Acne

Acne: What You Should Know

Acne in Basking Ridge, Morristown, Elizabeth, NJ

Acne is the most common skin condition in the United States. Although it's common, accurate information about acne can be scarce. This can make it difficult to get clearer skin. The information on this site can help you understand acne and how to successfully treat it.

Why treat acne?

Myths about acne are as common as the skin problem. One common myth is that you have to let acne run its course.

Dermatologists know that letting acne runs its course is not always the best advice.

Here's why:

  • Without treatment, dark spots and permanent scars can appear on the skin as acne clears.
  • Treating acne often boosts a person’s self-esteem.
  • Many effective treatments are available.

Signs and Symptoms

Acne can appear on the back, chest, neck, shoulders, upper arms and buttocks. Many people think that acne is just pimples, but a person who has acne can have any of these blemishes:

  • Blackheads
  • Whiteheads
  • Papules
  • Pustules (what many people call pimples)
  • Cysts
  • Nodules

Who Gets It & Why?

Who gets acne?

If you have a bad case of acne, you may feel like you are the only one. But many people have acne - it is the most common skin problem in the United States. About 40 to 50 million Americans have acne at any one time. Most people who have acne are teenagers or young adults, but acne can occur at any age. Some people get acne when they reach middle age - a growing number of women have acne in their 30s, 40s, 50s, and beyond.

What causes acne?

Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.

Sometimes bacteria that live on our skin, p. acnes, also get inside the clogged pore. Inside the pore, the bacteria have a perfect environment for multiplying very quickly. With loads of bacteria inside, the pore becomes inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule appears.

 

Diagnosis & Treatment

How do dermatologists diagnose acne?

To diagnose acne, a dermatologist will first examine your skin to make sure you have acne. Other skin conditions can look like acne. If you have acne, the dermatologist will:

  • Grade the acne. Grade 1 is mild acne. Grade 4 is severe acne.
  • Note what type, or types, of acne appear on your skin.

When to see a dermatologist

If you have a lot of acne, cysts, or nodules, a medicine that you can buy without a prescription may not work. If you want to see clearer skin, you should see a dermatologist who can offer the following types of treatment:

  • Topical treatment: Most acne treatments are applied to the skin. Some topicals help kill the bacteria, others work on reducing the oil. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid.
  • Acne medication: Medicine that works throughout the body may be necessary when you have red, swollen types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. Your dermatologist may prescribe one or more of these:
    • Antibiotics (helps to kill bacteria and reduce inflammation)
    • Birth control pills and other medicine that works on hormones (can be helpful for women).
    • Isotretinoin (the only treatment that works on all that causes acne).
  • Procedures: Your dermatologist may treat your acne with a procedure that can be performed during an office visit. These treatments include:
    • Lasers and light therapies: These devices reduce the p. acnes bacteria. Your dermatologist can determine whether this type of treatment can be helpful
    • Chemical peels: Chemical peels can treat 2 types of acne — blackheads and papules. You cannot buy the chemical peels that dermatologists use.
    • Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.
 

 

Tips for Managing Your Acne

You can reduce your acne by following these skin care tips from dermatologists.

  • Wash twice a day and after sweating. Perspiration, especially when wearing a hat or helmet, can make acne worse, so wash your skin as soon as possible after sweating.
  • Use your fingertips to apply a gentle, non-abrasive cleanser. Using a washcloth, mesh sponge or anything else can irritate the skin.
  • Be gentle with your skin. Use gentle products, such as those that are alcohol-free. Do not use products that irritate your skin, which may include astringents, toners and exfoliants. Dry, red skin makes acne appear worse.
  • Avoid the temptation to scrub your skin - it can make acne worse.
  • Rinse with lukewarm water.
  • Shampoo regularly. If you have oily hair, shampoo daily.
  • Let your skin heal naturally. If you pick, pop or squeeze your acne, your skin will take longer to clear and you increase the risk of getting acne scars.
  • Keep your hands off your face. Touching your skin throughout the day can cause flare-ups.
  • Stay out of the sun and tanning beds. Tanning damages your skin, and some acne medications make the skin very sensitive to ultraviolet (UV) light, which you get from both the sun and indoor tanning devices. Using tanning beds also increases your risk for melanoma, the deadliest form of skin cancer, by 75 percent.

Consult a dermatologist if your acne makes you shy or embarrassed, the products you've tried have not worked, or your acne is leaving scars or darkening your skin.

Today, virtually every case of acne can be successfully treated. Dermatologists can help treat existing acne, prevent new breakouts and reduce your chance of developing scars. If you have questions or concerns about caring for your skin, you should make an appointment to see a dermatologist.

Related resources:

  • Hidradenitis suppurativa - A skin disease called hidradenitis suppurativa (HS) can look like everyday acne. It is a long-term skin disease, which often goes undiagnosed. If you have acne in your armpit, on your groin, or under your breasts, you might have HS.
  • Hidradenitis Suppurativa Foundation
  • Suicide hotline - (800) 784-2433, Available 24 hours a day, 7 days a week in the United States.

 

© American Academy of Dermatology. All rights reserved. Reproduction or republication strictly prohibited without prior written permission. Use of these materials is subject to the legal notice and terms of use located at https://www.aad.org/about/legalImages used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

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