What is acne?

Acne vulgaris, or acne, is a very common skin disease characterized by pimples, blackheads, whiteheads, cysts, or nodules that can develop on the face, chest, and back. It occurs when the pores of the skin become clogged with oil, dead skin cells, and bacteria. When this clogged skin becomes infected by bacteria called Propionibacterium acnes (P. acnes), inflammation can occur, causing rupture of the pore and further inflammation of the surrounding skin. While it’s unclear why some people develop scars secondary to their acne and others do not, the severity of acne is thought to play a part.

What causes acne?

One of the main causes of acne is hormones. Increases in hormone levels during adolescence cause the oil glands to become larger and produce more oil (sebum). Most people with acne have normal hormone levels, but their oil glands can be more sensitive to the hormones.

For most people, acne tends to resolve in their 20s or 30s—although it can persist into, or even develop for the first time, during adulthood. Called “acne of maturity” or “post-pubertal acne,” this condition is more common in females. Acne can flare before or during a woman’s menstrual period and can occur while starting or discontinuing oral contraceptives.

Other factors that influence acne

• Diet – New research into the role of diet in acne has found an association between cow’s milk and an increased risk of acne, possibly due to hormones that occur naturally in milk. A correlation between patients who have high-glycemic diets and acne has also come to light. Probiotics, like those found in yogurt, may lessen acne in some individuals. While we may not completely understand the role of diet in acne, we recommend eating a healthy, well-rounded diet.
• Stress – Psychological stress can lead to new or increased severity of acne.
• Genetics – Acne is more likely to occur in people whose parents had acne.

Acne treatment

While almost all acne can be treated it’s important to note that not all acne is the same. Also, people with different skin types respond to acne medications differently. We’ll evaluate your skin carefully and recommend an acne treatment regimen that’s best for you.

Acne treatment focuses on healing current pimples, preventing new breakouts, and preventing scars from forming. For optimal results, the American Academy of Dermatology recommends using a combination or multi-faceted approach (utilizing more than a single medication).

It’s important to be patient. Most acne regimens typically require 6 to 8 weeks before observable improvement. Stick with your medications and trust that they’ll work. Discontinuing treatment too soon could lead to suboptimal results or acne recurrence. Also, it’s important to understand that your acne may look worse immediately after starting treatment before it begins to improve.

At-home acne treatments

• Clean skin gently. Use a mild skin cleanser twice a day, and pat skin dry. CeraVe or Cetaphil are two brands we recommend. Strong cleansers, hard manual scrubbing of skin, and astringents can actually worsen acne.
• Do not pop, squeeze, or pick at acne lesions. This can lead to further inflammation, infection, and scarring. Keep hands away from your face and other acne-prone areas of the skin.
• Choose gentle, non-oily skin products on acne-prone areas. Select a non-greasy skin product described as “non-comedogenic,” “oil-free,” or “water-based.” Some over-the-counter (OTC) skin products contain active acne-fighting ingredients, such as benzoyl peroxide or salicylic acid. These products may dry out or irritate the skin.

Medical acne treatments

• Topical retinoids (Differin, Epiduo, Retin A Micro, Tazorac, or tretinoin) help unclog sebaceous glands and keep skin pores open
• Topical and systemic antibiotics
• Topical benzoyl peroxide
• Facial peels
• Oral contraceptive medications, such as birth control pills, used by women to reduce sebum (oil) production and mediate hormonal causes of acne
• Spironolactone
• Oral isotretinoin, also known as Accutane or Absorbica