Acne is the most common skin problem treated in
the US. More than 85% of adolescents and 10% of
adults have the whiteheads, blackheads or pimples
on their cheeks, chest, shoulders and back. Some
people develop more pimples than others and for
these people we can offer treatment to make them
look better now and prevent permanent scarring in
the future.
The typical acne lesions result from a combination
of factors. First the hair follicle becomes blocked
with dead skin cells. Next, in response to hormones
like those increased with puberty, there is an overproduction
of sebum (an oily substance made in the follicles.)
Finally, a skin bacterium, Propionibacterium acnes
(P. Acnes), which grows well in the plugged up follicle,
causes inflammation and a pimple.
Rubbing, scrubbing with astringents, and picking
or popping the pimples will only make them worse
and make the face more irritated. Food has no direct
effect on the production of sebum so eating chocolates,
sweets or french fries will not make your acne worse.
In some people untreated acne can lead to cysts
and permanent scarring.
Treatment of acne is directed at its causes. The
choice of which type to use is based on how bad
it is. Treatment always starts with the use of a
mild moisturizing soap to gently wash the skin.
Harsh soaps can irritate the skin and make acne
worse. There are many acne medicines available without
a prescription. If you are not satisfied with these
products then we encourage you to came in for an
appointment with your doctor.
If the severity of your acne is mild to moderate
your doctor will prescribe for you a topical cream,
gel or ointment. Tretinoin (Retin A, Differin, ect.),
a topical form of Vitamin A, breaks up the blocked
hair follicles and helps to correct the overproduction
of squamous cells. Topical antibiotics, like benzoyl
peroxide 2.5%-10%, erythromycin, cleocin T or benzamycin,
a combination of benzoyl peroxide and erythromycin,
decrease the amount of P. Acnes in the hair follicle
by direct contact. They may be used alone or in
combination with other medications. The major side
effects of these medicines include peeling skin,
dryness, facial redness, sun sensitivity and allergic
contact sensitization.
If the acne is more severe oral antibiotics such
as tetracycline, minocycline, doxycycline and erythromycin
can be added to reduce bacteria in the hair follicles
and decrease inflammation. The major side effects
include stomach upset and sun sensitivity.
Finally, if the acne is very severe, Isotretinoin
(Accutane) an oral form of Vitamin A, can be used
to reduce sebum production, shedding of dead skin
and inflammation. However, there are a number of
very significant side effects including birth defects
in pregnant women, dry skin, poor night vision,
hair loss, muscle aches, joint pains, headaches
and sun sensitivity.
Through education about what causes acne, dispelling
myths and proper treatment your pediatrician can
help you look your best now and in the future. Arrange
an appointment to talk with us about your acne.
