What Is Acne?
Acne is a disorder resulting from the action of hormones and other substances on the skin's oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called “pimples
”. They usually occur on the face, neck, back, chest, and shoulders.
People with acne have a variety of lesions. The basic is the comedo
, an enlarged and plugged hair follicle. If the comedo stays beneath the skin and produces a white bump, it is called a whitehead
. A comedo that reaches the surface of the skin and opens up is called a blackhead
because it looks black on the skin's surface. The black discoloration is due to oxidation of the sebum as it is exposed to air. Both whiteheads and blackheads may stay in the skin for a long time.
Other troublesome acne lesions can develop, including the following:
What Causes Acne?
- Papules – inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
- Pustules (pimples) – papules topped by white or yellow pus-filled lesions that may be red at the base
- Nodules – large, painful, solid lesions that are lodged deep within the skin
- Cysts – deep, painful, pus-filled lesions that can cause scarring.
The exact cause of acne is unknown, but it results from several related factors. One important factor is an increase in hormones called androgens
(male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.
Another factor is heredity
. Certain drugs, including androgens and lithium, are known to cause acne.
Greasy cosmetics may alter the cells of the follicles and make them stick together, producing a plug.
Factors That Can Make Acne Worse
Factors that can cause an acne flare include:
Myths about the Causes of Acne
- Changing hormone levels in adolescent girls and adult women 2 to 7 days before their menstrual period starts
- Oil from skin products (moisturizers or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats)
- Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
- Environmental irritants, such as pollution and high humidity
- Squeezing or picking at blemishes
- Hard scrubbing of the skin
There are many myths about what causes acne.
Chocolate and greasy foods are often blamed, but there is little evidence that foods have much effect on the development and course of acne in most people.
Another common myth is that dirty skin causes acne; however, blackheads and other acne lesions are not caused by dirt.
How Is Acne Treated?
The goals of treatment are to heal existing lesions, stop new lesions from forming, prevent scarring, and minimize the psychological stress and embarrassment caused by this disease.
Depending on the extent of the problem, you may be recommended one of several over-the-counter (OTC) medicines and/or prescription medicines. Some of these medicines may be topical (applied to the skin), and others may be oral (taken by mouth). The doctor may suggest using more than one topical medicine or combining oral and topical medicines. Along with this personalized procedures will be prescribed based on your skin.
What is the procedure at Kosmoderma?
Treatment for Blackheads, Whiteheads, and Mild Inflammatory Acne
- During the consult, the skin is examined and tested to determine its condition.
- Based on the test results a home care regimen is prescribed including topical and possible oral medications. Your skin is given an initial clean up to remove the bacteria and as many comedones as possible.
- Clean ups using chemical peeling agents like Glycolic / Salicylic / Resorcinol / Retinol peels are recommended to decrease the chances of scarring. The number of sessions and frequency depends on the severity of the acne.
- We recommend between 4 – 8 sessions of acne peels 2 weeks apart to reduce the acne and decrease the scarring.
- The home care is continued for a 1 year post treatments to prevent recurrence.
Topical medicines are somewhat effective in treating acne when used regularly; however, it may take up to 8 weeks before you see noticeable improvement. Maintain your skin with our MediFacials every 4-6 weeks.
- Benzoyl peroxide – destroys P. acnes, and may also reduce oil production
- Resorcinol – can help break down blackheads and whiteheads
- Salicylic acid – helps break down blackheads and whiteheads. Also helps cut down the shedding of cells lining the hair follicles
Topical medicines are somewhat effective in treating acne when used regularly; however, it may take up to 8 weeks before you see noticeable improvement.
Treatment for Moderate to Severe Inflammatory Acne
People with moderate to severe inflammatory acne may be treated with prescription topical or oral medicines, alone or in combination.
Several types of prescription topical medicines are used to treat acne. They include:
- Antibiotics – help stop or slow the growth of bacteria and reduce inflammation
- Vitamin A derivatives (retinoids) – unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A. Some examples are tretinoin (Retin-A2), adapalene (Differin),
- Others – may destroy P. acnes and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation.
- Maintain your skin with our MediFacials every 4-6 weeks.
For some people, prescription topical medicines cause minor side effects, including stinging, burning, redness, peeling, scaling, or discoloration of the skin. With some medicines, such as tretinoin, these side effects usually decrease or go away after the medicine is used for a period of time. If side effects are severe or don't go away, notify your doctor.
The benefits of prescription topical medicines are not immediate. Your skin may seem worse before it gets better. It may take from 4 to 8 weeks to notice improvement.
Prescription Oral Medicines
For patients with moderate to severe acne, doctors often prescribe oral antibiotics. Oral antibiotics are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. Common antibiotics used to treat acne are tetracycline, minocycline and doxycycline.
Treatment for Severe Nodular or Cystic Acne.
For patients with severe inflammatory acne that does not improve with medicines such as those described above, a doctor may prescribe isotretinoin (Accutane), a retinoid (vitamin A derivative). Isotretinoin is an oral drug that is usually taken once or twice a day with food for 15 to 20 weeks. It markedly reduces the size of the oil glands so that much less oil is produced. As a result, the growth of bacteria is decreased.
Treatments for Hormonally Influenced Acne in Women.
In some women, acne is caused by an excess of androgen (male) hormones. Clues that this may be the case include hirsutism (excessive growth of hair on the face or body), premenstrual acne flares, irregular menstrual cycles, and elevated blood levels of certain androgens.
The doctor may prescribe one of several drugs to treat women with this type of acne:
Early treatment is the best way to prevent acne scars.
- Birth control pills – to help suppress the androgen produced by the ovaries
- Antiandrogen drugs – to reduce the excessive oil production.
Once scarring has occurred, the doctor may suggest a medical or surgical procedure to help reduce the scars. A fractional laser or Microneedling may be used to treat irregular scars. A doctor may also inject a synthetic filling material under the scar to improve its appearance.
How Should People With Acne Care for Their Skin?
Clean Skin Gently
If you have acne, you should gently wash your face with a mild cleanser (Ph balanced), once in the morning and once in the evening, as well as after heavy exercise. Wash your face from under the jaw to the hairline and be sure to thoroughly rinse your skin.
Using strong soaps or rough scrub pads is not helpful and can actually make the problem worse. Astringents are not recommended unless the skin is very oily, and then they should be used only on oily spots.
It is also important to shampoo your hair regularly. If you have oily hair, you may want to wash it every day.
Avoid Frequent Handling of the Skin
Avoid rubbing ansd touching skin lesions. Squeezing, pinching or picking blemishes can lead to the development of scars or dark blotches.
When using a safety razor, make sure the blade is sharp and soften your beard thoroughly with soap and water before applying shaving cream. Shave gently and only when necessary to reduce the risk of nicking blemishes.
Choose Cosmetics Carefully
While undergoing acne treatment, you may need to change some of the cosmetics you use. All cosmetics should be oil free. Choose products labeled non comedogenic (meaning they don't promote the formation of closed pores).