How does acne form?
Acne usually begins during puberty when hormone levels rise. The hormones stimulate the oil glands to make sebum. This sebum is excreted through a hair follicle and out a pore onto the skin. Oil and shedding skin cells stick together to plug the pore and form a comedo. Bacteria grow in the oil and dead skin cells and make chemicals that cause inflammation. The comedo can rupture under the skin and cause redness, swelling and pus. Sometimes the blocked pores will be white and sometimes they will be black. The black discoloration is oil that has oxidized when air touches it. It is not dirt.
When should you treat acne?
Acne can be very devastating psychologically for both teenagers and adults. People with severe acne may become depressed and may avoid social situations. Severe acne can form permanent scars on the face which remain even after the acne has cleared. Even people with mild acne can be traumatized by their condition. Some people aren’t bothered by their acne at all. You should seek treatment for your acne when it becomes bothersome to you.
How is acne treated?
Most people with acne are treated with varying combinations of the following products. Acne treatments work by preventing new acne and take time to work. If acne hasn’t improved in about 6 weeks, changes to your treatment may be needed.
Cleansing: Cleansing with a mild cleanser and warm water twice a day is recommended for most people. Sometimes a cleanser with either salicylic acid or glycolic acid is recommended. Washing too often or using a harsh scrub may make acne worse. Hair should also be washed regularly.
Benzoyl peroxide: This comes in wash, lotion, gel or cream form and can help unblock your pores and reduce bacteria. It can also help prevent bacterial resistance when used with antibiotics. It can cause some dryness and peeling and can bleach fabrics so careful use is recommended. Some newer prescription forms have added ingredients that are gentler on the skin.
• Retinoids (Retin A, Differin, Tazorac)
• Topical antibiotics and antibacterials
• Oral antibiotics
• Oral contraceptives
• Accutane (isotretinoin)
• Cortisone injections
• Adjunctive treatments: Acne peels with glycolic acid or salicylic acid can help unblock pores and improve acne. People can also see improvement in their acne with regular facials with a qualified esthetician. We have several wonderful estheticians in our clinic.
Does diet make a difference?
Contrary to previous research, new studies have shown that diet can make a difference. We will be happy to guide you to healthy and clear skin.
Are cosmetics OK?
Wearing make-up is fine as long as you choose a foundation or cover-up that is oil-free and non-comedogenic. Make sure that you wash your face every night.
What about moisturizer?
Some people with acne have very oily skin and may not require any moisturizer. Others may be very dry and will need one daily. Acne medications can make your skin drier, so even people with oily skin may benefit from a moisturizer. Choose one that is oil-free and non-comedogenic. There are many facial moisturizers available. Neutrogena, Cetaphil, Aveeno and Olay are among other brands that have a wide selection. For morning use, choose a moisturizer with an added sunscreen and an SPF of at least 15.