Acne & Acne Treatment
Acne Vulgaris is the term for plugged facial pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that occur on the face, neck, chest, shoulders, and back. Acne affects 40 to 50 million Americans each year. Most teenagers experience some acne, but this disease can affect individuals into their adult years. Clinical studies have found that acne is definitely more prevalent in males until they reach the age of 23, then surprisingly the incidence is reversed. After the age of 25, 12% of women were found to have clinical facial acne compared to only 3% of men. While acne is not life threatening, the clinical lesions and scars can be quite upsetting and permanently disfiguring. If left untreated, acne patients can experience diminished self-esteem, social withdrawal, and depression.
How Does Acne Form?
There are 4 key players involved in the development of acne; Oily skin, clogged pores, bacteria, and inflammation. Hormonal influences during puberty stimulate and enlarge the oil (sebaceous) glands of the skin. These glands are connected to hair-containing canals called follicles. The sebaceous glands make an oily substance called sebum, which normally migrates to the skin via the follicle. A plug called a comedone develops in the hair follicle as the first sign of acne. A bacteria, Propionibacterium acnes, grows in this mixture of oil, sebum and inflammatory cells. This bacteria mixture can cause the follicle wall to rupture, which can lead to the swelling and the red inflammatory pimples and pustules associated with acne.
What Are My Best Skin Care Choices?
There are presently a variety of over-the-counter choices for your skin care if you have acne. For normal skin care, washing your face twice a day with mild soap and warm water is your best choice. Blackheads and acne pimples are not caused by dirt. The black in a blackhead is dried oil and shed skin cells deposited in the pores. Therefore, washing too vigorously or with too harsh of soaps may make your acne worse. Many non-prescriptive lotions and creams may help milder cases of acne, but can also make your skin too dry if over used. Tint colored acne lotions containing benzoxyl peroxide, salicylic acid or sulfur can help hide pimples, reduce bacteria, and thus treat the blemishes. Make sure to follow the product instructions carefully to achieve the best results. Cosmetics, sunscreens, and facial moisturizers should be selected that are oil free and not just water based. Choose products that are “Non-comedogenic” (do not cause blackheads or whiteheads) or “non-acnegenic” (should not cause acne). Remember not to pick pimples –this can result in a longer healing time and risk of scarring.
How Can a Dermatologist Help My Persistent Acne?
If your acne persists and is not being cleared with the above recommendations, then it is time to seek a Dermatologist for the most advanced therapeutic acne treatment options. At present time, many medical modalities exist involving daily use of topical or oral medications. Prescription medications are formulated to target and reverse the skin changes – trapped oil, clogged pores, bacteria, and inflammation – that lead to the development of acne vulgaris. Topical lotions, creams, or gels with retinoid may be prescribed as a part of a comprehensive acne treatment program. Retinoids unplug the hair follicles, reduces inflammation, and slowly reduce pimple production. These products are useful but may cause some dryness and irritation, so proper application and follow-ups are necessary. They include Differin (adapalene), Retin A (tretinoin), and Tazorac (tazarotene).
Topical antibiotics are also prescribed and have been clinically proven to reduce bacterial counts in acne patients. Benzoxyl peroxide, clindamycin, sodium sulfacetamide, and erthyromycin lotions/gels work well to reduce acne inflammation, and pimple production. Sometimes these medications are used alone or in combination with other topical or oral medications.
Oral antibiotics such as tetracycline, doxycycline, minocycline, or erythromycin are often prescribed for moderate or severe acne. Antibiotic use has been shown to reduce bacterial counts in the follicle and decrease general redness and irritation. Presently, however, more than 40% of acne bacteria are now resistant to commonly used antibiotics. One retrospective study showed a higher rate of breast cancer with oral antibiotic use. Careful selection of the right antibiotic and follow-up is critical when orl antibiotics are used for acne.
In severe, cystic, or scarring forms of acne, that have not been responsive to other treatments, the use of Accutane, (oral Isotretinoin) may be recommended. The success of Accutane is well documented, but laboratory testing, psychological screening, and monthly monitoring are required to reduce systemic side effects. The FDA now mandates that patients, physicians, pharmacists, and drug companies be linked in a federal registry. The primary purpose is to reduce the number of pregnancies that occur to women who are actively taking Accutane with can result in birth defects.
Whatever acne treatment options we chose for Acne Vulgaris, one must remember that there is no instant cure, and maintenance therapy is necessary to prevent reoccurrence. The good news is that today acne suffers can benefit, as never before, from new proven medical and technological advances in the treatment of Acne Vulgaris.
For further information, please contact us at Olympic Dermatology and Laser Clinic at 1-360-459-1700. We are the leading dermatology center serving Olympia, Lacey, Tumwater, DuPont, Steilacoom, Centralia, Chehalis, Aberdeen, Hoquiam, Shelton and the South Sound region.