Acne

Acne is classified into categories based on the number and types of “break outs” on the skin. Acne is typically a skin disorder of the face. Acne can also appear on the neck, chest, back, arms and legs.  Acne can result in scarring, which can impact your appearance lifelong, and how you view yourself. Seek the advice of your health care provider for the treatment of acne, especially in severe cases, to avoid scarring and to rule out other types of skin disorders, such as rosacea, which presents with some of the same characteristics.  Rosacea, however, is isolated to the central part of the face with the absence of blackheads.

Fact or Fiction

There are many “myths” about acne regarding stress, diet, poor hygiene, and the use of cosmetics.  Research has shown none of the following are correct.  Years ago, we believed that a diet containing chocolate, sweets, fats and carbonated beverages contributed to acne.  Research now shows that chocolate, sweets, fats and soda do not affect acne.

            Many people associate acne with poor hygiene, when in fact, frequent or harsh washing of the skin may actually exacerbate the condition.

            Some people think you should not wear makeup if you have acne or that makeup causes acne.  Short-term use of makeup appears to be relatively harmless.  However, non-comedogenic, hypoallergenic, and nonirritating makeup is recommended.

How is Acne Treated?

There are a variety of treatments for acne.  The treatment of choice for acne affecting the skin with whitehead or blackheads is topical derivatives of vitamin A called retinoids. They work to increase the skin cell turnover, which promotes expulsion of material in the pore.  They also prevent the formation of new whiteheads/blackheads.  Examples of this product are Tretinoin, Retin-A, Avita, and Renova.  Creams tend to be less potent than gels, and some are less irritating than others. Retin-A Micro 0.1% releases Tretinoin over a longer period of time and is less irritating.  Care should be taken when starting therapy, as there has been an incidence of skin irritation with these products, as well as a risk of sunburn, so use a sunblock of at least SPF 15.

            Some medications kill the bacteria on your skin and in your pores.  Benzoyl peroxide, clindamycin, and erythromycin are applied directly to your skin and come in a variety of formulations.  You may experience irritation when you start using these products, but if you start with a low dose and work your way up, they will decrease your breakouts and inflammation.

            Your health care provider may recommend use of a combination treatment, for example Benzaclin, a cream applied twice a day.  Benzaclin contains both benzoyl peroxide and clindamycin.  Both are known to treat the bacteria that produce acne and have some anti-inflammatory properties as well.  Benzaclin is contraindicated during pregnancy and breast-feeding.

            Oral antibiotics may be given in conjunction with topical treatment depending upon severity of acne.  Antibiotics are used for their bacteria-killing and anti-inflammatory properties.  Common first-line oral antibiotics include erythromycin and tetracycline, or the derivatives doxycycline and minocycline.

            For women whose acne worsens cyclically, birth control pills can help, controlling the hormonal influence, but for some women, birth control pills can make acne worse.

            Accutane is another treatment for severe types of acne; it affects several of the factors of acne formation.  Side effects include severe birth defects; therefore, Accutane is contraindicated during pregnancy.  You must use two forms of birth control while using this product.

Be Patient!

The most important factor found to affect acne therapy is noncompliance with the treatment.  It is imperative once treatment is initiated to complete therapy for the best results.  Remember, it takes about 6 weeks for you to see results, so be patient.

            If scarring should occur, or already be present when you seek therapy, there are several treatments options for this as well, such as dermabrasion, laser therapy, collagen therapy, electrosurgery, chemical peeling, soft tissue elevation, and scar revision.  Ask a health care provider about these therapies.

            There is no instant or permanent cure for acne, but it is controllable and proper treatment can help prevent further outbreaks and scarring.

Skin Care 101

1. Wash your face. Skin care should include washing your face and other areas where breakouts occur twice a day with soap and water.  Remember that acne is not caused by dirt, and too vigorous or harsh rubbing can actually worsen acne.

2. Wash your hair. Regularly shampooing your hair is also recommended.  If your hair is “oily,” you may want to wash it more often, using a shampoo specifically for oily hair.

3. Don’t pop or squeeze your pimples.  This can make the pimples larger, which may cause infection and lead to scaring.

 Shave the right way.  Men with acne who shave should use an electric razor or safety razor to see which is more comfortable.  When using a safety razor, soften your beard with soap and warm water before applying shaving cream.  Shave only when necessary, and always use a sharp blade, shaving in the direction of the hair growth.

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