Acne

GENERAL INFORMATION:

What is acne? Acne, also known as acne vulgaris, is one of the most common skin problems. It usually seen on the face, neck, chest, shoulders, or upper back of almost every teenager and young adult. Acne occurs when the pores on the surface of the skin become plugged. A pore is the opening of a hair follicle (root) and an oil gland. Normally, oil glands help keep the skin smooth and remove old skin cells. When oil glands make too much sebum (grease), pores may become blocked. This allows dirt to collect, which encourages the growth of bacteria (germs) in the glands. When these bacteria release toxic substances, it can produce irritation and inflammation (swelling) of the skin. This leads to the formation of painful bumps or lumps, which are commonly called pimples or zits.

What causes acne? The exact cause of acne is not known. The following are possible causes of acne:

• Genetics: Acne is more likely to occur if other family members also had acne problems.
  
  
• Hormones: Hormones are special chemicals in the body. Hormonal changes may occur during puberty, monthly periods, pregnancy, or use of birth control pills. An increase in androgens (male sex hormones) may also cause the oil glands to enlarge and make more sebum.
  
  
• Infections: Germs, such as bacteria, may cause acne.
  
  
• Medicines: Certain medicines, such as steroids, hormones, and anticonvulsants (phenytoin) may cause acne.
  
  
• Skin cosmetics: Harsh skin make-up and cleansers may change the cells of the follicles and block the pores.
  
  
• Stress: Emotional and physical stress, such as tiredness and feeling upset, angry, or sad, may cause an acne flare-up.

• Comedones: Comedones, or plugs, are blocked pores having blackheads or whiteheads on their surface. Blackheads turn dark, or black, because pores are open to the air, while whiteheads are cream-colored and are in closed pores. Comedones are often found on the forehead, nose, cheeks, and sometimes in the ears.
  
  
• Papulopustular: These are small, pink, painful pimples, called papules, which are near the surface of the skin.
  
  
• Nodular: Nodules are large, hard, and painful pimples that are deep below the skin and are pus-filled.

• Laser treatment: A narrow beam of light is used to kill the overactive cells that are causing the inflammation (swelling).
  
  
• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Hormonal therapies: Medicines, such as oral contraceptives and androgen blockers, may control the production of sebum in the oil glands.
    
    
  • Isotretinoins: These are vitamin-based medicines, which are most useful in treating severe acne. These medicines may have serious side effects. It is important to ask your caregiver for more information before using isotretinoins.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.
    
    
  • Topicals: Topicals are medicines, such as gels, ointments, creams, pastes, or liquid solutions that are put on your skin. They may be antiseptics (germ-killers), comedone treatments, or medicines that decrease swelling and skin shedding.
    
    
  • Vitamin A and other mineral supplements: Caregivers may give you vitamin A or minerals to improve your skin.
  
  
• Phototherapy: You may need bright ultraviolet (UV) light treatments if your acne is very bad.
  
  
• Surgery: Surgery may be needed to treat severe forms of acne. Caregivers may use certain chemicals or tools to remove or scrape off skin that is affected by acne.

• Avoid using hot water or washcloths when washing your face: Rubbing or scrubbing your face with hot water or washcloths may irritate and damage your skin. Gently pat your face dry with a clean towel or cloth after washing your face.
  
  
• Be careful with the medicines you are taking: Certain medicines, including natural and herbal medicines, may trigger an acne flare-up. Always check for skin changes when taking your medicines. Ask your caregiver first before you use herbal medicines or products to control acne.
  
  
• Do not squeeze, pop, or pick your pimples: Using your bare hands or black head removers may damage your skin and cause infection or scarring. Sometimes, a caregiver may remove a pimple for you. This is done in a clean and germ-free way that will not hurt your skin.
  
  
• Protect your skin by avoiding too much sun exposure: Wear sunscreen that has a sun protectant factor (SPF) approved by your caregiver. Follow the directions on the label when using sunscreen.
  
  
• Try to avoid stress: You may talk to your family or friends about things that upset you. Tell them how acne may be affecting your life.
  
  
• Use water-based, oil-free makeup, soaps, or skin cleansers. Oil-based makeup may cause acne to get worse. Check product labels on water-based makeup, since even these may have some oil added to them. Use mild soaps or cleansers that are oil-free and do not irritate acne when washing your face.

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• National Institute of Arthritis and Musculoskeletal and Skin Disease
  Information Clearinghouse
  National Institutes of Health
  1 AMS Circle
  Bethesda, MD 20892-3675
  Phone: 1-301-495-4484
  Phone: 1-877-226-4267
  Web Address: http://www.niams.nih.gov