Symptoms of Acne
- The presence of blackheads, whiteheads, pustules, or cysts, with or without redness and inflammation around the eruptions
- In adolescents, the outbreak occurs mainly on the face, but also on the shoulders, back, neck, and buttocks.
- In adults it is usually confined to the chin and jawline.
- For women, symptoms may worsen before the start of each menstrual period.
- Groupings of red, inflamed cysts (cystic acne)
- Pockmarks and scarring (chronic acne)
What Is Acne?
Acne, a skin condition technically called acne vulgaris, is the bane of millions of teenagers, but it also strikes adults with its persistent and recurrent blemishes (red bumps, whiteheads, blackheads, nodules, or cysts) on the skin. It primarily affects adolescents, but one study indicates that even in their 50s, 6 percent of men and 8 percent of women continue to experience outbreaks. Except in severe cases, acne is generally harmless, although it can cause considerable psychological distress.
In both adults and adolescents, acne develops when oil glands in certain parts of the bodymostly glands associated with the pores from which face, chest, and back hairs emergesecrete too much sebum, the thick waxy lubricant that acts to retain moisture.
Excess sebum clogs the pores. If it remains beneath the skin, it results in whiteheads; blackheads occur if the plugs of sebum protrude above the skin. Angry red pimples appear if excess secretions invade and inflame surrounding tissue. The more extensive the inflammation, the more likely it will form abscesses and leave permanent scars and pits. Prompt medical treatment of severe acne will help prevent scarring.
What Causes Acne?
Acne’s causes at any age aren’t completely understood. As in adolescents, acne flare-ups in adults are linked to various kinds of hormonal changesfor women, the hormonal fluctuations that accompany menstruation appear to be a factor. Contrary to conventional wisdom, acne is not a sign of poor health or a consequence of dietary indiscretions, nor is it caused by masturbation or constipation.
There may be a hereditary factor: if one of your parents had acne, there’s a good chance you will have it as well. Other factors linked with acne include certain medications, such as oral contraceptives, corticosteroids, vitamin B12, and lithium. Also, grease, cosmetics, tight clothing, or anything that can block your pores can cause acne. In some instances stress, exposure to dioxin (a contaminant found in herbicides), or climate changes may trigger an outbreak.
What if You Do Nothing about Acne?
Acne is not life-threatening, and a mild outbreak will clear up by itself. However, if acne causes emotional distress or if it worsens, a family physician or dermatologist should be consulted.
Home Remedies for Acne
Acne can’t be cured, but you can take steps to keep mild symptoms under control until they go away.
- Use a nonprescription drying lotion or cream. The most effective over-the-counter preparations contain benzoyl peroxide, generally sold in either 5 percent or 10 percent solution. This active ingredient has a superficial irritant and drying action that helps loosen the plugs in the hair follicles. It can take four to six weeks to experience the full therapeutic effect of the drug.
- Wash daily, but not too roughly or too often. Use ordinary soap and water. Don’t waste money on medicated cleansers (the medication just rinses away) or granular facial scrubs (a washcloth does the same job). Facial saunas (actually facial steam baths) may aggravate acne.
- Watch what you eat. There is no scientific proof that nuts or colas can trigger flare-ups, but if they or other foods seem to act as a trigger for you, there’s no harm in avoiding them. Numerous studies have failed to show that even large amounts of chocolate trigger outbreaks of acne. A few people are allergic to chocolate and may develop a rash when they eat itbut that’s not acne.
- Get your rest. Flare-ups may also be related to emotional upset and too little rest, at least in some people.
- Change your exercise gear. Working up a sweat exercising while wearing tight-fitting, nonabsorbent clothes or sweatbands increases oil production and may contribute to acne.
- Take care of your hair. Style your hair away from your face to keep your complexion free of scalp oils, and avoid greasy hair dressings. Pull your hair away from your face when you sleep.
- Use water-based makeup. Oil-based cosmetics can block sebum from naturally reaching the skin’s surface. Skip cosmetics entirely if acne is severe. When buying makeup, make sure it’s “noncomedogenic” or “nonacnegenic.” Be sure to remove all cosmetics with soap and water before going to bed. Don’t overdo moisturizing.
- Avoid prolonged exposure to the sun and ultraviolet lamps. These light sources sometimes work to dry up acne, but they can cause long-term skin damage, which can result in skin atrophy and even cancer, and thus are ill-advised.
- Don’t pick at your face. Squeezing and picking increase inflammation and the risks of pitting and scarring. Ask your doctor if you can use a blackhead extractor (this device is available in most drugstores). Before you use the device, soften the affected area of skin with hot wet compresses for about 10 minutes. Make sure your hands and the extractor are very clean.
In June 2014, the FDA warned that OTC topical acne treatments can cause rare but serious allergic reactions or severe irritation. According to the FDA, it's unknown whether these potentially life-threatening reactions are caused by active ingredientsbenzoyl peroxide, salicylic acid, inactive substances in the products, or a combination of both. The topical acne products are marketed under several brand names and store brands. They are available as gels, lotions, face washes and scrubs, solutions, cleansing pads, etc.
Stop using the product and seek emergency medical care if you develop any of the following symptoms while using topical acne treatments.
- Difficulty breathing
- Feeling faint or lightheaded
- Swelling of the eyes, face, lips, or tongue
- Tightness in the throat
The FDA also cautions consumers to stop using the product immediately if the experience itching or hives. New recommendations involve testing acne products on one or two small areas of affected skin for 3 days prior to using the product as directed. If any discomfort occurs during the test period, the product should not be used. Additional research is ongoing, according to the FDA.
Prevention of Acne
Acne can’t be prevented, but outbreaks can be lessened by following the measures outlined above.
When to Call Your Doctor about Acne
Acne can be emotionally upsetting and, in severe cases, disfiguring. Contact your physician if you have acne that is making you self-conscious, depressed, frustrated, or embarrassed, or if your acne is typified by cysts or nodules, or if unexplained symptoms develop after taking prescription acne medication.
What Your Doctor Will Do about Acne
After a close examination of your skin, your physician may open pimples or remove blackheads and whiteheads. The doctor may prescribe a wide variety of therapies, including lotions and ointments, antibiotics, and a drug called tretinoin.
Commonly called Retin-A, tretinoina derivative of vitamin Ais a topical prescription medication that has proved to be very effective for treating blackheads and has shown modest results for treating pimples. Tretinoin should be used in moderate to severe cases of acne after treatment with milder agents has failed. Anyone using it should be aware that the skin can become extremely irritated.
The drug is available in cream-based preparations (the mildest form) as well as gels and liquids. Low concentrations are tried first, then the strength may be increased, depending on the degree of peeling and irritation that occurs. There are also newer formulations of tretinoin (Avita and Retin A Micro) that claim to be milder than the original tretinoin.
Tretinoin cannot be used by pregnant women or those planning to become pregnant. Also, the drug may enhance the tendency to sunburn, so protective measures must be taken to limit sun exposure.
Topical antibiotics, such as clindamycin or erythromycin (administered as a cream, gel, lotion, or skin pad), can be useful in controlling the signs of acne. Your doctor may also recommend systemic oral antibiotics, such as erythromycin or tetracycline, which are effective in treating extensive acne pimples.
For severe acne that has proved resistant to other forms of treatment, a more powerful oral medication called isotretinoin (Accutane) may be prescribed. Accutane has a number of complications, including liver toxicity, so be sure to discuss these with your doctor. Also, the drug should never be taken if you are pregnant or trying to become pregnant.
Any acne therapy can take several months for improvement to occur. For teenagers prone to acne, the therapy may have to be continued throughout adolescence.
For More Information about Acne
- American Academy of Dermatology
- National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse
Updated by Remedy Health Media