Acne

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Acne is a big concern, especially for women in their 20s. However, it would be wrong to say that men don’t suffer from acne. To many, acne is also known as blemishes, blackheads, whiteheads, pimples or cysts. It is most common during puberty and adolescence. According to recent data, almost 80 per cent of people in the age group of 11 to 30 years have acne outbreak at least once. Having said that, even adults are not fully immune. The number is low, but people in their 40s and 50s also get acne. There are also cases when a woman does not suffer from acne during teen but gets it in adulthood before her menstrual cycle.So what exactly is acne? Your skin has small holes (pores) that are connected to the oil glands lying under the skin through follicles. These glands are responsible for producing sebum, an oily substance. When these follicles get clogged, it leads to the outburst of acne. The reason acne occurs more around puberty or at the time of hormonal changes, is because there is excess secretion of oil.Acne, most commonly, does not have any serious health concern, but are distressing for the sufferer. Having said that, not all acne-like skin problems should be left untreated. Sometimes acne can have a more serious underlying cause such as polycystic ovarian disease (PCOD). The faster the issue is diagnosed, more effective will be its treatment.Acne should not be treated with antibiotics but can be fixed with certain dietary changes. For example, avoiding oily foods, preservatives, sweeteners, having two liters of mineral water along with having foods rich in Vitamin B6 helps dealing with acne.Oil-based products make acne worse, so do oil-based cosmetics. So for people with a family history of acute acne, must opt for water based products.

Symptoms:-

Common acne
Common Acne
Cystic acne
Cystic Acne

Acne signs vary depending on the severity of your condition:

  • Whiteheads (closed plugged pores)
  • Blackheads (open plugged pores)
  • Small red, tender bumps (papules)
  • Pimples (pustules), which are papules with pus at their tips 
  • Large, solid, painful lumps under the skin (nodules)
  • Painful, pus-filled lumps under the skin (cystic lesions)

Acne usually appears on the face, forehead, chest, upper back and shoulders.

Causes:-

How acne develops
How acne develops

Four main factors cause acne:

  • Excess oil (sebum) production
  • Hair follicles clogged by oil and dead skin cells
  • Bacteria
  • Inflammation

Acne typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands.

The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne.

Certain things may trigger or worsen acne:

  • Hormonal changes. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, particularly in women, can lead to breakouts too.
  • Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium.
  • Diet. Studies indicate that consuming certain foods — including carbohydrate-rich foods, such as bread, bagels and chips — may worsen acne. Further study is needed to examine whether people with acne would benefit from following specific dietary restrictions.
  • Stress. Stress doesn’t cause acne, but if you have acne already, stress may make it worse.

Acne myths

These factors have little effect on acne:

  • Chocolate and greasy foods. Eating chocolate or greasy food has little to no effect on acne.
  • Hygiene. Acne isn’t caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.
  • Cosmetics. Cosmetics don’t necessarily worsen acne, especially if you use oil-free makeup that doesn’t clog pores (noncomedogenics) and remove makeup regularly. Nonoily cosmetics don’t interfere with the effectiveness of acne drugs.

How is acne treated?

Your healthcare provider may suggest some non-prescription medications for your condition. Depending on the condition’s severity, your age, the type of acne you have and how effective the over-the-counter remedies have been, you may need stronger prescription medications.

The use of certain contraceptives can sometimes help a woman’s acne go away. The Food and Drug Administration has approved three types of birth control pills for treating acne. All four contain a combination of estrogen (the primary female sex hormone) and progesterone (a natural form of steroid that helps regulate menstruation).

Various medications and therapies have proven to be effective. They target the underlying factors that contribute to acne. You might require at least one or multiple, depending on the severity of your condition.

Medications applied topically:

  • Benzoyl peroxide is available as an over-the-counter product (such as Clearasil®, Stridex®, PanOxyl®) as a leave-on gel or wash. It targets surface bacteria, which often aggravates acne. Lower concentrations and wash formulations are less irritating to your skin. Irritation (dryness) is a common side effect.
  • Salicylic acid is available over-the-counter for acne, as a cleanser or lotion. It helps remove the top layer of damaged skin. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging.
  • Azelaic acid is a natural acid found in various grains such as barley, wheat and rye. It kills microorganisms on the skin and reduces swelling.
  • Retinoids (vitamin A derivatives)such as Retin-A®, Tazorac®, and Differin® (which is now available without a prescription) break up blackheads and whiteheads and help to prevent clogged pores, the first signs of acne. Most patients are candidates for retinoid therapy. These medications are not spot treatments and must be used on the entire area of skin affected by acne to prevent the formation of new pimples. The most common side effect is irritation, which usually improves with moisturization and time on the medication.
  • Antibiotics (topical types include clindamycin and erythromycin) control surface bacteria that aggravate and often encourage the swelling of acne. Antibiotics are more effective when combined with benzoyl peroxide.
  • Dapzone (Aczone®) is a topical gel, which also has antibacterial properties, can be used for inflamed acne. It’s applied to the skin twice a day.

Medications taken orally (by mouth):

  • Antibiotics, especially tetracycline antibiotics such as minocycline and doxycycline, are commonly used to treat moderate to severe acne.
  • Oral contraceptives can help with breakouts associated with menstrual cycles. Three classes of medications have been approved by the FDA for acne patients. Some brand names include Estrostep®, Beyaz®, Ortho Tri-Cyclen® and Yaz ®.
  • Isotretinoin (Amnesteem®, Claravis®, Sotret®), an oral retinoid, is an especially effective drug used only for the most severe cases of acne. Isotretinoin shrinks the size of oil glands, which contributes to acne formation. The most common side effect is dryness, but can also causebirth defects. Some evidence suggests a possible increased risk of ulcerative colitis and depression. Because of these risks, anyone using the drug must take part in a Food and Drug Administration-approved risk management program known as iPledge.

Other therapies:

Depending on your condition, your healthcare provider might suggest one of these specialized therapies, possibly combined with medication.

  • Steroids. Rarely, steroids can be used to treat severe acne or injected into large nodules to reduce inflammation.
  • Lasers. Currently, lasers are primarily used to treat acne scars. A laser delivers heat to the scarred collagen under the skin, this relies on the body’s wound healing response to create new, healthy collagen. This encourages the growth of new skin to replace it. There are different types of laser resurfacing—ablative and non-ablative. Your dermatologist will determine which type is best for your skin type and nature of acne scars.
  • Chemical Peels. This treatment uses special chemicals to remove the top layer of old skin. Typically whenever the top layer is removed, the new skin that grows in is smoother and can lessen acne scars.

Do I need to see a specialist?

Your acne can be managed by your general healthcare provider. However, when acne does not improve or is severe you should see a board certified dermatologist.

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