Acne

What is Acne?

Acne is a disease that affects the skin's oil glands and is caused by clogged pores in your skin. Pores are small holes in your skin . These pores connect to oil glands beneath the surface of the skin by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the skin.

This is how acne develops. Sometimes, the hair, sebum (oil) , and skin cells clump together within the follicle or canal. This allows a certain type of bacteria, called Propionibacterium acnes, to grow in the canal, or follicle. The bacterium in the plug causes swelling. Then when the plug starts to break down, a pimple grows.

Most pimples are found on the face, neck, upper back, shoulders and chest. Acne is not a serious health threat but it can cause scarring.

What are the types of Acne?

There are many types of pimples. The most common types are:

• Whiteheads. These are pimples that stay beneath the surface of the skin.
• Blackheads. These pimples rise to the skin's surface and look black. The black color is from changes in the oil or sebum secondary to air.
• Papules. These are small pink bumps that can be tender or painful.
• Pustules. These pimples are red at the bottom and have pus on top.
• Nodules. These are large, painful, solid pimples that are deep in the skin.
• Cysts. These can cause scarring and are deeper, and filled with pus.

Acne is the most common skin disease. People of all races and ages get acne. But it is most common in teenagers and young adults, roughly around the age group of 12-24. For most people, acne goes away by age 30, but some people have acne even when they are older.


What causes acne?

The cause of acne is unknown. Doctors think certain factors might cause it:

• Hormonal changes secondary to: rises in hormones during teenage years, pregnancy, starting or stopping birth control pills.
• Heredity (if your parents had acne, you might get it, too)
• Some types of medicine.
• Oil-based makeup, suntan oil

What things can make acne worse?

• Changing hormone levels in teenage girls and adult women 2 to 7 days before their period starts
• Leaning on, rubbing or irritating the skin
• Pressure from tight clothing, helmuts
• Pollution and high humidity
• Squeezing or picking at pimples
• Hard scrubbing of the skin.

How is Acne treated?


The goal of treatment is to:

• Heal pimples
• Stop new pimples from forming
• Prevent scarring -- Early treatment is the best way to prevent scars.

Types of treatment:

1) Topical Treatments: Your doctor may suggest topical (applied to the skin) over-the-counter or prescription strength acne treatment containing benzoyl peroxide or salicylic acid, or sulfur containing products. These come in the form of gels, soaps, lotions, and creams. They should be used regularly. Other drugs suggested are isoretinoin, or other Vitamin A derivatives.

2) Oral antibiotics like erythromycin, tetracycline. These must be taken regularly for 1-2 months before any improvement is seen.

3) Oral medication called Accutane, which is a Vitamin A derivative, is reserved for severe cystic or nodular acne. It is prescribed by a dermatologist and is usually taken for 15-20 weeks. Although it is highly effective, it can cause numerous side effects as well as birth defects in pregnant women. Consult your doctor before considering this medication.

4) Physical procedures include injections, chemical peels, comedo extraction, drainage and surgical extraction and laser therapy.

How should people with Acne care for their skin?

• Clean skin gently. Use a mild cleanser in the morning, evening, and after heavy workouts. Scrubbing the skin does not stop acne. It can even make the problem worse.
• Try not to touch your skin. People who squeeze, pinch, or pick their pimples can get scars or dark spots on their skin.
• Shave carefully. If you shave, you can try both electric and safety razors. With safety razors, use a sharp blade. Shave lightly and only when you have to.
• Stay out of the sun. Many acne drugs can make people more likely to sunburn.
• Use makeup that is oil free. Look for the word "noncomedogenic" on the label. This means that the makeup will not clog up your pores. Using oil free products, however, will not guarantee that you will not get acne.
• Some myths about acne include: Chocolate and greasy foods do not cause acne in most people nor does. Stress can exacerbate acne, but is not a primary cause of outbreaks.

References:

http://www.niams.nih.gov/hi/topics/acne/acne.htm

American Family Physician® ( Vol. 69/No. 9 (May 1, 2004)

Domino, Frank. J. 5 Minute Clinical Consult,

Hardbound, 2007. Lipincott, Williams,

and Wilkins, NY, NY.

Copyright 2007, MD Kiosk