Acne may well be the acme of adolescence. Is there a teenager on Earth who hasn’t stared in dismay at the pock-marked face in the mirror gazing back? How could nature be so cruel as to strike down youth’s beauty at the very time of life when attracting a mate is most important?
Unless you are a very fortunate person, your complexion has been compromised by unwanted, unsightly skin eruptions. What causes acne and what can be done to treat it – or better yet, prevent it?
Acne (Acne vulgaris) is a chronic, inflammatory skin condition. Dead skin cells and oil clog the hair follicles, producing pimples, blackheads, or whiteheads. It is the most common skin condition in the United States.
Acne is not restricted to the facial area. It can afflict the chest, upper back, and shoulders as well. And even though we associate acne with the teenage years, it can strike people of all ages.
A single blocked hair follicle is called a comedo. Multiple acne lesions (comedones) are what develop into whiteheads and blackheads. Chemicals that stimulate comedo production in the body are called comedogenic. Using cosmetics marked noncomedogenic can help reduce acne.
Comedons that are open at the surface of the skin are blackheads filled with excess oil and dead skin cells. Contrary to what you might think, their dark appearance comes from light that reflects irregularly from the clogged follicle.
Whiteheads occur when comedones remain closed at the skin’s surface. Oil and skin stop the ability of a hair follicle to open.
A papule is an inflamed comedon that creates tiny red or pink bumps on the skin. Papules can be painful to the touch. Avoid the urge to pick or squeeze them to prevent the inflammation from spreading and scarring.
An inflamed pimple is called a pustule which looks like a whitehead except that is has a red ring around the raised bump. As with papules, squeezing or picking at pustules can produce dark spots and scars.
How can you tell if an acne outbreak is mild or severe? Doctors say mild cases have fewer than 20 whiteheads or blackheads, fewer than 15 inflamed bumps, or fewer than 30 total skin lesions.
A moderate case of acne features 20 to 100 whiteheads or blackheads, 15 to 50 inflamed bumps, or 30 to 125 total lesions.
Although acne tends to fade on its own over time, professionals agree that there is an upside to taking action when skin conditions erupt. Not only does a clear complexion boost the self-esteem and give confidence in public, but failure to treat acne may also result in dark spots and permanent scarring after the skin eruptions clear.
If acne doesn’t improve and clear on its own, first consult with your primary care physician (PCP). Stronger pharmaceutical drugs may solve the problem. If not, your PCP can refer you to a dermatologist (skin specialist).
There are many over-the-counter remedies available for acne. Blackheads and whiteheads often respond well to non-prescription formulas, although it can take as much as eight weeks to see marked improvement.
Pharmacy products that contain benzoyl peroxide, resorcinol, salicylic acid, or sulfur can help fight mild cases of acne.
Moderate to severe cases may need a specialist’s attention. Dermatologists can prescribe stronger medications to clear up more extreme outbreaks. The acne may appear to get worse before it starts to clear and this may take a few weeks.
A doctor may prescribe a topical -applied directly to the skin – antimicrobial or retinoid cream to treat mild to moderately severe acne.
Taking medicine internally, by mouth (orally) is a systemic therapy that may be used either as an alternative treatment or in combination with a topical ointment. Tetracycline, minocycline, doxycycline, and erythromycin are all prescription antibiotics that kill bacteria and calm inflamed skin.
Other systemic therapies include spironolactone (an anti-androgen hormone pill) and isotretinoin (high-dose prescription vitamin A). Isotretinoin is a treatment of last resort, appropriate when other treatments have failed. Regular physician visits are necessary for a course of isotretinoin treatment.
Women often experience an acne attack about a week before menstruation. Oral contraceptives are effective in easing skin inflammation for some women.
Large, inflamed bumps that feel firm when touched are called nodules. These do require a doctor’s intervention. Likewise, cysts are large, pus-filled lesions that resemble boils. Cysts are quite painful and typical of more severe forms of acne. Seek professional help.
Nodulocystic acne presents with multiple inflamed cysts and nodules. The inflammation may turn from reddish-pink to deep red or purple. Scarring is common so seek professional help to avoid permanent disfiguration. Severe nodulocystic acne may call for corticosteroid injections directly into the nodules and cysts to shrink their size and reduce the painful inflammation.
The appearance of acne in an older adult may indicate the presence of an underlying disease that needs professional medical help.
Because it is known that hormones called androgens are linked to acne, and adolescent bodies create more androgens than adults, skin blemishes are almost inevitable in the teen years.
Regardless of age, reduce the chance of an acne outbreak, eat a diet with less skim milk, chocolate, and carby foods like chips, bread, and sugary cereals. Stress can also trigger an acne attack.
Contrary to popular belief, there is little scientific evidence that eating greasy foods causes acne. Overactive sebaceous glands are the real culprit. These microscopic skin ducts secrete sebum, the oily, waxy substance that clogs hair follicles.
Eating foods high in omega-3 fatty acids may ease the pain and embarrassment of common acne. Such foods include:
- Fish, such as mackerel, salmon, and sardines
- Pastured eggs
- Soybeans and soy products, such as tofu
- Spinach and Kale
- Navy beans
- Grass-fed beef
- Nuts, such as walnuts and almonds
- Mustard seeds
- Wild rice
Protect your health and well-being by staying on top of unhealthy skin conditions like acne. In the long run, you’ll be glad you did.