Frequently Asked Questions About Acne
Acne is a very common disease. People who have
it tend to have similar kinds of questions about it and its treatment.
This section addresses some of the common questions asked by people
with acne. Please remember that your dermatologist is always the
best source of specific information about your individual health
issues, including acne.
Questions and Answer does follows:
1. What causes acne?
The causes of acne are linked to the changes that
take place as young people mature from childhood to adolescence
(puberty). The hormones that cause physical maturation also cause
the sebaceous (oil) glands of the skin to produce more sebum (oil).
The hormones with the greatest effect on sebaceous glands are androgens
(male hormones), which are present in females as well as males,
but in higher amounts in males.
Sebaceous glands are found together with a hair
shaft in a unit called a sebaceous follicle. During puberty, the
cells of the skin that line the follicle begin to shed more rapidly.
In people who develop acne, cells shed and stick together more so
than in people who do not develop acne. When cells mix with the
increased amount of sebum being produced, they can plug the opening
of the follicle. Meanwhile, the sebaceous glands continue to produce
sebum, and the follicle swells up with sebum.
In addition, a normal skin bacteria called P. acnes,
begins to multiply rapidly in the clogged hair follicle. In the
process, these bacteria produce irritating substances that can cause
inflammation. Sometimes, the wall of the follicle bursts, spreading
inflammation to the surrounding skin. This is the process by which
acne lesions, from blackheads to pimples to nodules, are formed.
2. I wash my face several times
a day. Why do I still get acne?
Many people still believe that acne is caused by
dirty skin. The truth is, washing alone will not clear up or prevent
acne. Washing does, however, help remove excess surface oils and
dead skin cells. Many people use all kinds of products, including
alcohol-based cleansers, and scrub vigorously, only to irritate
the skin further and worsen their acne. Washing the skin twice a
day gently with water and a mild soap is usually all that is required.
However, acne is actually caused by a variety of biologic factors
that are beyond the control of washing. For that reason, you should
use appropriate acne treatments for the acne.
3. Does stress cause acne?
Stress is commonly blamed for the development of
acne. Stress can have many physiologic effects on the body, including
changes in hormones that may theoretically lead to acne. In some
cases the stress may actually be caused by the acne lesions, not
the other way around! If the acne is being treated effectively,
stress is not likely to have much impact on the majority of people.
4. I never had acne as a teenager.
Why am I now getting acne as an adult?
Usually, acne begins at puberty and is gone by
the early 20s. In some cases, acne may persist into adulthood. Such
types of acne include severe forms that affect the body as well
as the face (which afflict males more than females) and acne associated
with the menstrual cycle in women. In other cases, acne may not
present itself until adulthood. Such acne is more likely to affect
females than males.
There are several reasons for this. As females
get older, the pattern of changes in hormones may itself change,
disposing sebaceous glands to develop acne. Ovarian cysts and pregnancy
may also cause hormonal changes that lead to acne. Some women get
acne when they discontinue birth control pills that have been keeping
acne at bay. Sometimes young women may wear cosmetics that are comedogenic-that
is, they can set up conditions that cause comedones to form.
5. What role does diet play in
acne?
Acne is not caused by food. Following a strict
diet will not, clear your skin. While some people feel that their
acne is aggravated by certain foods, particularly chocolate, colas,
peanuts, shellfish and some fatty foods, there is no scientific
evidence that suggests food causes or influences acne. Avoid any
foods which seem to worsen your acne and, for your overall health,
eat a balanced diet-but diet shouldn't really matter if the acne
is being appropriately treated.
6. Does the sun help acne?
Many patients feel that sunlight improves their
acne lesions and go to great lengths to find sources of ultraviolet
light. There is no proven effect of sunlight on acne. In addition,
ultraviolet light in sunlight increases the risk of skin cancer
and early aging of the skin. It is, therefore, not a recommended
technique of acne management, especially since there are many other
proven forms of treatment for acne. Moreover, many acne treatments
increase the skin's sensitivity to ultraviolet light, making the
risk of ultraviolet light exposure all the worse.
7. What is the best way to treat
acne?
Everyone's acne must be treated individually. If
you have not gotten good results from the acne products you have
tried, consider seeing a dermatologist. Your dermatologist will
decide which treatments are best for you. For more information about
the types of acne treatments that are available, and for basic acne
treatment guidelines, please see Acne Treatments in the main part
of AcneNet.
8. What kind of cosmetics and
cleansers can an acne patient use?
Look for "noncomedogenic" cosmetics and
toiletries. These products have been formulated so that they will
not cause acne.
Some acne medications cause irritation or pronounced
dryness particularly during the early weeks of therapy, and some
cosmetics and cleansers can actually worsen this effect. The choice
of cosmetics and cleansers should be made with your dermatologist
or pharmacist.
Heavy foundation makeup should be avoided. Most
acne patients should select powder blushes and eye shadow over cream
products because they are less irritating and noncomedogenic. Camouflaging
techniques can be used effectively by applying a green undercover
cosmetic over red acne lesions to promote color blending.
9. Is it harmful to squeeze my
blemishes?
Yes. In general, acne lesions should not be picked
or squeezed by the patient. In particular, inflammatory acne lesions
should never be squeezed. Squeezing forces infected material deeper
into the skin, causing additional inflammation and possible scarring.
1. Can anything be done about
scarring caused by acne?
Scarring is best prevented by getting rid of the
acne. Dermatologists can use various methods to improve the scarring
caused by acne. The treatment must always be individualized for
the specific patient. Chemical peels may be used in some patients,
while dermabrasion or laser abrasion may benefit others. It is important
that the acne be well controlled before any procedure is used to
alleviate scarring.
2. How long before I see a visible
result from using my acne medication?
The time for improvement depends upon the product
being used, but in almost all cases it is more a matter of weeks
or months instead of days. Most dermatologists would recommend the
use of a medication or combination of medications daily for 4 to
8 weeks before they would change the treatment. It is very important
for patients to be aware of this time frame so they do not become
discouraged and discontinue their medications. Conversely, if you
see no change whatsoever, you might want to check with your dermatologist
regarding the need to change treatments.
3. Would using my medication more
frequently than prescribed speed up the clearing of my acne?
No-always use your medication exactly as your dermatologist
instructed. Using topical medications more often than prescribed
may actually induce more irritation of the skin, redness and follicular
plugging, which can delay clearing time. If oral medications are
taken more frequently than prescribed, they won't work any better,
but there is a greater chance of side effects.
4. My topical treatment seems
to work on the spots I treat, but I keep getting new acne blemishes.
What should I do?
Topical acne medications are made to be used on
all acne-prone areas, not just individual lesions. Part of the goal
is to treat the skin before lesions can form and to prevent formation,
not just to treat existing lesions. Patients are generally advised
to treat all of the areas (forehead, cheeks, chin and nose) that
tend to break out rather than just individual lesions.
5. My face is clear! Can I stop
taking my medication now?
If your dermatologist says you can stop, then stop-but
follow your dermatologist's instructions. Many times patients will
stop their medication suddenly only to have their acne flare up
several weeks later. If you are using multiple products, it may
be advisable to discontinue one medication at a time and judge results
before discontinuing them all at once. Ask your dermatologist before
you stop using any of your medications.
6. Does it matter what time I
use my medication?
Check with your dermatologist or pharmacist. If
you were taking one dose a day of an antibiotic, you could probably
take it in the morning, at midday or in the evening, although you
should pick one time of day and stay with it throughout your treatment.
With oral medications prescribed twice a day or three times a day,
you should try your best to spread out the doses evenly. Some antibiotics
should be taken on an empty or nearly empty stomach. For optimal
results with topical treatments, you should strictly follow your
dermatologist's recommendations. For example, if instructed to apply
benzoyl peroxide in the morning and a topical retinoid at bedtime,
it is important to follow these directions strictly. If the two
were applied together at bedtime, for example, you could decrease
the efficacy of the treatment because of chemical reactions that
make them less effective.
7. I have trouble remembering
to take my oral medication every day. What's a good way to remember?
What should I do if I forget a dose?
This is a common problem. Many patients try to
associate taking their medication with a routine daily event such
as brushing teeth or applying makeup. It also helps to keep the
medication close to the area where the reminder activity is carried
out.
In most cases, if you miss a day of your oral treatment,
do not double up the next day; rather, get back to your daily regimen
as soon as possible-but there may be different instructions for
different oral medications. Ask your dermatologist or pharmacist
about what to do if you miss a dose of your particular medication.
8. I have been using topical benzoyl
peroxide and an oral antibiotic for my acne and have noticed blue-black
and brown marks developing on my face and some discoloration on
my body. The marks are especially noticeable around acne scars and
recently healed lesions. Is this a side effect of medication and
is it permanent?
It is not possible to make general statements about
side effects of medications that apply to individual cases. A dermatologist
should be consulted. The facial marks and body discoloration described
by the patient in this case do fall within the range of side effects
of some antibiotics.
Unique patterns of pigmentation are sometimes seen
in acne patients treated with certain oral antibiotics-particularly
minocycline. The pigmentation patterns that appear may include:
* Localized blue-black or brown marks in and around acne scars and
in areas of previous acne inflammation
* A "muddy skin" appearance that may
cover much of the body
* Diffuse brownish pigmentation of the feet and
lower legs.
The pigmentation side effect gradually disappears
after the therapy is discontinued.
Any side effect of a medication should be noted
by the patient and brought to the attention of the physician. While
most side effects are temporary they should be discussed with the
physician and monitored.
9. My doctor is prescribing a
topical retinoid for my acne. He said a retinoid is a substance
related to vitamin A. If the drug is related to vitamin A, shouldn't
vitamin A dietary supplements be helpful in getting rid of acne?
Dietary vitamin A is essential to good health,
especially vision. It has healthful effects in the skin. Large doses
of vitamin A for the treatment of acne is not recommended on grounds
of safety. The retinoids and retinoid-like substances used as topical
treatments for acne are prepared especially for their potent effect
on the shedding of cell lining in the sebaceous follicle. Their
use should be monitored by a dermatologist.
Dietary vitamin A has multiple health effects in
the human body. Vitamin A is essential for good vision. Extreme
vitamin A deficiency can result in blindness, usually accompanied
by dry, scaly skin. Vitamin A overdose that far exceeds the Recommended
Dietary Allowance (RDA) of 5,000 IU can have effects nearly as catastrophic.
Extreme vitamin A overdose can cause the skin to blister and peel-an
effect first seen in early North Pole explorers who nearly died
after eating polar bear liver that has an extraordinarily high vitamin
A content.
Topical retinoids are usually prescribed as a treatment
for moderate to severe acne. Side effects are chiefly dermatologic,
including redness, scaling and dryness of the skin, itching and
burning. These side effects can usually be managed by adjustment
of the amount and timing of retinoid applied to the skin. Dose adjustment
must be discussed with the dermatologist who prescribed the treatment.
10. Are there any acne treatments
specifically for people with dark skin? Are there any treatments
specifically harmful to dark skin?
There are no acne treatments specifically for use
on dark skin. Acne treatments are generally as safe and effective
on dark skin as on light skin. Some treatments for acne scars may
cause temporary lightening of dark skin.
Acne is a common skin disease that has the same
causes and follows the same course in all colors of skin.
Very dark or black skin may be less well-moisturized
than lighter skin. Topical anti-acne agents such as benzoyl peroxide
that have a drying effect on the skin should be used under the supervision
of a dermatologist. Benzoyl peroxide also is a strong bleach and
therefore must be applied carefully to avoid inadvertent decolorization
of a patch of hair, towels or clothing.
Darker skin has a tendency to develop post-inflammatory
hyperpigmentation (excessive skin darkening at places where the
skin was inflamed). Severe inflammatory acne may result in dark
spots. The spots resolve over time; a dermatologist may be able
to recommend cosmetic measures to make the spots less apparent until
they resolve. Some acne treatments, such as topical retinoids and
azelaic acid, may also help fade the discoloration.
Removal of acne scars by dermabrasion or chemical
peeling may cause temporary lightening or darkening of dark skin
in the areas of treatment. Scar treatment should be discussed with
a dermatologist or dermatologic surgeon before it is undertaken.
Alterations of melanin (dark pigments that give
the skin its color) pigmentation such as vitiligo and melasma are
not related to acne, but they may be present simultaneously with
acne. The diagnosis and treatment of melanin pigmentation disorders
such as vitiligo requires a dermatologist with knowledge and experience
in treating these conditions.
11. Is acne that appears for the
first time in adulthood different from acne that appears in adolescence?
Acne has a specific definition as a disease of
sebaceous follicles. This definition applies to acne that occurs
at any age. However, it may be important to look for an underlying
cause of acne that occurs for the first time in adulthood.
Current understanding of the causes of acne vulgaris
is described in the Main Text section Why and how acne happens.
In brief summary, acne vulgaris develops when excessive sebum production
and abnormal growth and death of cells in the sebaceous follicle
result in plugging of follicles with a mixture of sebum and cellular
debris and formation of comedones (blackheads and whiteheads). Bacteria
in the follicles-chiefly Propionibacterium acnes, the most common
bacterial colonist of sebaceous follicles-may contribute to the
inflammation of acne by release of metabolic products that cause
inflammatory reaction. The pathogenic events, which cause disease,
in the sebaceous follicle are believed to be due in large degree
to changes in levels of androgenic (male) hormones in the body-a
circumstance usually associated with growth and development between
ages 12 and
12. Some acne investigators believe
that although this understanding is generally correct, there is
more yet to be learned about the causes of acne vulgaris.
Acne that appears after the age of 25-30 years
is (1) a recurrence of acne that cleared up after adolescence, (2)
a flare-up of acne after a period of relative quiet-for example,
during pregnancy, or (3) acne that occurs for the first time in
a person who had never previously had acne.
Acne that occurs in adulthood may be difficult
to treat if there are multiple recurrences. Some patients with severe
recurrent acne have undergone repeated courses of treatment with
the potent systemic drug isotretinoin.
Acne flares in association with pregnancy or menstruation
are due to changes in hormonal patterns.
Acne that appears for the first time in adulthood
should be investigated for any underlying cause. Drugs that can
induce acne include anabolic steroids (sometimes used illegally
by athletes to "bulk up"), some anti-epileptic drugs,
the anti-tuberculosis drugs isoniazid and rifampin, lithium, and
iodine-containing drugs. Chlorinated industrial chemicals may induce
the occupational skin disorder known as chloracne. Chronic physical
pressure on the skin-for example, by a backpack and its straps,
or a violin tucked against the angle of the jaw and chin-may induce
so-called acne mechanica. Some metabolic conditions may cause changes
in hormonal balance that can induce acne.
Some lesions that appear to be acne may be another
skin disorder such as folliculitis-infection and inflammation of
hair follicles-that require different treatment than acne. Acne
that appears for the first time in adulthood should be examined
and treated by a dermatologist.
13. My 15-year-old daughter has
what I would describe as a very mild case of acne. She has made
it much worse by constant picking and squeezing. She looks in the
mirror for hours, looking for some blackhead or blemish she can
pick or squeeze. Does she need psychological counseling?
Excessive picking and squeezing of otherwise mild
acne is a condition called excoriated acne, seen most often in young
women. A dermatologist may provide effective counseling.
The typical person with excoriated acne is a person-often
a young women-who is so distressed with her appearance due to acne
that she literally tries to "squeeze the acne out of existence."
The acne is often very mild, but the person's face may constantly
be covered with red marks from squeezing, and open sores where lesions
have been picked open.
The word excoriate means to scratch or abrade the
skin. Excoriated acne is a medically recognized condition that should
be discussed with a dermatologist. Occasionally giving in to a temptation
to squeeze a blackhead is not defined as excoriated acne. Hours
in front of a mirror, squeezing and picking every blemish, is a
definition of excoriated acne. A dermatologist may be able to counsel
the patient regarding a course of treatment in which the patient
can participate, but keep "hands off."
14. Can the rate of secretion
or the composition of sebum be altered by diet? If it can, shouldn't
alteration of diet be considered a treatment for acne?
Diet has never been proven to have a role in the
cause or treatment of acne. Dietary manipulation may have a role
in the treatment of some scaling diseases of the skin, but not in
the treatment of acne.
Dietary cause is one of the most persistent myths
about acne. Foods, such as chocolate or greasy foods, do not cause
acne, but certain foods seem to make some people's acne worse. The
following can bring on or worsen it:
*Hereditary factors
*An increase in male hormones found in both males
and females
*Menstruation
*Emotional stress
*Oil and grease from cosmetics, work environment
No food has been shown to be effective in preventing
or treating acne. A healthy diet is, of course, necessary for good
general health.
15. Shouldn't I just try to eliminate
sebum from my body?
No. When it isn't blocked in your pores, sebum
helps keep your skin healthy.
16. Why does acne usually start
at puberty?
No one knows for certain. What is known is that
the sebaceous glands that produce sebum get much larger at puberty
than they were before.
9. Why does the skin around a
pimple turn red?
This redness is caused by the body's inflammatory
response. Inflammation is a sign that your immune system is working
to fight an infection. However, the inflammatory response doesn't
always work perfectly, and can even be the cause of scarring.
17. If my skin turns red, does
that mean that I'm going to have scars?
Usually, no. Even when there will be no permanent
scar, the aftereffects of the inflammatory response can leave the
skin red for months, sometimes for more than a year.
18. What are free radicals?
Free radicals are byproducts of oxidation in your
body. We all need oxidation to occur as part of our life process,
but there is concern that the buildup of unrecycled free radicals
contributes to many conditions, including skin damage. Antioxidants,
including several of the active ingredients in Acuzine, help prevent
the buildup of free radicals.
* * *
Jesica Bacalla writes for
Acne Article [http://www.acneblogs.net]
for more info visit [http://www.acneblogs.net]
Article Source: http://EzineArticles.com/?expert=Rachel_D_Frag
|