Submitted by Doug Leone, MD and Adrienne Schupbach, MD, Dermatology and Mohs Surgery Institute
There are many myths about what causes acne. While the cause is not really known, there is little evidence to suggest that chocolate or French fries have much effect. However, certain factors such as the hormone increase in teenage years, hormone changes during pregnancy, starting or stopping birth control pills, heredity, some types of medicine, and greasy makeup may cause acne to develop.
People of all races and ages get acne. Although it is most common in adolescents and young adults, it is becoming more common in pre-teens. Many people continue to have acne well into their adult years. Acne is not a serious health threat, but some kids are so embarrassed by their acne that they refuse to leave the house, and severe acne can lead to permanent scarring. Adults with acne frequently suffer social, psychological, and emotional consequences. Therefore, it is not a condition that should be ignored or considered a trivial problem.
Acne begins in the skin’s oil glands. The oils travel up to the skin’s surface through the follicle and pore openings. The hair, oil, and cells that line the narrow follicle can form a plug and block the pore, preventing oil from reaching the skin’s surface. This mix of oil and cells allows bacteria that normally live on the skin to grow in plugged follicles. Your body’s defense system then moves to attack the bacteria and the area gets inflamed.
If the plugged follicle stays beneath the skin, you get a white bump called a whitehead. If it reaches the surface of the skin and opens up, you get a blackhead. It’s not because of dirt; the oil becomes black on the skin’s surface when it’s exposed to air. Both whiteheads and blackheads may stay in the skin for a long time. Eventually, the wall of the plugged follicle can break down, leading to pimples.
There are many treatment options for acne. For mild acne, the first place to start is with over-the-counter medications. Benzoyl peroxide is generally quite effective but some people find that Salicylic acid works best. These medicines are available in many forms, such as gels, lotions, creams, soaps, or pads. It can take up to eight weeks before you notice an improvement in the appearance of your skin. If an over-the-counter acne product doesn’t seem to help after two months, then it’s time to consult a dermatologist.
The likely next step would be topical retinoids. These are prescription medications like Retin-A, Avita, and Differin. They are vitamin A derivatives and work by speeding up skin cell turnover, which helps unclog pores. The main side effects of topical treatments are skin irritation and dryness as well as increased sensitivity to the sun.
If the acne continues to be moderate to severe, then oral antibiotics can help. When pores become clogged with oil and skin cells, bacteria can grow in the pore and cause inflammation. Antibiotics help by killing bacteria and soothing inflammation.
Isotretinoin, commonly known as accutane, is a medicine that can be used to treat severe acne that hasn’t responded to other treatments. Isotretinoin is a very strong drug with some significant side effects. It is generally considered as a “last resort.” It’s crucial to take it only under a physician’s close supervision.
If you have acne, here are some ways to care for your skin:
- Wash your face gently twice a day, with a soap-free, pH-balanced cleanser. Avoid harsh cleansers and scrubs, which often make the problem worse.
- Try not to touch your skin. Squeezing, pinching, or picking at them can lead to scars or dark blotches.
- Stay out of the sun. Many acne medicines can make people more likely to sunburn.
- Choose oil-free cosmetics. Look for the word “noncomedogenic” on the label. This means that the makeup will not clog up your pores.
- Shampoo your hair regularly. If your hair is oily, you may want to shampoo daily.
Researchers continue to work on developing new drugs to treat acne. They’re also trying to better understand the causes of acne so they can explore new remedies. With so many treatment options available, there is no reason why anyone should have to live with acne that is severe or that causes them emotional distress.
For more information, you may contact the Dermatology and Mohs Surgery Institute at 309-451-DERM (3376) or www.dermatologistbloomington.com. Dr. Leone and Dr. Schupbach, both residents of Bloomington, are board-certified dermatologists, specializing in medical and cosmetic dermatology, including the treatment of skin cancer, moles, acne, rashes, warts, and all skin disorders. Dr. Leone is one of the few Mohs-trained surgeons in the area. Their new practice, located at 3024 E. Empire St. 2nd floor (in the Advocate BroMenn outpatient center) in Bloomington, is now open with immediate availability.