All About Acne: Causes, Treatments and Prevention
Acne is a skin condition from which virtually everyone has suffered to some degree, and it is one of the most common concerns of our patients at Janiga MDs Reno Dermatology. It is not only a widespread affliction, but because there are several causes, treatment can be complicated and require multiple steps.
What Is Acne?
In simplest terms acne is a disease of the hair follicle. Glands in the follicle produce oil called sebum, which lubricates the skin and allows for the smooth growth of the hair. Our hormones especially androgens, which are male hormones that occur in both males and females, influence the production of this oil and, during puberty, times of stress or women during their menses, these hormonal fluctuations cause an excess of sebum.
Excess sebum can alter the way skin cells mature, resulting in a plugging of the cells in the hair follicle. This plugging then develops into a visible bump, known as blackheads if exposed to air or whiteheads if covered by a thin layer of skin cells. The wall of the follicle can then rupture under the pressure of the clogging causing inflammation of the surrounding skin. These inflamed bumps then present as pimples and if this inflammation spreads deeper into the skin it can cause what is known as cystic acne.
There are also certain bacteria associated with acne which thrives in the environment provided by the plugged follicle, therefore treatment must address not only the overproduction of oil and the clogging of the pores, but also bacteria and the body’s inflammatory reaction.
How do you treat acne?
The goal of treatment is to resolve the underlying cause of the acne in order to prevent a recurrence of the bumps, which can result in permanent and unsightly scarring. Benzoyl peroxide is the most commonly used acne medication and is available without a prescription. It kills the bacteria and helps the skin to slough. Alternative topical medications available over the counter are sulfur and alpha hydroxy acids such as glycolic, salicylic and lactic acid.
Depending on whether the acne is inflammatory, with redness, swelling and inflammation; or non-inflammatory, with blackheads or whiteheads only, a variety of treatments are available. For non-inflammatory acne, retinoids, which exfoliate the packed cells are recommended. These topically applied medications include Differin, Tazorac, and Atralin. When the acne is mildly to moderately inflammatory a retinoid plus topical antibiotics is recommended. Commonly prescribed topical antibiotics include clindamycin, sulfacetamide and dapsone.
If the inflammation is moderate to severe, an oral medication may be prescribed. Oral or systemic medications include oral antibiotics, hormone therapy and isotretinoin. Such antibiotics are commonly used since they have an anti-inflammatory effect while also inhibiting the growth of the bacteria associated with acne.
Minocycline and doxycycline are the oral antibiotics of choice in the treatment of inflammatory acne. Alternatively, hormone therapy in the form of birth control pills, which contain estrogen, can offset the acne-causing influence of androgens. Spironolactone is another oral medication, usually safe for long-term use that can counter the effects of androgens. Finally, the aforementioned Isotretinoin is an oral medication, which effectively decreases the oil-production in the follicle, which is the root cause of acne and thus can be considered a cure.
It should be remembered however, that all medications carry the risk of side effects. In deciding whether or not to take to take a pill, which can affect the entire body system, the potential side effects must be taken into consideration.
How can I prevent acne altogether?
In regard to the prevention of acne, while it may be inevitable that most people will experience some degree of outbreaks, there are simple steps one can take, which may help prevent or lessen the severity of these breakouts.
It is recommended that one use a gentle cleanser with warm water at least once or twice a day and avoid harsh soaps as they can strip the skin of its protective oil. This leads to re-bound oiliness, which in turn leads to acne. Moisturize your skin regularly with a non-comedogenic lotion or cream, and if you wear makeup, try to use only non-comedogenic products.
Remember that products used on your your hair or even just oily hair coming into contact with the skin can put you at risk for acne breakouts. Therefore, try to limit if not avoid products with perfumes and gels in and keep your hair away from the facial skin as much as possible.
Besides being embarrassing and sometimes even painful, acne can also be a frustrating skin disorder that is often resistant to treatment. If over the counter products are not resolving the problem to your satisfaction, you may benefit from a consultation to determine whether prescription medications should be tried.