, the hair, sebum, and skin cells clump together into a plug. The bacteria in the plug causes swelling. Then when the plug starts to break down, a pimple grows.

There are many types of pimples. The most common types are:

  • Whiteheads. These are pimples that stay under the surface of the skin.
  • Blackheads. These pimples rise to the skin's surface and look black. The black color is not from dirt.
  • Papules. These are small pink bumps that can be tender.
  • Pustules. These pimples are red at the bottom and have pus on top.
  • Nodules. These are large, painful, solid pimples that are deep in the skin.
  • Cysts. These deep, painful, pus-filled pimples can cause scars.

Who Gets Acne?

Acne is the most common skin disease. Nearly 17 million people in the United States have it. People of all races and ages get acne. But it is most common in teenagers and young adults. Nearly 85 percent of people between the ages of 12 and 24 get acne. For most people, acne goes away by age 30. But some people in their forties and fifties still get acne.

What Causes 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 pregnancy control pills
  • Heredity (if your parents had acne, you might get it, too)
  • Some types of prescriptions
  • Greasy makeup.

How is Acne Treated?

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.

 

Early treatment is the best way to prevent scars. Your doctor may suggest over-the-counter (OTC) or prescriptions. Some acne treatments are put right on the skin. Other remedies are pills that you swallow. The doctor may tell you to use more than one treatment.

How Should People With Acne Care for Their Skin?

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.

What Things Can Make Acne Worse?

Some things can make acne worse:

  • Changing hormone levels in teenage girls and adult women 2 to 7 days before their monthly starts
  • Pressure from bike helmets, backpacks, or tight collars
  • Pollution and high humidity
  • Squeezing or picking at pimples
  • Hard scrubbing of the skin.


What Are Some Myths About the Causes of Acne?

There are many myths about what causes acne. Dirty skin and stress do not cause acne. Also, chocolate and greasy foods do not cause acne in most people.

What Research is Being Done on Acne?

Scientists are looking at new ways to treat acne. They are:

  • Working on new drugs to treat acne
  • Looking at ways to prevent plugs
  • Looking at ways to stop the hormone testosterone from causing acne.

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Disclaimer : The text presented on these pages is for your information only. It is not a substitute for professional medical advice. It may not represent your true individual medical situation. Do not use this information to diagnose or treat a health problem or disease without consulting a qualified health care provider. Please consult your health care provider if you have any questions or concerns. ©2004 - 2007 drbodoh.com

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