Acne

What is acne?

Acne is a skin condition that occurs when the oil-secreting glands in the skin are clogged and become inflamed or infected.

What is the cause?

Acne is caused by inflammation or infection of the oil glands in the skin and at the base of hairs. In the teenage years, hormones stimulate the growth of body hair, and the oil glands secrete more oil. The skin pores (where the hairs grow out) get clogged and irritated from the excess oil. Whiteheads, blackheads, and pustules form in these areas.

Clogged pores can get infected by bacteria that are on the surface of the skin. This is especially likely to happen if you squeeze or pick the pimples.

Most teenagers have some acne.

Stress and too little rest can make acne worse.

What are the symptoms?

The symptoms of acne are:

• 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, and plugged oil glands, sometimes filled with pus

Some pustules may be painful. In severe cases, cysts or nodules (large fluid-filled bumps) may develop under the skin.

How is it diagnosed?

Your healthcare provider will check your skin to see what type of problem you are having (such as blackheads or cysts). Your provider will look to see where you are having problems, for example, your face or back. Your provider will want to know how long you have had the problem, how you have been caring for your skin, and what treatments you have tried that have or have not worked.

How is it treated?

Treatment is aimed at keeping oil and dirt out of the pores and reducing inflammation.

You and your healthcare provider 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 an antibiotic medicine on your skin, or your healthcare provider may prescribe an antibiotic to be taken by mouth. You may also need to use a skin cream or gel containing tretinoin (Retin-A).

Birth control pills are another treatment that might be prescribed for women. The pills can be used to change the hormone levels and decrease acne. Birth control pills are generally considered safe but they can have some side effects and health risks.

An oral medicine called isotretinoin is available for severe acne. However, women must use isotretinoin very carefully. It can cause severe birth defects if a woman gets pregnant while she is taking the drug or even if she has taken it 1 or 2 months before getting pregnant. You must tell your healthcare provider if you are pregnant, think you might be pregnant, have been trying to get pregnant, or are thinking about getting pregnant BEFORE taking any acne medicine, especially isotretinoin.

If you have large cysts, your healthcare provider may inject them with medicine to try to prevent scarring.

How long will the effects last?

New whiteheads usually stop appearing after 4 to 6 weeks of treatment (the time it takes your body to make a new layer of skin). However, you will probably need to continue the treatment for several months. If you are taking an antibiotic, at some point your healthcare provider will ask you to stop taking it to see if it is still needed. Sometimes acne treatment must be continued for several years.

Many things may worsen acne temporarily. For example, women may notice that their acne gets worse before each menstrual period. Try to figure out and change, when possible, the things in your environment or lifestyle that make the acne worse.

How can I take care of myself?

Follow the full treatment prescribed by your healthcare provider. In addition you can:

• Wash your face gently 1 to 2 times a day with a mild soap. Change your washcloth every day (bacteria can grow on damp cloth). Wash as soon as possible after you exercise.
• Wash your hands often and keep your hands away from your face as much as possible. Don't squeeze, pick, scratch, or rub your skin. If you squeeze pimples, you may spread cause infection and infection can cause scars to form. 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. Try avoiding those foods.
• Avoid working in hot kitchens where greasy foods are cooked.
• Avoid extreme stress if possible. Practice stress reduction strategies such as exercise, meditation, and counseling if you have a lot of stress.
• Get physical exercise regularly.
• Keep your follow-up appointments with your healthcare provider. Keep a record of the treatments you have tried and how they have worked. Let your provider know if your medicine isn't working. There are many alternatives for you and your provider to try, so don't give up!