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Acne (Pimples)


What is Acne (Pimples)?

Acne is a skin condition that causes whiteheads, blackheads, and inflamed red lesions (papules, pustules, and cysts) to form. These growths are commonly called pimples or "zits."

Alternative Names

Acne vulgaris; Cystic acne; Pimples; Zits; Spots

Types of Acne

There are three main types of acne scars

  • Ice-pick scars: small, deep holes in the surface of your skin that look like the skin has been punctured with a sharp object.
  • Rolling scars: caused by bands of scar tissue that form under the skin giving the surface of the skin a rolling and uneven appearance.
  • Boxcar scars: round or oval depressions, or craters, in the skin.

Symptoms of Acne

  • Blackheads
  • Crusting of skin eruptions
  • Cysts
  • Pustules
  • Redness around the skin eruptions
  • Scarring of the skin
  • Whiteheads

Signs and tests of Acne

Your doctor can diagnose acne based on the appearance of the skin. Testing is usually not required.

Causes, incidence, and risk factors of Acne

Acne

Acne is most common in adolescents but can occur in both sexes and all ages. Apparently there is a familial tendency to develop acne. Usually begins at puberty and may continue over many years. Three of every four teenagers have acne to some extent, probably caused by hormonal changes that stimulate the sebaceous glands to produce fat. Other hormonal changes, such as those occurring during menstruation or pregnancy, and those produced by the use of pills of birth control or stress also exacerbate acne.

There are two clinical forms: a mild, called polymorphous juvenile acne or acne superficial and more serious, called cystic acne or deep acne conglobata.

Acne occurs when the sebaceous glands that produce fat and empty into the hair follicle itself, generate more secretion of the skin is able to remove by peeling, so that fat plugs are produced in the follicles (comedones ). When the surface of the plug darkens called pimples. By breaking the cap can get dead skin cells with accumulated grease and bacteria form nodules infected area called pustules.

If these infected areas of skin are deep, can expand to form cysts. A sebaceous cyst forms when the sebaceous gland continues to produce fat. Instead of breaking the wall of the follicle, it continues to get bigger and forming a hard lump (known as cyst) under the skin. The cyst is usually not painful unless they become infected. Acne typically appears on the face and shoulders but can be extended to the trunk, arms and legs.

Dirt does not cause acne, but dirt and grease on the face can aggravate the problem. Other factors that increase the possibility of occurrence of acne are hormonal changes, exposure to extreme weather, stress, oily skin, endocrine disorders, certain tumors, and the use of certain medications (such as cortisone, testosterone, estrogen, and other ). Acne is not contagious. The tendency to have acne can persist up to 30 or 40 years.

Despite the popular belief that chocolate, nuts, and other foods cause acne, research does not confirm this idea.

Treatment for Acne

Take the following self-care steps to lessen the effects of acne:

  • Clean your skin gently with a mild, non-drying soap (such as Dove, Neutrogena, or Basics). Remove all dirt or make-up. Wash once or twice a day, including after exercising. However, avoid excessive or repeated skin washing.
  • Shampoo your hair daily, especially if it's oily. Comb or pull your hair back to keep the hair out of your face. Avoid tight headbands.
  • Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to skin infections and scarring.
  • Avoid touching your face with your hands or fingers.
  • Avoid greasy cosmetics or creams. Look for water-based or "non-comedogenic" formulas. Take make-up off at night. Non-comedogenic products have been tested and proven not to clog pores and cause acne.

If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These products are applied directly to the skin. They may contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid. They work by killing bacteria, drying up the oil, and causing the top layer of your skin to peel. They may cause redness or peeling of the skin.

If pimples are still a problem, a dermatologist can prescribe stronger medications and discuss other options with you.

Prescription medicines include:

  • Oral antibiotics (taken by mouth) such as minocycline, doxycycline, tetracycline, erythromycin, and amoxicillin
  • Topical antibiotics (applied to the skin) such as clindamycin, erythromycinm or dapsone
  • Retinoic acid cream or gel (Retin-A) and isotretinoin pills (Accutane) -- pregnant women and sexually active adolescent females should NOT take Accutane, as it causes severe birth defects. Women taking Accutane must use two forms of birth control before starting the drug and enroll in the iPledge program.
  • Prescription formulas of benzoyl peroxide, sulfur, resorcinol, salicylic acid
  • A pill called spironolactone may help women with hormonally controlled acne.
  • A laser procedure called photodynamic therapy may also be helpful.

Birth control pills can sometimes help clear up acne. (In some cases, though, they may make it worse.)

Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion, or removal, drainage, or injection of cysts.

A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays is not recommended because it increases the risk of skin cancer.

Complications of Acne

Acne scarring can sometimes develop as a complication of acne when the most serious types of spots - nodules and cysts - rupture (burst) damaging nearby skin. Scarring can also occur if you pick or squeeze your spots, so it is important to avoid doing this.

Possible complications include

  • Changes in skin color
  • Cysts
  • Damage to self-esteem, confidence, personality, and social life
  • Permanent facial scars
  • Side effects of Accutane (including very dry skin and mucus membranes, high triglyceride levels, liver damage, and birth defects in an unborn baby; call your doctor right away if you become pregnant while taking this drug)
  • Side effects of other medications

Prevention of Acne

Acne is not infectious and it is not caused by poor hygiene. However, a build-up of sebum (an oily substance that stops hair and skin drying out) and dead cells on the skin surface may increase the risk of blocked follicles and allow bacteria to multiply. You can help prevent this by washing your face with a gentle cleansing product. If you are wearing any make-up, make sure you wash it off before you go to bed. There is no evidence that wearing make-up causes spots but the less you touch your skin, the fewer bacteria will be spread on your skin. To prevent the spread of bacteria, wash your hands before touching your face (for example to apply make-up). A good balanced diet is, however, important in keeping you healthy.


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