Acne
Acne frustrates men and women of all ages. Blemishes occur mainly on the face, but often involve the neck, chest, back, and upper arms. To reduce the physical and emotional impact of acne, Worcester and Chelmsford Dermatology Associates in Massachusetts offers a variety of treatment options.
To learn more from board-certified dermatologist Dr. Seth Kates or Dr. A. David Simkin, request a consultation online or call us at 508-754-3823 in Worcester or 978-256-4151 in Chelmsford.
Causes of Acne
Acne occurs when oil glands of the skin become blocked by skin cells, bacteria, and oil (sebum). At puberty, the oil glands in the skin start producing an oily material called sebum. Sebum is discharged onto the skin's surface. Sometimes the wall of the oil gland gets blocked, breaks and spills the sebum within the skin. The sebum irritates the skin tissues and causes redness, swelling, and pus – in other words, a pimple.
In mild acne, only a few oil glands break open; in severe acne, many do. How easily oil glands do this seems to be "built into" you. Acne runs in families.
Age
Acne usually begins mildly in the teens, gradually worsens, and then after a time improves. Sometimes acne does not begin until later in life. How long you will have acne is impossible to predict. Acne will go through stages, but proper treatment will improve it faster and hopefully prevent scarring. Preventing acne scarring is one of the most important goals of treatment.
Skin Hygiene
Dirt does not cause acne, despite what you may have been told. The oil on the skin's surface does no harm. Special soaps, astringents, exfoliants, and acne cleansers are only part of a more comprehensive acne regimen. Gently wash your face with a mild soap or cleanser only as much as you need to keep it clean. Too much washing and scrubbing can cause skin irritation and actually exacerbate acne.
Although picking or squeezing is not great for your face, most of the population does it – including dermatologists. If you do it, do it gently and, if nothing happens, leave the area alone. Harsh picking or squeezing can cause marks that last for months or even scars.
Diet
Foods do not cause acne. Many people try all sorts of diets and are frustrated because they don't help. However, if you find an association between acne breakouts and a certain food, avoid that food. Acne has ups and downs of its own; make sure that the worsening isn't just a coincidence. If certain foods definitely worsen your acne, avoid them.
Nerves and Acne
Acne is not caused by nerves, but may become worse under stress. These stress-related breakouts are usually mild, temporary flare-ups. Some people react to stress by picking, squeezing, or rubbing their pimples, and this can make acne worse.
Treating Acne
Without treatment, most people will outgrow their acne, although this can take years. Ramifications of untreated acne include physical scarring and psychological issues, especially in teenagers. These can affect people for the rest of their lives.
Topical Medicines
There are many different topical medicines used for acne, including over-the-counter treatments and prescription treatments. These include:
- Antibacterial products (eg. benzoyl peroxide, azelaic acid)
- Antibiotics (eg. clindamycin, dapsone, sulfa products)
- Retinoids (retin A micro, Differin®, TAZORAC®)
- Combination products (containing usually two products mixed together)
These can be extremely effective used alone or when combined with oral antibiotics but they can also be irritating and may not be an option for some patients. It is important to remember that medications can take 6 to 12 weeks to be effective.
Antibiotics
Tetracycline and its derivatives doxycycline and minocycline are among the most common antibiotics used in treating acne. Sometimes it's necessary to try several different antibiotics before acne is controlled. Acne can go into remission after a course of treatment but it is very common for acne to respond to these medications and quickly recur after they are discontinued.
Antibiotics generally take about 6 weeks to be effective for the face and longer for the trunk. It is not uncommon for an individual to fail with one antibiotic but respond to a different one.
Accutane
Accutane is a vitamin A derivative that has been used to treat acne since the mid 1970s. In the correct patient and under very close medical supervision it is a safe and effective option. However, side effects and complications make it very important to choose a dermatologist you trust for Accutane treatment.
