What Is Acne?
Your skin has tiny holes called
pores that that can
become blocked by oil, bacteria, and dirt. When this occurs, you may
develop a pimple or “zit.” If your skin is repeatedly affected by this
condition, you may have acne.
According to the American Academy of Dermatology (AAD), acne is one of
the most common skin problems in the United States. At any one time,
between 40 and 50 million people have this condition (
AAD, 2012 ).
Although acne is not a life-threatening condition, it can be painful,
particularly when it is severe. It can also cause emotional distress.
Acne that appears on the face can impact self-esteem and, over time,
may cause permanent scarring. Fortunately, there are effective
treatments for this condition that reduce both the number of pimples
you get and the chance for scarring to occur.
What Causes Acne?
Acne occurs when the pores on your skin become blocked with oil,
dead skin, or bacteria. Each pore on your skin is the opening to a
follicle. The follicle is made up of a hair and a
sebaceous
(oil) gland.
The oil gland releases sebum (oil), which travels up the hair, out of
the pore, and onto your skin. The sebum keeps your skin lubricated and
soft. If you develop acne, this may be because of one or more problems
in this lubrication process. These possible causes include:
- too much oil or sebum is being produced by the follicle
- dead skin cells are accumulating in the pore
- bacteria has built up in the pore
An overabundance of oil, a pore clogged by dead skin cells, and
bacteria all contribute to the development of pimples. A zit appears
when the bacteria grows in the clogged pore and the oil is unable to
escape.
What Are the Risk Factors for Developing Acne?
Myths about what contributes to acne are quite common. Many people
believe that foods such as chocolate or French fries will contribute to
the development of acne. While there is no scientific support for
these claims, there are certain risk factors that may put you at risk
for developing acne. These include:
- hormonal changes caused by puberty or pregnancy
- certain medications such as birth control pills or corticosteroids
- a diet high in refined sugars or carbohydrates such as bread and chips
Young people are most at risk for developing acne during puberty.
During this time, the body undergoes drastic hormonal changes. These
hormones can trigger oil production, leading to an increased risk of
acne. Hormonal acne related to puberty usually subsides when a teenager
reaches adulthood.
What Are the Symptoms of Acne?
Acne can be found anywhere on your body. It most commonly develops on
the face, back, neck, chest, and shoulders. If you have acne, you will
typically notice pimples that are white or black in appearance. Both
blackheads and whiteheads are known as
comedones.
Blackheads open at the surface of the skin giving them a black appearance.
Whiteheads are
closed just under the surface of the skin, giving them a white
appearance.
While whiteheads and blackheads are the most common types of acne,
other lesions can occur. Inflammatory lesions are more likely to cause
scarring of the skin and include the following:
- papules—small red, raised bumps caused by infected hair follicles
- pustules—small red pimples that have pus at their tips
- nodules—solid, painful lumps that are beneath the surface of the skin
- cysts—infections found beneath the skin that contain pus and are often painful
How Is Acne Diagnosed and Treated?
If you have symptoms of acne, your doctor will be able to confirm a diagnosis by examining your skin.
At-Home Care
You can use a number of self-care activities at home to prevent
pimples and to clear up your acne. Home remedies for acne may include:
- cleaning the skin daily with a mild soap to remove excess oil and dirt
- regularly shampooing your hair and keeping it out of your face
- not squeezing or picking pimples, as this spreads the bacteria and excess oil
- avoiding hats or tight headbands
- avoiding touching your face
- using makeup that is water-based or labeled as “noncomedogenic” (not pore-clogging)
Medication
If self-care activities do not help with your acne, there are a
number of over-the- counter acne medications that may be helpful. Most
of these medications contain ingredients that can help kill bacteria or
dry the skin. These active ingredients include:
- benzoyl peroxide: present in many acne creams and gels, used for drying out existing pimples and preventing new ones
- sulfur: a natural ingredient with a distinctive smell that is found in lotions, cleansers, and masks
- resorcinol: a less common ingredient that is used to remove dead skin cells
- salicylic acid: often contained in soaps and acne washes
Sometimes, you may continue to experience symptoms. If this happens,
you may want to seek medical advice. Your doctor can prescribe
medications that may help reduce your symptoms and prevent scarring.
Your doctor may give you oral or topical
antibiotics. These
kill the bacteria that cause pimples. Typically, antibiotics are only
used for a short amount of time so that your body doesn’t build up a
resistance. Antibiotic resistance can make you prone to infections.
Topical creams
like retinoic acid or prescription strength benzoyl peroxide are often
stronger formulas of over-the-counter treatments. These work to dry
out the skin and reduce oil production.
Women with hormonal acne may be treated with
birth control pills or spironolactone. These medications seek to regulate the hormone-causing acne.
Isotretinoin (Accutane) is a vitamin A-based
medication that is used to treat certain cases of severe nodular acne.
It has serious side effects, and is only used when all other treatments
have failed.
Additional Treatments
Your doctor may recommend additional procedures to treat severe acne
and prevent scarring. Many of these work by removing damaged skin.
- photodynamic therapy: also known as laser treatment, uses light pulses to remove the top layer of skin
- dermabrasion: removes the top layer of skin with a rotating brush
- chemical peel: an aesthetician applies a
chemical to your face which essentially burns the top layer of
skin. That skin later peels off to reveal less damaged skin
underneath
Your doctor may suggest using
cortisone injections
if your acne consists of large cysts. Cortisone is a steroid naturally
produced by the body. It can reduce inflammation and speed healing.
What Is the Outlook for Someone With Acne?
Treatment for acne is often successful. Most people can expect their
acne to clear up within six to eight weeks. However, flare-ups of the
condition are common and may require additional treatment.
Scarring that occurs as a result of acne can cause emotional distress.
Prompt treatment can help prevent scarring.
How Can Acne Be Prevented?
It’s difficult to prevent acne. However, you can take some steps at
home to help prevent acne following treatment. These include:
- washing your face twice a day with an oil-free cleanser
- using an over-the-counter acne cream to remove excess oil
- avoiding makeup that contains oil
- cleaning the skin thoroughly before bed, including removing makeup
- showering after exercising
- avoiding tight-fitting clothing
