Acne
What is it?
Acne is characterized by minor, though occasionally severe, skin eruptions due to inflammation around the sebaceous glands. Most prominent on the face, upper chest, and back, the sebaceous glands secrete sebum, a thick, oily substance that lubricates the skin. Acne develops when sebum flow is blocked by skin cells, dried sebum, or bacteria. A complete blockage produces a light-colored bump (whitehead); an incomplete blockage leads to a dark-colored spot (blackhead). Bacteria normally found on the surface of the skin may then infect the whitehead or blackhead, produce pus, and cause an eruption (pimple). In severe cases, known as cystic acne, painful purple lumps develop.
Except in cases that cause widespread skin pustules, cysts, or scarring, acne is generally harmless and responsive to treatment. It is most common during adolescence and can cause considerable psychological distress. Eruptions tend to wane by one's 20s, but they may persist. In women, acne may first appear in the 20s or 30s. Unexplained outbreaks of acne in older adults may be a sign of a more serious underlying problem.
What Causes It?
- Hormonal changes during puberty, resulting in increased sebum production.
- Hereditary factors.
- Certain drugs or compounds, including corticosteroids, illegal anabolic steroids, iodides, bromides, and lithium.
- Grease, tar, heavy oils, cosmetics, tight clothing, oranything else that can physically block the pores.
- In adults, underlying medical conditions, includingovary or adrenal gland dysfunction, such as polycysticovary disease and Cushing's syndrome.
- Other factors including climate changes, stress, andexposure to dioxin.
Prevention
- There is no evidence that dietary modifications(such as avoiding chocolate or greasy foods) will reduce the incidence of acne in those so predisposed,although good hygiene may reduce severity.
- Picking or squeezing acne lesions may increase the danger of infection and scarring.
Diagnosis
- Diagnosis can be made upon visual inspection.
How to Treat It
- Regular washing of the face with unscented soap to remove excessive oil is recommended. However,overwashing can irritate skin, making acne worse.
- Topical solutions that dry the skin, promote peeling, and kill bacteria usually improve acne. Over-the-counter preparations most commonly contain salicylic acid or benzoyl peroxide.
- Several different prescription forms of synthetic vitamin A (Retin A, Differ in, and Tazorac) can be administered topically.
- In more severe cases, topical or oral antibiotics like tetracycline and erythromycin may be prescribed.
- For severe cases resistant to antibiotics, an oral vita-min A der ivative drug, Accutane, may be used. This drug can damage a fetus so extreme caution must beused to ensure that pregnancy does not occur during treatment. Accutane has other potential side effects;people taking it must be closely monitored by a physician, usually with monthly visits and blood tests.
- After acne has been fully controlled, scars can be treated with standard or laser surgery, or a resurfacing procedure called dermabrasion.
When to Call a Doctor
- Consult a doctor or dermatologist to discuss optimal ways to treat acne.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.