ACNE
Acne is a very common skin condition in which the skin develops plugged pores (blackheads), inflamed pus bumps (pustules), and deeper, more painful nodules (cysts). It typically occurs during the teenage years with the onset of puberty, but also not uncommonly is seen later in life as well.
What causes acne? Contrary to what many believe, acne is not caused by dirt. Testosterone, a hormone seen in both males and females at puberty, stimulates the sebaceous glands of the skin to enlarge, produce oil and plug up the pores. Bacteria present on the face are then encouraged by this situation to multiply causing pus bumps and nodules. Many parents accuse their teenage children of not washing their face enough, but this has little impact on the cause or continuation of acne. It also is not due to foods such as chocolate, coke, sweets etc., although a recent article found that large quantities of milk may exacerbate existing acne. Organic milk (milk produced without adding hormones to the milk cows) can be substituted. Wearing make-up also does not cause acne, but oil or petroleum based make-up can exacerbate acne. Wearing as little make-up as possible or getting loose powder make-up and brands that are “non-comedogenic” or “non-acnegenic” are desirable.
Treatment. The best we can do is control acne and not cure it. This means that treatment or control of acne is an ongoing process requiring close follow up and often changing medications when there is no response after a couple months of a certain regimen. There are many topical medications that may be prescribed including benzoyl peroxide, topical antibiotics or topical vitamin a medications called “retinoids”. Oral antibiotics are also often prescribed, sometimes for months to a year at a time. Birth control pills can be used as well, especially if a flare of the acne is noted just prior to menses. Most cases of acne require what we call “combination therapy” where several different medications are prescribed at one time. A new treatment is emerging involving the use of blue lights, sometimes added with a topical medication called levulan. It appears that the blue light therapy helps clear acne, but most patients will need at least additional topical, if not oral medication as well.
Cosmetic options. Many spas will advertise that they treat acne. Many times this will include a microdermabrasion, or chemical peel. Sometimes they will recommend a particular skin care line they sell which usually will contain glycolic or salicylic acid. While some patients may obtain some benefit from these procedures, the majority of patients at some point will require prescription medication to achieve satisfactory control. Prescriptions for acne are covered by insurance while these procedures and over the counter skin care products are not. If there is any doubt as to whether you will require or currently would benefit from prescription medication, please consult with a dermatologist on this website to evaluate you.