ACNE

Acne. Pimples. Zits. "Bad complexion."

Whatever you call it, acne can be a frustrating problem. Acne may be viewed as a nuisance or rite of passage, but having bad acne can contribute to depression, anxiety and low self-esteem. If you are feeling bad about yourself because of acne, come in to see one of the practitioners at the Student Health Center. There are very effective treatments for acne today and there is no need to suffer in silence.

Who Gets Acne?

Most of us will experience acne during our teenage years. The increase in certain hormones during adolescence is a major factor in the development of teenage acne. "Male" hormones, called androgens, cause an increase in oil (called sebum) production in the pores of the skin, especially on the face, chest and back. Both males and females produce androgens, but males produce higher levels of this "male" hormone. This is the reason that acne tends to be more severe in teenage males than females. Women may notice that their acne gets worse right before their period---this is because of the hormones which produce the menstrual cycle. Both pre-teens and adults can get acne, too. Acne is very common in adult women, even if they didn't have problem skin during their teenage years.

What Causes Acne?

Acne blemishes are caused by three things:

• Too much oil (sebum) is present in certain skin pores.
• Skin cells (called epithelial cells) behave abnormally and block the pores.
• Bacteria love to hang out in the excess sebum and blocked pores. This causes inflammation (redness) and pus to form.

What Doesn't Cause Acne?

Acne is NOT caused by greasy foods, chocolate or anything in the diet. Rarely, some individuals are sensitive to certain foods. If you notice that your acne flares in response to certain foods, try to avoid them! Acne is not caused by "dirty" skin.

All Blemishes Are Not Created Equal

Doctors have all sorts of scientific-sounding words to describe the various sorts of blemishes you get with acne: open and closed comedones ("blackheads" and "whiteheads"), papules and cysts. There are different treatments for the different types of acne. Some types of acne, especially cysts, can cause significant scarring.

You Can Fight Back!

There are definitely things you can do to help decrease the amount of pimples you get.

• Wash your face twice daily using warm water and a mild soap. No need to scrub-just use your hands. Too much scrubbing can irritate your skin and make acne worse instead of better.
  
• Keep your hands off your face. Have you ever noticed how pimples are prone to appear in areas of the face that rest on your hands, like your chin and jaw line?
  
• Keep hair off your forehead if this is an area where you have acne. Keep your hair from rubbing against your cheeks and neck if acne is a problem in these areas by tying or clipping hair off your face and neck.
  
• Don't squeeze those pimples! (Your mother was right about that one.) Squeezing or picking at acne can lead to inflammation and scarring and almost always makes the situation worse.
  
• Try non-prescription or "home" remedies for mild cases of acne. Benzoyl peroxide is available without a prescription at the pharmacy. Start with a mild preparation (2.5%) and use as directed. Stop if your skin becomes irritated.
  
• If you use make-up or facial lotions, make sure they are water-based. Look for the words "non-comedogenic" on the label, or check with the pharmacist.
  
• Sun exposure does NOT help acne and it can damage your skin.

When To See Your Doctor

If you are bothered by your acne and it has not responded to non-prescription acne medicine after a few weeks, come into the Student Health Center to be seen by a practitioner who can prescribe treatments that will work for your particular kind of acne.

How Do Acne Medicines Work?

Benzoyl peroxide is an ingredient found in both prescription and non-prescription acne medicines. It comes in a liquid, cream or gel form to be applied once or twice daily to your face. (It can stain clothes and sheets, so watch out!) It works by killing bacteria and by increasing the turn-over of skin cells.

Topical antibiotics are prescription medicines that come in liquid or gel form and are applied on the surface of the skin. They fight the bacteria that cause the inflammation (redness and pus) associated with many acne blemishes.

Oral antibiotics are prescribed by doctors for inflammatory acne that doesn't respond to topical (surface) treatments. They are usually prescribed in lower dosages than you would take for infections and are taken for long periods of time (months).

Retinoic acid is another type of topical treatment. It comes in a cream or a gel and it destroys certain types of acne blemishes (comedones). It makes your skin more sensitive to the sun, so you need to be careful about using sunscreen and wearing a hat.

Isoretinoin, also known as Accutane, is a very potent (strong) oral medication usually used in severe cases of scarring cystic acne that have failed to respond to other treatments. It is very effective. It is usually taken for about 4 months, then stopped. It cannot be used by women who could become pregnant while taking the medicine because it causes serious birth defects. It is most often prescribed by a specialist (dermatologist).

Patience Is A Virtue

Acne medicines take time to work---but they will work if you persist and use them EVERY DAY as prescribed. Your doctor may need to check your response to the medicines every 8 weeks or so and change medicines if necessary. Often, more than one type of medicine will need to be used. Make sure that you understand how to use your medicines and ask about possible side effects of the medicines. The practitioners at the Student Health Center have a lot of experience in treating acne and will be able to work with you to devise a regimen to help improve your complexion. If specialist consultation is necessary, your Student Health practitioner can refer you to the visiting dermatologist.

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