Acne is a common condition that causes blocked pores, pimples, cysts and other lesions on the skin of the face, neck, chest, back, shoulders and upper arms. Although teenagers are often affected, adults of any age can suffer from acne. Acne is not life-threatening, but can lead to physical disfigurement and emotional distress. There are several effective treatment methods that improve the skin’s appearance and prevent future breakouts.
Causes of Acne
Despite its prevalence, the causes of acne are still somewhat of a mystery. There is also a good deal of misinformation out there. It’s believed that acne results from a combination of factors. In teenagers, the primary cause is the rise in the male sex hormone androgen, which increases in both sexes during puberty. When androgen levels rise, the sebaceous glands enlarge and produce more oil. This oil production is normal and is the way our skin and hair are lubricated and stay moist. But overproduction of oil in the sebaceous glands can lead to the glands becoming clogged. When this happens, the p. acnes bacteria that are common in the hair follicles (the location of the sebaceous glands) begin to multiply. This causes inflammation of the follicle resulting in a breakout. Different people have different sensitivity to this inflammation. In one teen such inflammation may lead to a pimple or two while in others it may trigger a full breakout.
Genetics also play a role. Some people are simply more prone to the condition. Hormonal changes during pregnancy can trigger acne outbreaks, even if you got off easy as a teenager. Certain cosmetics and medications cause breakouts for some people. Friction and heat from sports helmets can cause what is known as acne mechanica.
In adults, full breakouts are rare, as the androgen levels have returned to normal. Hormonal fluctuations during pregnancy and other times can lead to breakouts. And when a hair follicle clogs due to oil or dead skin cells it can lead to the development of an isolated pimple or two.
In the first few months of life, some infants have acne. This is a common condition caused by exposure to maternal hormones in the womb; it clears up on its own within a few weeks or months.
Symptoms of Acne
Although they can appear anywhere, symptoms of acne usually appear on the face, neck, shoulders, back or chest. Symptoms of acne may include the following:
These symptoms can come and go, and may flare up at certain times as a result of hormonal or environmental triggers, such as pregnancy, menstrual periods, high levels of humidity, use of oily cosmetics or hair products, and taking certain medications. Severe cases of acne may cause scarring, which can have a damaging emotional effect on the sufferer. If acne symptoms do not respond to over-the-counter treatments, or if scarring develops as the acne clears up, a dermatologist should be consulted.
Treatment methods for acne aim to reduce oil production and increase the speed of skin-cell turnover to prevent new blemishes from developing. Acne treatment also focuses on reducing inflammation to help treat current symptoms. Treatment may include a combination of topical creams and ointments, and prescription medications that include antibiotics and oral contraceptives.
Topical creams and ointments applied to the affected area are often the first form of treatment used to treat acne. Over-the-counter creams and ointments, which are used to treat mild forms of acne, may contain benzoyl peroxide, salicylic acid or lactic acid as their active ingredient. Prescription topical treatments may contain higher concentrations of these active ingredients, as well as retinoic or azelaic acid.
Oral Prescription Medications
Moderate cases of acne can often be treated with prescription oral antibiotics, which reduce bacteria and inflammation. They are often combined with topical treatments. Isotretinoin may be prescribed for severe cases of acne that do not respond to other treatment methods. In some cases, oral contraceptives are prescribed for women to treat moderate cases of acne.
Certain procedures may be recommended to treat scarring caused by acne. They include skin fillers, dermabrasion, microdermabrasion and laser treatment. Many patients experience effective results from these types of treatments, which help to smooth the skin and remove the scars created by severe acne.
It may take up to 8 weeks before results from treatment are apparent, and acne may get worse before getting better.
Although acne cannot always be prevented, there are certain ways to reduce the risk of breakouts. They include the following:
- Avoiding heavy or oily cosmetics
- Removing makeup before going to bed
- Using mild cleansers
- Avoiding sun exposure
- Avoiding constant touching of the skin
Patients should also avoid picking or squeezing blemishes and should be aware of anything that comes in contact with the affected area, because it may contain unwanted bacteria.
Does diet or personal hygiene cause or affect acne?
This is the largest bit of misinformation about acne. Food choices, such as chocolate, greasy French fries, potato chips, and the like have nothing to do with acne. These foods have no effect on the sebaceous glands clogging due to oil production. Research has not shown any connection between food and acne.
There is also the incorrect assumption that personal hygiene can cause acne, but dirty skin and acne are not related. It was long thought that aggressive scrubbing of the skin would open pores and improve acne. Actually, the opposite is true. Scrubbing and using harsh treatments irritates the skin and can make acne worse.
Who gets acne and would be a good candidate for treatment?
Acne is the most common skin disorder of teenagers. It affects around 85 percent of American teens at some point between the ages of 13 and 20. That equates to an estimated 40 to 50 million Americans. Acne typically starts during puberty, between the ages of 10 and 13, and it can last from five to 10 years.
Around 20 percent of acne plagues adults, mainly mild to moderate acne that can last into the 30s. This is due to hormone fluctuations.
Anyone, especially those saddled with continuing acne, is a great candidate to come see our team at Advanced Laser and Skin Cancer Center so that we can get a handle on their acne. This is particularly true if the patient has cystic acne, which can lead to permanent acne scarring across the face and upper back.
These conditions are a good sign it’s time your acne needs professional treatment:
- It is making the person unhappy, overly self-conscious, or uncomfortable
- It is producing scars
- It is causing dark patches to appear on the skin
- It is severe with deep nodules and persistent pimples
- It isn’t responding to over-the-counter treatments, and prescription medicine could be necessary
What kind of results can I expect from your acne treatments?
At Advanced Laser and Skin Cancer Center our acne treatments target the three main factors leading to breakouts: excess oil production, bacteria growth, and clogged hair follicles/pores. These are not instant fixes; it may take up to two months to really see a change in the patient’s acne. As treatments begin, acne may actually appear to be getting worse before it begins to calm.
Every patient’s situation is unique and we treat each case that way. We may need to employ different approaches before we find the best solution to your (or your teenager’s) acne. But once we reduce the excess oil production and kill the bacteria, the changes can be dramatic. Our goal with most patients is to achieve at least a 70 percent improvement in the patient’s acne within three to four months.
How long is the treatment process for acne?
There is not a defined timeline for these treatments. Some patients show immediate improvement and it is the start of their acne going into decline for good; others need ongoing treatment to keep up with hormones.
How should I maintain or improve my skin in between my treatments?
What’s most important is to try and not help the follicles/pores clog. This means avoiding the use of heavy and oily cosmetics. Patients should remove all of their makeup before going to bed. There once was a time when the thinking was using harsh cleansers and scrubs to decrease oil on the skin, but this is actually backwards. These cleansers further inflame the clogged pores and skin. You’ll need to switch to mild cleansers. Excessive sun exposure also isn’t good for acne-prone skin, despite the thought that you can somehow bake it away.
Finally, patients must not pick or “pop” blemishes and shouldn’t touch their skin continually, feeling for blemishes. Doing so can move bacteria from breakout areas to areas that didn’t have excess bacteria.
During your treatments, we’ll advise you on what to do to keep your skin as acne-free as possible.
For more information click here to read our recent blog article: “Want to Get a Handle on Acne?”