What causes acne?
The oil glands in your skin produce a substance called sebum, which is a natural moisturizer. As your body matures, sex hormones cause these oil glands to produce larger quantities of sebum. Sebum, combined with a build-up of debris and shed skin, causes plugging up of the follicles. The plug is called a comedo, more commonly known as a blackhead or whitehead. The tops of blackheads are black because of a chemical reaction of the oily plug with air.
In addition there are many bacteria or germs on the skin surface. Most of these are harmless, but some can become trapped in the opening of the oil gland, irritation and inflammation. The inflammation may be superficial or very deep. This is why there is a great variation in the severity of acne in different people.

Does acne occur only during the teen years?
Definitely not. Although it usually begins during adolescence, it can persist well into adult life. It can also begin in the 20s and 30s.

Why does acne tend to get worse at times?

• Changes in the hormone levels often affect acne. Many girls and women will notice a slight flare-up of acne before or during a menstrual period. Birth control pills or pregnancy also influence the degree of severity. Male hormones play a significant role in acne.
• It is thought by many that stress and tension can cause a worsening of acne. Some people react to stress by picking or rubbing pimples, and this can make their acne worse.
• Certain medications may either cause acne or make existing acne worse. If you are taking any medication regularly, please tell your doctor or nurse.

Does diet affect acne?
There is no evidence that chocolate, soda pop, or fatty foods are bad for acne. However, if certain foods definitely worsen your acne, avoid them. Iodine containing foods (shellfish) may aggravate acne.

How is acne treated?
Unfortunately, there is no medical cure for acne. The goal of treatment is to control your acne until you outgrow it. This will take time; therefore, treatment may continue for months or years sand may need to be changed from time to time. Even the most effective medications take 6-8 weeks to begin working and sometimes even longer – so be patient. The therapy your dermatologist will recommend will vary according to the severity of your acne.

Basic treatment for all acne

• Wash your face with a mild soap (for example, Neutrogena, Purpose gentle cleansing wash, Cetaphil gentle skin cleanser) twice a day and after exercise. Too much washing and scrubbing can irritate the skin and make acne worse. Special astringents are probably a waste of money.
• Do not pick, squeeze, or scratch your pimples.
• Avoid using greasy hair products since they can spread to the face and worsen acne, especially on the forehead.
• If you use make-up, use water-based and oil-free products (look for the word “noncomedogenic”). Cosmetics should be removed at night with soap and water. An oil free powder based makeup is ideal. Shield your face when applying hairsprays and gels.
• Shampoo your hair daily, avoid 2 in 1 shampoos with conditioner.

Topical therapy
Mild acne is often controlled with topical therapy. Remember that treatment of acne prevents new lesions. Therefore, topical medications must be applied to the areas of your skin where you tend to break out, not just to the pimples.

• Benzoyl peroxide 5% gel helps to open pimples and unplug blackheads. It also kills bacteria. It is available without a prescription. Apply the gel once a day at bedtime. If your skin becomes red or scaly, you are using too much of the medicine or applying it too often. Try using less of it or applying it less often.
• Topical Retinoids: (Avita Cream, Retin-A, and Differin) are prescription medications that also help to unplug blackheads. These are vitamin A based creams that help prevent plugging of the follicle and blackhead formation.
• Topical antibiotics may be prescribed if you have red bumps and pus bumps.

Oral medications

• Oral antibiotics including tetracycline, doxycycline, erythromycin and minocycline may be needed if you have many red bumps and pus bumps.
• Oral Isotretinoin, such as Accutane, Sotret, or Amnesteem is used only for severe, scarring, or cystic acne. Accutane has many possible side effects. Prevention of pregnancy is a must since the drug can cause severe birth defects if taken during pregnancy.
• Isotretinoin is regulated by a program called iPledge: For more information information on the iPledge Program, click the following: Oral Isotretinoin (Accutane, Sotret): The IPLedge Program
• For general information on Isotretinoin, it's indications and side effects, click the following: Isotretinoin (Accutane, Sotret)

Remember: each person is different, and your provider will recommend therapy for you and the type of acne you have.

For more information go to The skin care physicians website.