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Patient Education

WHAT IS ACNE?

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Acne affects teenagers and many adults and is a common skin disease. It is a condition that produces blocked pores (whiteheads and blackheads), "pimples", cysts and/or boils. It is most common on the face, but also occurs on the back, neck, shoulders and chest.

Acne is a disorder of the sebaceous glands ("oil glands"). It typically starts when rising hormone levels (especially in teenagers) stimulate these glands and cause them to produce excessive oil and skin cells that line hair follicles. This excess material causes a blockage leading to overgrowth of bacteria and inflammation. This is the basis for the red, inflamed lesions common in severe cases of acne.

Almost everyone with acne has experienced or knows someone who has experienced the negative psychological effects of acne. Moreover, because acne can cause permanent scarring, these consequences can last a lifetime. Acne is a highly treatable condition.

Essentially, there is a "pyramid" of treatment choices for acne. As we move up the steps of the pyramid, the side effect/benefit ratio changes: more benefit may be associated with more side effect possibilities. In other words, at the highest step of the pyramid, the most dramatic results will be seen, but may be associated with more potential side effects.

How can Acne be treated?

Here are some tips for "mild" acne:

• Wash your face twice a day with a mild non-soap, nondrying cleanser. Although surface dirt and grease can contribute to breakouts, acne is not caused by dirt. It is important to wash, but not too vigorously, because the skin can become irritated.
• Don't squeeze or pick pimples or use sharp object to open them. This can cause infection, further inflammation and scarring.
• Make sure all cosmetics are non-comedogenic.
• Over the counter medications can be very effective when used consistently. The most commonly used medications contain benzyl peroxide and salicylic acid. These products can produce irritation and allergic reactions. It is important to read the label and use as instructed.
• Wear sunscreen daily. Resist the urge to sunbathe or tan. Although acne can improve in the short term with sun exposure or indoor tanning, in the long run causes the sebaceous glands to produce excess oil leading to more acne.
• Consider having clinical facials or physician strength salicylic acid peels. These Therapeutic treatments can help to keep the skin exfoliated, pores extracted and reduce bacteria levels of the skin.

If acne does not respond to these actions, we can develop a treatment plan according to its severity. Treatments range from mild topical medications to very potent oral medications. A brief list of treatment options includes:

Oral contraceptives: These inhibit endogenous hormone production.

Antibiotics: These fight the infection in the follicle. There are many topical antibiotics and oral antibiotics that are very effective.

Inhibitors of excess oil production: These medications include oral and topical retinoids. The retinoids are a potent class of medications that include Retin-A and Accutane.

There is no "cure" for acne in the teenage years. Even adult acne can be difficult to fully eradicate. However, there are certainly ways to improve the situation. There are always options.