| ACNE
Acne
is the term for plugged pores (blackheads and whiteheads),
pimples, and even deeper lumps (cysts or nodules) that
occur on the face, neck, chest, back, shoulders and
even the upper arms. Acne affects most teenagers to
some extent. However, the disease is not restricted
to any age group; adults in their 20s - even into their
40s - can get acne. While acne usually clears up after
several years even if untreated, you need not wait to
outgrow it. Untreated acne can leave lifelong scars.
While
not a life threatening condition, acne can be upsetting
and disfiguring. When severe, acne can lead to serious
and permanent scarring. Even less severe cases can lead
to scarring.
How
Acne Forms
Rising
hormone levels during adolescence (puberty) cause the
oil (sebaceous) glands of the skin to get bigger. These
glands are found in areas where acne is common (the
face, upper back, and chest). They are stimulated by
male hormones found in both males and females.
The
glands are connected to a hair-containing canal called
a follicle. The sebaceous glands make an oily substance
called sebum which reaches the surface by emptying through
the opening of the follicle on to the skin surface.
The oil (sebum) seems to stimulate the lining of the
follicle. The cells from the lining shed more rapidly
and stick together, forming a plug at the skin surface.
The mixture of oil and cells also helps bacteria in
the follicles grow. These bacteria make chemicals that
can cause the wall of the follicle to break. Then sebum,
bacteria and shed skin cells spill into the skin causing
redness, swelling and pus - a pimple.
Cleansing
Acne
is not caused by dirt. The black in a blackhead is dried
oil and shed skin cells in the openings of the hair
follicles, not dirt. For the normal care of your skin,
wash your face with soap and warm water twice a day.
Washing too often may actually make your acne worse.
Regular shampooing is also recommended. If your hair
is oily, you may want to wash it more often. Your dermatologist
can recommend the best face and hair washing routine.
Men
with acne who shave should try both an electric and
a safety razor to see which is more comfortable. If
you use a safety razor, soften your beard thoroughly
with soap and warm water before applying shaving cream.
To avoid nicking pimples, shave as lightly as possible.
Shave only when necessary and always use a sharp blade.
Diet
Acne
is not caused by the foods you eat. Dermatologists have
differing opinions on the importance of diets in the
management of acne. One thing is certain, a strict diet
by itself will not clear your skin. On the other hand,
some people find that certain foods seem to make their
acne worse. If that's the case, foods that clearly worsen
your acne should be avoided. But be careful about jumping
to conclusions, acne has many ups and downs on its own.
Sunlight
A
tan can mask your acne, but the benefits are temporary.
Since sunlight ages the skin and can cause skin cancer,
you should not sunburn, “bake in the sun" or use
sunlamps. Choose
a sunscreen that is oil-free, such as a gel sunscreen.
Cosmetics
If
you wear a liquid foundation or use a moisturizer, look
for ones that are oil-free and not just water-based.
Choose products that are "non-comedogenic"
(should not cause whiteheads or blackheads) or "non-acnegenic"
(should not cause acne). Remove your cosmetics every
night with soap and water.
A
fresh-tinted acne lotion can safely hide blemishes.
Loose powder mixed with oil-free product is also good
for cover-up.
Shield
your face when applying hairsprays and gels. If the
spray comes in contact with your facial skin, it can
cause a cosmetic type of acne.
Treatment
Control
of acne is an ongoing process. All acne treatments work
by preventing new acne. Existing blemishes must heal
on their own. Improvement takes time. If your acne has
not improved after 6 to 8 weeks, you may need a change
in your treatment.
The
treatment your dermatologist recommends will vary according
to your type of acne. Occasionally, an acne-like rash
can be due to another cause - such as makeup or lotions
you've used or oral medication. Rarely acne can be due
to a hormone imbalance. It's important to help your
dermatologist by providing a history of what you are
using on your skin or taking internally. Women will
want to discuss changes in the menstrual pattern.
Many
non-prescription acne lotions and creams help milder
cases of acne. However, many will also make your skin
dry if used too often. If you use these products, follow
instructions carefully.
Your
dermatologist may prescribe topical creams or lotions
such as vitamin A acid or benzoyl peroxide to help unblock
the pores and reduce the bacteria. These may cause some
drying and peeling. Your dermatologist will advise you
on the correct use and how to handle side effects.
There
are also antibiotics that are applied to the skin. These
are used in less severe cases of acne. When large red
bumps are present, the dermatologist may inject a cortisone
directly into the bumps to help them go away.
Your
physician may open pimples or remove blackheads and
whiteheads. Don't pick, scratch, pop or squeeze pimples
yourself. When the pimples are squeezed, more redness,
swelling, inflammation and scarring may result.
Antibiotics
taken by mouth such as tetracycline, minocycline or
erythromycin are often prescribed for moderate or severe
cases, especially when there is a lot of acne on the
back or chest. The antibiotics reduce the bacteria in
the follicle and may also decrease the redness directly.
When taking oral antibiotics some women develop a yeast
infection in the vaginal area. If this occurs, continue
your medicine and contact your dermatologist immediately
for treatment of the yeast.
Women
who are taking birth control pills may notice a significant
improvement in their acne, and occasionally birth control
pills are used specifically for the treatment of acne.
It is also important to know that oral antibiotics may
decrease the effectiveness of birth control pills. This
is uncommon but possible, especially if you notice break-through
bleeding. As with most medicines, check with your doctor
about taking antibiotics if you are pregnant or nursing.
In
cases of severe acne, other drugs may be used orally.
These may include female hormones or medications that
decrease the effects of male hormones. Another oral
medication, isotretinoin, is
sometimes used for severe acne that has not
responded to other treatments. Patients using isotretinoin
must thoroughly understand the side effects of this
drug. Frequent follow-up visits are necessary to monitor
side effects. Prevention of pregnancy is a must, since
the drug causes severe birth defects if taken during
pregnancy.
Proper care is necessary
No
matter what special treatments your physician may use,
remember that you must continue proper skin care until
the tendency to have acne has passed. There is no instant
or permanent cure for acne, but it is controllable and
proper treatment may prevent scars.
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