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Frequently
Asked Questions About Acne
Author:Kerwin
Chang
Frequently Asked Questions About Acne
Acne is a very common disease.
People who have it tend to have similar kinds of questions about it and
its treatment. This section addresses some of the common questions
asked by people with acne. Please remember that your dermatologist is
always the best source of specific information about your individual
health issues, including acne.
Questions and Answer does follows:
-
What causes acne?
The causes of acne are linked to
the changes that take place as young people mature from childhood to
adolescence (puberty). The hormones that cause physical maturation also
cause the sebaceous (oil) glands of the skin to produce more sebum
(oil). The hormones with the greatest effect on sebaceous glands are
androgens (male hormones), which are present in females as well as
males, but in higher amounts in males.
Sebaceous glands are found
together with a hair shaft in a unit called a sebaceous follicle.
During puberty, the cells of the skin that line the follicle begin to
shed more rapidly. In people who develop acne, cells shed and stick
together more so than in people who do not develop acne. When cells mix
with the increased amount of sebum being produced, they can plug the
opening of the follicle. Meanwhile, the sebaceous glands continue to
produce sebum, and the follicle swells up with sebum.
In addition, a normal skin
bacteria called P. acnes, begins to multiply rapidly in the clogged
hair follicle. In the process, these bacteria produce irritating
substances that can cause inflammation. Sometimes, the wall of the
follicle bursts, spreading inflammation to the surrounding skin. This
is the process by which acne lesions, from blackheads to pimples to
nodules, are formed.
-
I wash my face several times a
day. Why do I still get acne?
Many people still believe that
acne is caused by dirty skin. The truth is, washing alone will not
clear up or prevent acne. Washing does, however, help remove excess
surface oils and dead skin cells. Many people use all kinds of
products, including alcohol-based cleansers, and scrub vigorously, only
to irritate the skin further and worsen their acne. Washing the skin
twice a day gently with water and a mild soap is usually all that is
required. However, acne is actually caused by a variety of biologic
factors that are beyond the control of washing. For that reason, you
should use appropriate acne treatments for the acne.
-
Does stress cause acne?
Stress is commonly blamed for
the development of acne. Stress can have many physiologic effects on
the body, including changes in hormones that may theoretically lead to
acne. In some cases the stress may actually be caused by the acne
lesions, not the other way around! If the acne is being treated
effectively, stress is not likely to have much impact on the majority
of people.
-
I never had acne as a teenager.
Why am I now getting acne as an adult?
Usually, acne begins at puberty
and is gone by the early 20s. In some cases, acne may persist into
adulthood. Such types of acne include severe forms that affect the body
as well as the face (which afflict males more than females) and acne
associated with the menstrual cycle in women. In other cases, acne may
not present itself until adulthood. Such acne is more likely to affect
females than males.
There are several reasons for
this. As females get older, the pattern of changes in hormones may
itself change, disposing sebaceous glands to develop acne. Ovarian
cysts and pregnancy may also cause hormonal changes that lead to acne.
Some women get acne when they discontinue birth control pills that have
been keeping acne at bay. Sometimes young women may wear cosmetics that
are comedogenic-that is, they can set up conditions that cause
comedones to form.
-
What role does diet play in
acne?
Acne is not caused by food.
Following a strict diet will not, clear your skin. While some people
feel that their acne is aggravated by certain foods, particularly
chocolate, colas, peanuts, shellfish and some fatty foods, there is no
scientific evidence that suggests food causes or influences acne. Avoid
any foods which seem to worsen your acne and, for your overall health,
eat a balanced diet--but diet shouldn't really matter if the acne is
being appropriately treated.
-
Does the sun help acne?
Many patients feel that sunlight
improves their acne lesions and go to great lengths to find sources of
ultraviolet light. There is no proven effect of sunlight on acne. In
addition, ultraviolet light in sunlight increases the risk of skin
cancer and early aging of the skin. It is, therefore, not a recommended
technique of acne management, especially since there are many other
proven forms of treatment for acne. Moreover, many acne treatments
increase the skin's sensitivity to ultraviolet light, making the risk
of ultraviolet light exposure all the worse.
-
What is the best way to treat
acne?
Everyone's acne must be treated
individually. If you have not gotten good results from the acne
products you have tried, consider seeing a dermatologist. Your
dermatologist will decide which treatments are best for you. For more
information about the types of acne treatments that are available, and
for basic acne treatment guidelines, please see Acne Treatments in the
main part of AcneNet.
-
What kind of cosmetics and
cleansers can an acne patient use?
Look for "noncomedogenic"
cosmetics and toiletries. These products have been formulated so that
they will not cause acne.
Some acne medications cause
irritation or pronounced dryness particularly during the early weeks of
therapy, and some cosmetics and cleansers can actually worsen this
effect. The choice of cosmetics and cleansers should be made with your
dermatologist or pharmacist.
Heavy foundation makeup should
be avoided. Most acne patients should select powder blushes and eye
shadow over cream products because they are less irritating and
noncomedogenic. Camouflaging techniques can be used effectively by
applying a green undercover cosmetic over red acne lesions to promote
color blending.
-
Is it harmful to squeeze my
blemishes?
Yes. In general, acne lesions
should not be picked or squeezed by the patient. In particular,
inflammatory acne lesions should never be squeezed. Squeezing forces
infected material deeper into the skin, causing additional inflammation
and possible scarring.
-
Can anything be done about
scarring caused by acne?
Scarring is best prevented
by getting rid of the acne. Dermatologists can use various methods to
improve the scarring caused by acne. The treatment must always be
individualized for the specific patient. Chemical peels may be used in
some patients, while dermabrasion or laser abrasion may benefit others.
It is important that the acne be well controlled before any procedure
is used to alleviate scarring.
-
How long before I see a
visible result from using my acne medication?
The time for improvement
depends upon the product being used, but in almost all cases it is more
a matter of weeks or months instead of days. Most dermatologists would
recommend the use of a medication or combination of medications daily
for 4 to 8 weeks before they would change the treatment. It is very
important for patients to be aware of this time frame so they do not
become discouraged and discontinue their medications. Conversely, if
you see no change whatsoever, you might want to check with your
dermatologist regarding the need to change treatments.
-
Would using my medication
more frequently than prescribed speed up the clearing of my acne?
No--always use your
medication exactly as your dermatologist instructed. Using topical
medications more often than prescribed may actually induce more
irritation of the skin, redness and follicular plugging, which can
delay clearing time. If oral medications are taken more frequently than
prescribed, they won't work any better, but there is a greater chance
of side effects.
-
My topical treatment seems
to work on the spots I treat, but I keep getting new acne blemishes.
What should I do?
Topical acne medications are
made to be used on all acne-prone areas, not just individual lesions.
Part of the goal is to treat the skin before lesions can form and to
prevent formation, not just to treat existing lesions. Patients are
generally advised to treat all of the areas (forehead, cheeks, chin and
nose) that tend to break out rather than just individual lesions.
-
My face is clear! Can I stop
taking my medication now?
If your dermatologist says
you can stop, then stop--but follow your dermatologist's instructions.
Many times patients will stop their medication suddenly only to have
their acne flare up several weeks later. If you are using multiple
products, it may be advisable to discontinue one medication at a time
and judge results before discontinuing them all at once. Ask your
dermatologist before you stop using any of your medications.
-
Does it matter what time I
use my medication?
Check with your
dermatologist or pharmacist. If you were taking one dose a day of an
antibiotic, you could probably take it in the morning, at midday or in
the evening, although you should pick one time of day and stay with it
throughout your treatment. With oral medications prescribed twice a day
or three times a day, you should try your best to spread out the doses
evenly. Some antibiotics should be taken on an empty or nearly empty
stomach. For optimal results with topical treatments, you should
strictly follow your dermatologist's recommendations. For example, if
instructed to apply benzoyl peroxide in the morning and a topical
retinoid at bedtime, it is important to follow these directions
strictly. If the two were applied together at bedtime, for example, you
could decrease the efficacy of the treatment because of chemical
reactions that make them less effective.
-
I have trouble remembering
to take my oral medication every day. What's a good way to remember?
What should I do if I forget a dose?
This is a common problem.
Many patients try to associate taking their medication with a routine
daily event such as brushing teeth or applying makeup. It also helps to
keep the medication close to the area where the reminder activity is
carried out.
In most cases, if you miss a
day of your oral treatment, do not double up the next day; rather, get
back to your daily regimen as soon as possible--but there may be
different instructions for different oral medications. Ask your
dermatologist or pharmacist about what to do if you miss a dose of your
particular medication.
-
I have been using topical
benzoyl peroxide and an oral antibiotic for my acne and have noticed
blue-black and brown marks developing on my face and some discoloration
on my body. The marks are especially noticeable around acne scars and
recently healed lesions. Is this a side effect of medication and is it
permanent?
It is not possible to make
general statements about side effects of medications that apply to
individual cases. A dermatologist should be consulted. The facial marks
and body discoloration described by the patient in this case do fall
within the range of side effects of some antibiotics.
Unique patterns of pigmentation are
sometimes seen in acne patients treated with certain oral
antibiotics—particularly minocycline. The pigmentation patterns that
appear may include: * Localized blue-black or brown marks in and around
acne scars and in areas of previous acne inflammation
* A "muddy skin" appearance that may cover much of the body
* Diffuse brownish pigmentation of the feet and lower legs.
The pigmentation side effect gradually disappears after the therapy is
discontinued.
Any side effect of a medication should be noted by the patient and
brought to the attention of the physician. While most side effects are
temporary they should be discussed with the physician and monitored.
-
My doctor is prescribing a
topical retinoid for my acne. He said a retinoid is a substance related
to vitamin A. If the drug is related to vitamin A, shouldn't vitamin A
dietary supplements be helpful in getting rid of acne?
Dietary vitamin A is essential
to good health, especially vision. It has healthful effects in the
skin. Large doses of vitamin A for the treatment of acne is not
recommended on grounds of safety. The retinoids and retinoid-like
substances used as topical treatments for acne are prepared especially
for their potent effect on the shedding of cell lining in the sebaceous
follicle. Their use should be monitored by a dermatologist.
Dietary vitamin A has multiple
health effects in the human body. Vitamin A is essential for good
vision. Extreme vitamin A deficiency can result in blindness, usually
accompanied by dry, scaly skin. Vitamin A overdose that far exceeds the
Recommended Dietary Allowance (RDA) of 5,000 IU can have effects nearly
as catastrophic. Extreme vitamin A overdose can cause the skin to
blister and peel—an effect first seen in early North Pole explorers who
nearly died after eating polar bear liver that has an extraordinarily
high vitamin A content.
Topical retinoids are usually
prescribed as a treatment for moderate to severe acne. Side effects are
chiefly dermatologic, including redness, scaling and dryness of the
skin, itching and burning. These side effects can usually be managed by
adjustment of the amount and timing of retinoid applied to the skin.
Dose adjustment must be discussed with the dermatologist who prescribed
the treatment.
-
Are there any acne treatments
specifically for people with dark skin? Are there any treatments
specifically harmful to dark skin?
There are no acne treatments
specifically for use on dark skin. Acne treatments are generally as
safe and effective on dark skin as on light skin. Some treatments for
acne scars may cause temporary lightening of dark skin.
Acne is a common skin disease
that has the same causes and follows the same course in all colors of
skin.
Very dark or black skin may be
less well-moisturized than lighter skin. Topical anti-acne agents such
as benzoyl peroxide that have a drying effect on the skin should be
used under the supervision of a dermatologist. Benzoyl peroxide also is
a strong bleach and therefore must be applied carefully to avoid
inadvertent decolorization of a patch of hair, towels or clothing.
Darker skin has a tendency to
develop post-inflammatory hyperpigmentation (excessive skin darkening
at places where the skin was inflamed). Severe inflammatory acne may
result in dark spots. The spots resolve over time; a dermatologist may
be able to recommend cosmetic measures to make the spots less apparent
until they resolve. Some acne treatments, such as topical retinoids and
azelaic acid, may also help fade the discoloration.
Removal of acne scars by
dermabrasion or chemical peeling may cause temporary lightening or
darkening of dark skin in the areas of treatment. Scar treatment should
be discussed with a dermatologist or dermatologic surgeon before it is
undertaken.
Alterations of melanin (dark
pigments that give the skin its color) pigmentation such as vitiligo
and melasma are not related to acne, but they may be present
simultaneously with acne. The diagnosis and treatment of melanin
pigmentation disorders such as vitiligo requires a dermatologist with
knowledge and experience in treating these conditions.
-
Is acne that appears for the
first time in adulthood different from acne that appears in
adolescence?
Acne has a specific definition
as a disease of sebaceous follicles. This definition applies to acne
that occurs at any age. However, it may be important to look for an
underlying cause of acne that occurs for the first time in adulthood.
Current understanding of the
causes of acne vulgaris is described in the Main Text section Why and
how acne happens. In brief summary, acne vulgaris develops when
excessive sebum production and abnormal growth and death of cells in
the sebaceous follicle result in plugging of follicles with a mixture
of sebum and cellular debris and formation of comedones (blackheads and
whiteheads). Bacteria in the follicles—chiefly Propionibacterium acnes,
the most common bacterial colonist of sebaceous follicles—may
contribute to the inflammation of acne by release of metabolic products
that cause inflammatory reaction. The pathogenic events, which cause
disease, in the sebaceous follicle are believed to be due in large
degree to changes in levels of androgenic (male) hormones in the body—a
circumstance usually associated with growth and development between
ages 12 and
-
Some acne investigators believe
that although this understanding is generally correct, there is more
yet to be learned about the causes of acne vulgaris.
Acne that appears after the age
of 25-30 years is (1) a recurrence of acne that cleared up after
adolescence, (2) a flare-up of acne after a period of relative
quiet—for example, during pregnancy, or (3) acne that occurs for the
first time in a person who had never previously had acne.
Acne that occurs in adulthood
may be difficult to treat if there are multiple recurrences. Some
patients with severe recurrent acne have undergone repeated courses of
treatment with the potent systemic drug isotretinoin.
http://acne-how-to-succeed.com/Acne flares in association with
pregnancy or menstruation are due to changes in hormonal patterns.
Acne that appears for the first
time in adulthood should be investigated for any underlying cause.
Drugs that can induce acne include anabolic steroids (sometimes used
illegally by athletes to "bulk up"), some anti-epileptic drugs, the
anti-tuberculosis drugs isoniazid and rifampin, lithium, and
iodine-containing drugs. Chlorinated industrial chemicals may induce
the occupational skin disorder known as chloracne. Chronic physical
pressure on the skin—for example, by a backpack and its straps, or a
violin tucked against the angle of the jaw and chin—may induce
so-called acne mechanica. Some metabolic conditions may cause changes
in hormonal balance that can induce acne.
Some lesions that appear to be
acne may be another skin disorder such as folliculitis—infection and
inflammation of hair follicles—that require different treatment than
acne. Acne that appears for the first time in adulthood should be
examined and treated by a dermatologist.
-
My 15-year-old daughter has what
I would describe as a very mild case of acne. She has made it much
worse by constant picking and squeezing. She looks in the mirror for
hours, looking for some blackhead or blemish she can pick or squeeze.
Does she need psychological counseling?
Excessive picking and squeezing
of otherwise mild acne is a condition called excoriated acne, seen most
often in young women. A dermatologist may provide effective counseling.
The typical person with
excoriated acne is a person—often a young women—who is so distressed
with her appearance due to acne that she literally tries to "squeeze
the acne out of existence." The acne is often very mild, but the
person's face may constantly be covered with red marks from squeezing,
and open sores where lesions have been picked open.
The word excoriate means to
scratch or abrade the skin. Excoriated acne is a medically recognized
condition that should be discussed with a dermatologist. Occasionally
giving in to a temptation to squeeze a blackhead is not defined as
excoriated acne. Hours in front of a mirror, squeezing and picking
every blemish, is a definition of excoriated acne. A dermatologist may
be able to counsel the patient regarding a course of treatment in which
the patient can participate, but keep "hands off."
-
Can the rate of secretion or the
composition of sebum be altered by diet? If it can, shouldn't
alteration of diet be considered a treatment for acne?
Diet has never been proven to
have a role in the cause or treatment of acne. Dietary manipulation may
have a role in the treatment of some scaling diseases of the skin, but
not in the treatment of acne.
Dietary cause is one of the most
persistent myths about acne. Foods, such as chocolate or greasy foods,
do not cause acne, but certain foods seem to make some people's acne
worse. The following can bring on or worsen it:
-
Hereditary factors
-
An increase in male hormones
found in both males and females
-
Menstruation
-
Emotional stress
-
Oil and grease from
cosmetics, work environment http://acne-how-to-succeed.com/No food has
been shown to be effective in preventing or treating acne. A healthy
diet is, of course, necessary for good general health.
-
Shouldn't I just try to
eliminate sebum from my body?
No. When it isn't blocked in
your pores, sebum helps keep your skin healthy.
-
Why does acne usually start at
puberty?
No one knows for certain. What
is known is that the sebaceous glands that produce sebum get much
larger at puberty than they were before.
-
Why does the skin around a
pimple turn red?
This redness is caused by the
body's inflammatory response. Inflammation is a sign that your immune
system is working to fight an infection. However, the inflammatory
response doesn't always work perfectly, and can even be the cause of
scarring.
-
If my skin turns red, does that
mean that I'm going to have scars?
Usually, no. Even when there
will be no permanent scar, the aftereffects of the inflammatory
response can leave the skin red for months, sometimes for more than a
year.
-
What are free radicals?
Free radicals are byproducts of
oxidation in your body. We all need oxidation to occur as part of our
life process, but there is concern that the buildup of unrecycled free
radicals contributes to many conditions, including skin damage.
Antioxidants, including several of the active ingredients in Acuzine,
help prevent the buildup of free radicals.
Article Source: http://www.articlesbase.com/health-articles/
frequently-asked-questions-about-acne-27348.html
About the Author
Kerwin Chang writes for http://www.acnestuff.net
where you can find out more about acne
and other skin care topics.
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