Acne appears on the skin as
1. occluded pores (“comedones”), also known as blackheads or whiteheads,
2. tender red bumps also are known as pimples or zits,
3. pustules (bumps containing pus), and occasionally as
4. cysts (deep pimples, boils).
5. One can do a lot to treat acne using products available at a drugstore or cosmetic counter that does not require a prescription. However, for tougher cases of acne, one should consult a physician for treatment options.
No one factor causes acne. Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin.
Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a “blackhead.”
The plugged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin’s surface produces a pustule; deeper inflammation results in a papule (pimple); if the inflammation is deeper still, it forms a cyst.
Here are some factors that don't usually play a role in acne:
Food: Parents often tell teens to avoid pizza, greasy and fried foods, and junk food. While these foods may not be good for overall health, they don’t cause acne or make it worse. Although some recent studies have implicated a high-carbohydrate diet, milk, and pure chocolate in aggravating acne, these findings are very far from established.
Dirt: Blackheads are oxidized oil, not dirt. Sweat does not cause acne and is produced by entirely separate glands in the skin. On the other hand, excessive washing can dry and irritate the skin.
Stress: Some people get so upset by their pimples that they pick at them and make them last longer. Stress, however, does not play much of a direct role in causing acne.
In occasional patients, the following may be contributing factors:
Heredity: If one of your parents had severe acne, it is likely that your acne will be more difficult to control.
Pressure: In some patients, pressure from helmets, chin straps, collars, suspenders, and the like can aggravate acne.
Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] or the steroids that bodybuilders or athletes sometimes take). Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium (Eskalith, Lithobid). Most cases of acne, however, are not drug-related.
Occupations: In some jobs, exposure to industrial products like cutting oils may produce acne.
Cosmetics: Some cosmetics and skin-care products are pore-clogging (“comedogenic”). Of the many available brands of skin-care products, it is important to read the list of ingredients and choose those which have water listed first or second if one is concerned about acne. These “water-based” products are usually best for those with acne.
When should someone start acne treatment?
Since everyone gets acne at some time, the right time to treat it is when it becomes bothersome or when the potential for scarring develops. This can be when severe acne flares suddenly, for mild acne that just won’t go away, or even when a single pimple decides to show up the week before one’s prom or wedding.
What can people do to get rid of their acne?
1. Lifestyle: Moderation and regularity are good things, but not everyone can sleep eight hours, eat three good meals, and drink plenty of water a day. One can, however, still control acne despite one’s frantic and unpredictable routine. Probably the most useful lifestyle changes one can make is to never to pick or squeeze pimples. Playing with or popping pimples, no matter how careful and clean one is, nearly always makes bumps stay redder and bumpier longer. People often refer to redness as “scarring,” but fortunately, it usually isn’t permanent. It’s just a mark that takes months to fade if left entirely alone.
2. Open the pores: Occasional visits to an esthetician who is an expert at safely removing blackheads during a facial can be beneficial.
3. Cleansing and skincare: Despite what one might read in a popular style and fashion magazines, there is no magic product or regimen that is right for every person and situation.
4. Mild cleansers: Washing once or twice a day with a mild cleansing bar or liquid (for example, Dove, Neutrogena, Basis, Purpose, and Cetaphil are all inexpensive and popular) will keep the skin clean and minimize sensitivity and irritation.
5. Exfoliating cleansers and masks: A variety of mild scrubs, exfoliants, and masks can be used. These products may contain salicylic acid in a concentration that makes it a very mild peeling agent. These products remove the outer layer of the skin and thus open pores. Products containing glycolic or alpha hydroxy acids are also gentle skin exfoliants.
6. Reduce the oil: One cannot stop oil glands from producing oil. Even isotretinoin (Accutane, see below) only slows down oil glands for a while; they resume normal activity later. It is possible to get rid of oil on the surface of the skin and reduce the appearance of shine.
7. Use a gentle astringent/toner to wipe away oil. (There are many brands available in pharmacies, as well as from manufacturers of cosmetic lines.
8. Products containing glycolic acid or one of the other alpha hydroxy acids are also helpful in clearing the skin by causing the superficial layer of the skin to peel (exfoliate).
9. Masks containing sulfur and other ingredients draw out facial oil.
10. Antibacterial pads containing benzoyl peroxide have the additional benefit of helping to wipe away oil.
How does treat acne? Is it possible to remove acne scars?
It’s best to consult a primary-care physician or dermatologist if an individual is unable to adequately control his or her acne. The goal of treatment should be the prevention of scarring (not a flawless complexion) so that after the condition spontaneously resolves there is no lasting sign of the affliction. Here are some of the options available:
1. Chemical peels: Whether the superficial peels (like glycolic acid) performed by estheticians or deeper ones performed in the doctor’s office, chemical peels are of modest, supportive benefit only, and in general, they do not substitute for regular therapy.
2. Light treatments / the benefits of laser acne treatment: Recent years have brought reports of success in treating acne using special lights and similar devices, alone or in conjunction with photosensitizing dyes. It appears that these treatments are safe and can be effective, but it is not clear that their success is lasting. At this point, laser treatment of acne is best thought of as an adjunct to conventional therapy, rather than as a substitute.
3. Light Therapy shrinks sebaceous (oil) production
4. A proprietary blend of chemical peels are safe for all skin colors and types
5. Helps destroy bacteria deep within your pores
6. Only a few treatments needed for clear skin
how does acne treatment work?
Laser acne treatment helps to reduce acne in two distinct ways. The first benefit of Laser acne treatment is the destruction of the Bacteria that causes inflammation and acne breakouts. Bacteria can cause acne when it gets clogged in a hair follicle without oxygen. Laser acne therapy aims to penetrate the clogged follicle, bringing in oxygen, destroying the bacteria.¹
The second way laser acne treatments help to reduce acne is by heating your sebaceous gland (the gland that produces your skin’s oil.) When the oil gland is heated, it shrinks and produces less oil.
What are other things you can do for acne? Are there any home remedies for acne?
Cosmetics: Don’t be afraid to hide blemishes with flesh-tinted cover-ups or even foundation, as long as it is water-based (which makes it non-comedogenic). There are many quality products available.
Facials: While not absolutely essential, steaming and “deep-cleaning” pores are useful, both alone and in addition to medical treatment, especially for people with “whiteheads” or “blackheads.” Having these pores unclogged by a professional also reduces the temptation to do it oneself.
