Acne is one of the most common dermatologic conditions, affecting millions of individuals in the United States. It's characterized by whiteheads, blackheads and blemishes. In general, acne typically develops in teenagers; however, many adults have some degree of acne as well.
The exact cause of acne is unknown. Hormonal changes during the teenage years, as well as during pregnancy, may be contributing factors. In general, there are two types of acne:
• Noninflammatory acne, characterized by the presence of whiteheads and blackheads.
• Inflammatory acne, characterized by the presence of pimples, which may rupture to form inflammatory lesions that are raised, reddened areas on the skin called "papules."
In the majority of cases, individuals exhibit both types of acne. Acne typically occurs in the facial area, chest and back, where the sebaceous glands are the most prominent. Acne can also occur on other areas of the body as well, such as on the neck and upper arms.
Causes of Acne
There are a variety of factors that may contribute to or worsen acne. These factors can be classified as environmental, physical or emotional. Examples of these factors include:
• Oil-based cosmetic use.
• Stress and anxiety.
• Humidity or exposure to dirt.
• Premenstrual changes or hormonal changes.
• Physical irritation from occlusive clothing, headbands, hats, helmets, etc.
• Use of certain medications, such as phenytoin, isoniazid, phenobarbital, lithium, quinine, rifampin and steroids.
Preventing Acne
There are various preventative measures that may prevent or reduce acne flare-ups. Examples include:
• To prevent the incidence of scarring, never squeeze or pick acne lesions.
• Establish a daily skin-care regimen, which includes cleansing the skin with a soft wash cloth, warm water and an appropriate facial soap at least twice a day.
• Use only oil-free skin and hair care products.
• Avoid scrubbing the skin when cleansing.
• Women should use makeup that is oil-free or labeled "non-comedogenic."
• Always cleanse skin after sweating.
• Wear daily sun protection, since some acne medications may increase the skin's sensitivity to sunlight.
Treating Acne
In general, the goals of acne treatment are to prevent or minimize pimples, and to prevent scarring. Early treatment is best to avoid scarring. The treatment selected for acne is dependent upon the type of acne and the severity of the acne.
Your doctor may suggest one of the various topical over-the-counter products available for the management of mild-to-moderate cases of acne. Self-treatment is typically appropriate for mild acne cases, and can be easily managed and controlled by following a daily skin-care regimen and avoiding factors that may worsen acne flare-ups.
Currently, there are a variety of nonprescription skin-care products for the self-treatment of mild-to-moderate cases of acne. These products are available as medicated cleansing bars, liquids, lotions, creams, gels and pads/wipes, and they typically contain at least one of the following ingredients: benzoyl peroxide, salicylic acid, sulfur with or without resorcinol and sulfur with sodium sulfacetamide.
It's important to use these products as directed, and to adhere to the selected treatment regimen. If you experience any adverse reactions due to these products, you should stop using them immediately and contact your primary health care provider.
If your acne shows no signs of improvement or worsens after regular use, consider consulting a dermatologist to discuss other treatment options or recommendations for your acne.
If you have a moderate-to-severe case of acne, you should always seek medical care for evaluation to avoid further complications. Your doctor may prescribe a prescription product, either an oral or topical medication, to treat your acne. In some cases, your doctor may suggest a combination of treatments. Since some medications should not be used during pregnancy, it's important to inform your doctor if you're pregnant, breast-feeding or planning to become pregnant.
Prior to prescribing any medications for acne treatment, your doctor will obtain a full medical, allergy and medication history to prevent any possible contraindications or drug interactions. It's important to adhere to the recommended treatment for the medication to be effective, especially since it may take several weeks to see any signs of improvement. You should always discuss any concerns about your treatment with your physician or pharmacist, and be sure you clearly understand how to use your medication and the side effects associated with its use.
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