Acne

Acne is the most frequent skin condition in the United States. It is characterized by pimples that appear on the face, back and chest. Every year, about 80% of adolescents have some form of acne and about 5% of adults experience acne.

Acne is made up of three types of blemishes:

  • Whiteheads/Blackheads, also known as comedones, are non-inflammatory and appear more on the face and shoulders. As long as they remain uninfected, they are unlikely to lead to scarring.
  • Red Pustules or Papules are inflamed pores that fill with pus. These can lead to scarring.
  • Cysts or nodules are larger deep seated inflammatory lesions that can also lead to scarring.

Causes

In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. The sebum moves from the bottom to the top of each hair follicle and then spills out onto the surface of the skin, taking with it sloughed-off skin cells. With acne, the structure through which the sebum flows gets plugged up. This blockage traps sebum and sloughed-off cells below the skin, preventing them from being released onto the skins surface. If the pores opening is fully blocked, this produces a whitehead. If the pores opening is open, this produces blackheads. When either a whitehead or blackhead becomes inflamed, they can become pustules, red papules or cysts..

It is important for patients not to pick or scratch at individual lesions because it can make them inflamed and can lead to long-term scarring.

Treatment

Treating acne is a relatively slow process; there is no overnight remedy. Some treatments include:

  • Benzoyl Peroxide Used in mild cases of acne, benzoyl peroxide reduces the blockages in the hair follicles.
  • Oral and Topical Antibiotics Used to treat  infection and inflammation in the pores.
  • Hormonal Treatments Can be used for adult women with hormonally induced acne or acne not responsive to other treatments.
  • Tretinoin A derivative of Vitamin A, tretinoin and other retinoids help unplug the blocked-up material in whiteheads/blackheads. It has become a mainstay in the treatment of acne.
  • Extraction Removal of whiteheads and blackheads using a small metal instrument that is centered on the comedone and pushed down, extruding the blocked pore.
  • Isotretinoin Originally known as Accutane, it is the ultimate treatment for severe acne, scarring acne, or acne unresonsive to other treatments. It has many potential side effects, and needs laboratory monitoring before and while on therapy  
  • Steroid injections dilute concentrations of corticosteroids can be injected into cysts to help shrink them