Acne (acne vulgaris) is a skin condition that occurs primarily when sebum, oil naturally produced by the body, clogs hair follicles and they become filled with oil, dead skin cells and sometimes bacteria. Hair follicles are connected to sebaceous glands, which secrete sebum to keep your hair and skin lubricated. Normally, the sebum comes out through the openings in your hair follicles; but when there is an overproduction of sebum, it can’t escape causing acne.
The clogged follicle can appear as a “whitehead” if it is covered by a thin layer of skin or it can become a “blackhead” if the darker portion is exposed to the air. If the clogged follicle grows, the wall of the follicle may rupture allowing normal skin bacteria to enter into a deeper layer of the dermis causing a pustule, a pimple, nodules or if very deep, a cyst under the skin.
Acne most commonly appears on the face, neck, chest, back and shoulders, areas with a significant number of oil glands. Contributing factors can include:
- Hormonal changes. Boys and girls going through puberty can experience an increase in androgens causing the sebaceous glands to enlarge and create more sebum than is needed. Women can experience hormonal changes while pregnant or when taking birth control.
- Pressure. Regular pressure from things like chin straps or helmets can cause acne irritations
- Medicine. Some medicines like injected steroids, iodides, bromides and lithium are known to aggravate acne.
- Cosmetics. Some cosmetics have pore-clogging oils. It is best to check the labels and look for water-based ingredients as the first or second ingredient. (Ingredients are listed in the order of most to least.)
There are many myths surrounding what causes acne. Here are the truths:
- Sweat. Sweat does not cause acne. Sweat is produced by different glands and has nothing to do with acne.
- Dirty skin. Blackheads are not dirt under your skin; it is oxidized oil from your body.
- Food. Your food choices do not impact acne by creating it or adding to existing acne.
Acne treatments work by reducing oil production, speeding up skin cell turnover, fighting bacterial infection, reducing the inflammation or doing all four. With most prescription acne treatments, you may not see results for four to eight weeks, and your skin may get worse before it gets better.
Your doctor or dermatologist may recommend a prescription medication you apply to your skin (topical medication) or take by mouth (oral medication). Oral prescription medications for acne should not be used during pregnancy, especially during the first trimester.
Types of Acne Treatments Include:
- Over-the-Counter Topical Treatments. You can cleanse twice a day with benzoyl peroxide or salicylic acid and apply a benzoyl peroxide gel or cream. This will assist in drying up the oil and killing any bacteria. This is a good protocol for mild acne; but may have some initial side effects such as skin irritation, drying and flaking.
- Topical Treatments Available by Prescription. If your acne doesn’t respond to over the counter treatments within a month, prescription treatments are your next step. There are many types of topical antibiotics and antibacterial to assist in addressing the acne. Retin-A is a common treatment with minimal side-effects which include irritation or sensitivity to the sun. Your doctor or dermatologist will determine the best course of action based on your specific acne situation.
- Oral Antibiotics. For moderate to severe acne, your doctor may recommend antibiotics to help eliminate the bacteria and fight inflammation caused by acne.
- Other Forms of Acne Treatment. Includes drugs that block hormone receptors, Isotretinoin, soft tissue fillers, oral contraceptives, laser light therapy, chemical peels, dermabrasion, microdermabrasion, laser resurfacing, and for those with permanent scarring there are surgical procedures available.
For more information about Acne Treatment, or to schedule an Acne Treatment consultation, please contact Dr. Garramone’s office today at 239-482-1900.