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.

How does it occur?

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) become clogged and bacteria grow in the clogged pores. When the body works to kill the bacteria, then whiteheads, blackheads, and pustules form in these areas. Ninety percent of teenagers get 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, infected plugged oil glands, sometimes filled with pus.

Some pustules may be painful. In severe cases, cysts (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 and how you have been caring for your skin.

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 antibiotic medications on your skin, or your healthcare provider may prescribe antibiotics 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. All of the same precautions apply as when women are using the pills for birth control.

An oral medicine called isotretinoin (Accutane) is available for severe acne. However, women must use isotretinoin very carefully. It can cause severe birth defects if a woman becomes pregnant while she is taking the drug or even if she has taken it 1 or 2 months before becoming pregnant.

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, but you will probably need to continue the treatment for several months. If you are taking antibiotics, at some point your healthcare provider will ask you to stop taking them to see if they are still needed. Sometimes acne treatment must be continued for several years.

Many factors may worsen acne temporarily. For example, women may notice that their acne gets worse before each menstrual period. So even with proper treatment, results may vary over time. Try to discover and change, when possible, the factors 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 2 times a day with a gentle 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 infection and scars may 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!