By Anne Neeley, MD
November is “healthy skin” month, so I’m writing about something that affects almost everyone at some point in their life: acne. Contrary to popular belief, acne isn’t just the plight of pubescent teenagers: “Infantile acne” can occur in babies as a result of exposure to mom’s hormones in utero. This usually resolves, but can sometimes be severe enough to cause scarring, and may warrant treatment. Teenage acne, or “acne vulgaris,” can range in severity from mild to very severe. And finally, acne is a common problem for adults, especially women aged 20-50. Read on for a detailed look into what causes acne, and what you can do to keep your skin healthy.
What is Acne?
Acne begins when a pore (hair follicle opening) becomes plugged. This is referred to as a “comedone.” There are two types of comedones: blackheads and whiteheads. A “plug” at the surface of the skin turns black from exposure to oxygen and is referred to as a blackhead. If the plug is deeper down, a whitehead forms due to build-up of dead skin and oil. Sometimes, a clogged pore fills with too much oil or becomes home to a bacteria called p. acnes. When this happens, the pore is likely to burst and release oil and bacteria into the surrounding skin, creating a pimple.
When pimples are severe and lead to scarring, we refer to it as “cystic” acne. The treatment for acne is thus multifaceted, targeting both the clogged pore and bacteria.
The treatment for clogged pores includes medications to dissolve the “plug” (such as salicylic acid) and medications that prevent pores from becoming clogged in the first place. These medications belong to a class called “retinoids,” including tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac). These are available by prescription only. Salicylic acid products are available over-the-counter as cleansers, astringents and lotions. All acne treatments work best when used regularly and should be applied to the entire acne-prone area.
Pimples and cystic acne tend to require antibacterial treatment in addition to topical retinoids. Benzoyl peroxide-containing products are available in stores for mild cases. Oral antibiotics may be needed for moderate to severe acne, or when scarring is present. In very severe cases, an oral retinoid called isotretinoin (formerly known as Accutane) can be prescribed by a dermatologist.
Adult acne affects females more frequently than males and is often related to hormone fluctuations. This type of acne most frequently affects the jawline, chin and back. There are several hormone-directed treatments available in addition to the medications already discussed.
There is Help!
The bottom line is that you don’t have to live with acne. There are numerous over-the-counter and prescription treatments available to help keep your skin healthy. Ask your doctor or dermatologist which regimen is best for you.
Dr. Neeley is certified by the American Board of Dermatology. She practices at KMC Dermatology in Leawood and is currently accepting new patients. To schedule a consultation with Dr. Neeley, please contact KMC Dermatology at 913-451-5934.
11301 Nall Avenue,
Suite 205, Leawood, KS