Acne or acne vulgaris is a common skin condition seen in women and men of all ages, but comprising a significant part of pediatric dermatology. Nearly all teenagers develop acne that occurs when your hair follicles or skin pores become plugged with oil and dead skin cells (keratin). Acne, a chronic inflammatory skin conditionusually includes comedones, whiteheads or blackheads, and inflamed papules and pustules.
What is Acne Vulgaris?
Acne vulgaris is a common skin condition in which hair follicles within the pores of the skin become blocked with oil, dead skin cells, or bacteria, causing the affected area to become irritated and/or inflamed. Acne most often presents on the face, chest, back, or shoulders, as these are the areas of the body with the most sebaceous (oil) glands. Acne can occur at any age, but most commonly affects teenagers and young adults. While acne is certainly not a life-threatening condition, it can seriously affect self-esteem, cause emotional distress, and scar the affected skin.
What Causes Acne?
The tiny pores of the skin are openings for follicles which each contain a hair and a sebaceous gland that produces sebum, an oily substance that lubricates hair and skin to keep them soft. Acne occurs when this process encounters a problem, such as:
- Excess oil is produced
- Dead skin cells block the pores
- Bacteria builds up in the pores
One of the main causes of acne is hormonal fluctuation, especially androgen (a male hormone which increases during puberty). Fluctuating hormone levels can also contribute to acne in females during the menstrual cycle, pregnancy, or when starting or stopping birth control medications.
Other factors that can worsen or contribute to acne outbreaks include:
- Squeezing or picking at blemishes
- Taking certain medications (such as testosterone, corticosteroids, and birth control pills)
- Scrubbing the affected area too roughly
- Using oily make-up or lotions
- Friction or pressure on the skin (such as tight collars, helmets, or backpacks)
- Eating a diet high in carbohydrates and/or refined sugars
- Family history of acne
- Stress
Types of Acne
When a follicle becomes clogged, the oil inside is unable to exit, and bacteria begins to grow which causes a pimple. The most common type of pimple is a comedo. Comedones (plural of comedo) include both whiteheads, which stay just under the surface, and blackheads, which open at the skin’s surface and appear black due to oxygen exposure.
Other types of acne lesions include:
- Cysts: Large, deep pimples that contain pus and are often painful
- Nodules: Solid, painful pimples under the skin’s surface
- Papules: Small, pink or red bumps under the skin’s surface
- Pustules: Small, red pimples with pus at the tips
Acne Treatments
Acne can often be treated at home through self-care routines and over-the-counter medications.
Following these self-care tips can help treat and prevent acne:
- Gently clean your skin with mild cleanser every morning and evening, as well as after heavy physical activities.
- Avoid touching, picking, or squeezing pimples, as this can spread bacteria and cause scarring.
- Shampoo your hair regularly and try to keep it away from your face.
- Use oil-free, water-based make up. Look for “noncomedogenic” (won’t clog pores) on the label.
- Avoid wearing hats or headbands that touch the forehead.
- Be extra cautious when shaving the face.
Over-the-counter medications for acne should contain ingredients that reduce oil and/or kill bacteria. Some OTC ingredients to look for are:
- Benzoyl peroxide- Kills bacteria and dries existing acne
- Sulfur- Natural cleanser
- Salicylic acid- Prevents clogged pores
- Resorcinol- Removes dead skin cells
When Should I See a Dermatologist for Acne?
If self-care remedies are unsuccessful, or you are experiencing chronic outbreaks of acne, the skincare experts at Colleyville Dermatology offer acne treatments to help reduce symptoms, as well as prevent scarring.
Prescription medications that may be used to treat acne include:
- Oral and/or topical antibiotics – To reduce inflammation and kill bacteria
- Topical creams, such as prescription strength benzoyl peroxide and retinoids – To reduce oil production and inflammation
- Isotretinion- To treat severe cases of nodular acne, inflammatory pustules and papules, blackheads, and whiteheads
- Spironolactone or birth control pills (for women) – To regulate hormones and decrease oil production
- Cortisone injections – To treat large cysts by reducing inflammation
Your dermatologist may also recommend additional procedures to treat or prevent scarring. Office treatments commonly used at Colleyville Dermatology include:
- Intralesional cortisone injections: To directly treat larger cysts and papules by reducing the size and inflammation of the individual lesions. Results typically are seen in 24-48 hours.
- Chemical peel: The top layers of skin are exfoliated using alphahydroxy acid (AHA) or betahydroxy acid (BHA) to reveal a smoother layer of skin beneath.
- TCA CROSS is the chemical reconstruction of skin scars (CROSS) using trichloroacetic acid (TCA). The procedure involves depositing small amounts of TCA at high concentrations (80-100%) at the base of the atrophic scars.
- Microneedling: Collagen is stimulated through micro-injuries, while minimizing cellular damage. This procedure is safe for all skin types. We proudly utilize SkinPen, the only FDA approved micro-needling device, for the treatment of acne scars and fine lines.
- Fractora fractional laser resurfacing treatment. Fractora delivers radiofrequency energy through a set of pins, that reaches the deep dermis and stimulates collagen restructuring.
Professional acne treatment is typically extremely successful for patients experiencing chronic or painful blemishes, and most patients experience clearer skin within 6-8 weeks of treatment. If you are bothered by recurring or severe acne or home treatments have been unsuccessful, please contact the dermatological experts at Colleyville Dermatology for an evaluation.