Acne

Acne is the most common skin condition affecting adolescents and young adults. It can present as pimples, whiteheads, blackheads, cysts, nodules, and can sometimes leave behind scars. Most acne occurs on the face, but it can also involve the chest, neck, abdomen, back, shoulders, and arms. Acne is easily diagnosed and can be treated with effective and affordable options that aim to clear the acne, prevent scarring, and alleviate the emotional and psychological effects associated with acne. Up to 90% of adolescents experience some form of acne, and sometimes acne can also present or continue into adulthood. Acne is not a cosmetic condition but a medical condition that requires treatment.

What causes Acne?

Acne develops when pores become clogged and inflamed. A pimple is formed when oil glands produce too much oil and block hair follicles leading to bacteria overgrowth and subsequent inflammation. A whitehead is formed when a pore becomes completely blocked by oil and dead skin cells. A blackhead is formed when the pore is open but clogged with oil and bacteria that turn brown when exposed to air. Excessive oil production and inflammation can lead to deep inflammation, causing cysts and nodules to develop.

There are many causes of acne. Oil production in the skin is under the influence of hormonal, genetic, and environmental factors. Androgens are hormones that increase during puberty, menstrual cycles, and pregnancy that cause sebaceous glands to produce more oil and as a result cause acne flares. A family history of acne can indicate an increased likelihood of an individual developing acne. Environmental factors include comedogenic makeup, certain medications, diet, and stress.

Treatment of Acne

The goal of acne treatment is to control skin shedding, oil production, inflammation, and scarring. Most dermatologists will use combination of oral and topical treatment options. It is important to be patient and compliant with the prescribed treatment plan because it can take up to three months to see results from any given regimen. Not all treatments plans will work for everyone, so it is important to follow up with your dermatologist regularly to develop an individualized treatment plan that works best for you. It is also important to avoid any known triggers and only use skin care products that are labeled ‘non-comedogenic’ so that they will not clog your pores and worsen your acne. Examples of common acne treatments are as follows:

• Topical Antibiotics: Topical antibiotics can be used to decrease the growth of acne causing bacteria on the skin and help reduce inflammation.

• Oral Antibiotics: Oral antibiotics can be used to decrease the growth of acne causing bacterial when inflammation is severe to reduce scarring from nodules and cysts

• Benzoyl Peroxide: Benzoyl peroxide can be used to remove excess oil and help destroy bacteria on the skin

• Salicylic Acid: Salicylic acid exfoliates and increases shedding of skin (seems hanging)

• Retinoids: Retinoids increase the rate of skin shedding to help flatten all existing acne lesions and prevent formation of new lesions. The most common retinoids used are tretinoin, adapalene, and tazarotene.

• Spironolactone: Spironolactone is an oral medication used in female patients with predominantly hormonal acne that presents as deep-seated pimples or nodules on the lower face and fluctuates with hormone levels and menstrual cycles. It is important to let your dermatologist know if you are pregnant, nursing, or planning to conceive when discussing this medication.

• Oral contraceptive pills (birth control): Certain birth control pills can help regulate hormonal fluctuations in menstruating patients to control hormonal acne. It is important to let your dermatologist know if you smoke, have high blood pressure, migraines or personal or family history of breast cancer, ovarian cancer, uterine cancers, or blood clots when discussing this treatment.

• Isotretinoin (Accutane): Accutane is an oral retinoid used for severe cystic or scarring acne once all other treatment options fail. Isotretinoin reduces oil production and secretion at the gland level inside the skin. Treatment with this option requires enrollment in the FDA regulated iPledge program. Patients who cannot get pregnant can be started on this program with minimal delay, but patients who can get pregnant require a minimum of 31-33 day wait period and two negative pregnancy tests before the medication can be dispensed. Treatment generally spans over a course of 6-8 months.

Our dermatologists can assess your acne and recommend a treatment plan based on your age, gender, skin type, symptoms, and scarring.