Acne Causes & Treatment
Acne is the most common skin condition in the United States. Approximately 85% of people between the ages of 11 and 30 experience at least minor acne. Acne usually begins in puberty and affects many adolescents and young adults, but can occur at any stage of life. Acne is characterized by pimples, comedones (blackheads and whiteheads) and deeper cysts that appear on the face, neck, shoulders, upper arms, back and chest. If not treated, acne can cause permanent scarring and poor self image resulting in depression and anxiety.
Causes of Acne
In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. The sebum moves from the bottom to the top of each pore and then spills out onto the surface of the skin, taking with it sloughed-off skin cells.
The exact cause of acne is unknown. Factors contributing to the production of acne are overactive sebaceous glands producing excess oil. There is an increase cell production within the pores. The cells become sticky and instead of flowing onto the skin where they exfoliate, these sticky cells adhere to each other, remain in the pore and form a plug called a comedone. There are bacteria (Propionibacterium acnes) which inhabit the pores. These bacteria induce an inflammatory response resulting in a pimple or cyst.
Hormones, menstruation, genetic factors and emotional stress can produce acne or cause it to flare.
Foods producing a high glycemic load (or high sugar levels in the blood) such as white potatoes, white bread, cookies, watermelon, doughnuts, cereals, and dates may cause acne to flare. Low glycemic index food such as low-fat yogurt, apples, kidney beans and most vegetables and proteins are a better choice of foods to help control acne flares.
It is important for patients not to pick or scratch at individual lesions because it can make them inflamed and can lead to long-term scarring.
How to Care for Acne
- Gently wash affected areas once or twice a day with mild non-drying soap. Vigorous washing and scrubbing can irritate your skin and make acne worse. Acne is hormonal and is not caused by an excess of dirt on the face.
- Avoid astringents and masks which may unnecessarily dry the skin.
- Use oil-free, noncomedogenic (does not cause acne) makeup, moisturizers, and sunscreens.
- Seek treatment early for acne that does not respond to over the counter medications.
Treatment for Acne
The initial response to treated acne may take 6 to 8 weeks; there is no overnight remedy.
- Mild Acne -- Topical therapy is the standard of care for mild acne. This may include topical antibiotics, topical retinoids, benzoyl peroxide and acne washes.
- Moderate to Severe Acne -- Combination therapies using oral antibiotics combined with the above topical agents have been found to be effective.
- Hormonal Treatments — Can be used for women with hormonally induced acne.
- Oral Isotretinoin — A derivative of Vitamin A, isotretinoin helps unplug the blocked pores and reduces sebum production. It is approved for severe recalcitrant nodular cystic acne, the most serious form acne.
- Extraction — Removal of whiteheads and blackheads using a small metal instrument that is centered on the comedone and pushed down, extruding the contents of the blocked pore.
- Incision and Drainage -- Large cysts and pustules can be opened and drained using sterile instruments in the office.
- Cortisone Injections -- Hard, red acne cysts can be injected with hydrocortisone to quickly shrink the lesion.
Consult Dr. Oshman and receive a personalized regimen to treat your acne prone skin.