Acne vulgaris

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What is acne?

Acne, also known as acne vulgaris, occurs as plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) on the face, neck, chest, back, shoulders and upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s – even into their 40s – can get acne. It is the most common skin condition in the United States. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring. To avoid acne scarring, treating acne early is important.

What causes acne?

There are four known culprits that cause acne in a chain reaction:

• Excess oil: Our bodies make oil, “sebum,” to prevent our skin from drying out. Sebum is often overproduced during adolescence when androgen hormones are in overdrive.
• Clogged pores occur when the sebum is produced faster than it can flow freely to the skin’s surface.
• Bacteria called P. acnes, which is found on everyone’s skin, thrives and multiples in the excess oil.
• Inflammation is caused by the bacteria. If the sebum flow is blocked near the skin’s surface, you get a little inflammation which results in a blackhead or whitehead, also called a “comedo.” With deeper blockage a pimple (“papule”) forms. And with really deep blockage there is a lot of inflammation, and a painful nodule or cyst results.

Several things can trigger acne or make breakouts worse, including:

• Heredity/genetics
• Hormones
• Menstruation
• Emotional stress

There is no scientific evidence that shows food causes or influences acne, but care should be taken when eating greasy foods so the oil from the food doesn’t get directly on the face, such as around the mouth since this might make acne worse. Similarly, people with oily hair should wash it daily to help prevent the oil from getting on the skin.

Cosmetics and acne

To avoid clogging pores, cosmetics, as well as toiletries and sunscreens, do not need to be avoided, but should be oil-free. An oil-free product will be labeled “non-comedogenic” (should not cause blackheads or whiteheads) or “non-acnegenic” (should not cause pimples). Also when applying a spray, gel, or other product to your hair, shield your face so that the product does not get on your skin where it can clog pores.

Some of our patients have had excellent results reducing their acne by either using our acne-friendly product lines alone or in combination with medical acne treatments. In particular, PCA Skin has daily skin care products designed to treat acne at home in addition to in-office extraction treatments. Jane Iredale Mineral Cosmetics can also provide excellent coverage and natural sunscreen while also improving acne because the ingredients are non-comedogenic and anti-inflammatory.

The patient above used PCA’s Acne Control Solution kit with pHaze 32 Blemish Control Bar and Jane Iredale’s PurePressed Mineral Powder for 3 months with 2 PCA Oxygenating Detox / Extraction treatments.

To explore the cosmetic options to treat and conceal your acne, call us for a free consultation at 509-735-1100, ext. 114.

Medical treatments

Dermatologists make treatment plans based on factors such as severity of acne, age and gender. Medication in the plan may be topical (applied to the skin) or systemic (works inside the body). Laser and light-based technologies may also be recommended.

• Common topical medications dermatologists prescribe include benzoyl peroxide, antibiotics, retinoids and salicylic acid.
• Oral antibiotics may be prescribed for moderate to severe acne that doesn’t respond to topical treatments alone. Common antibiotics include tetracycline, doxycycline, minocycline, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim and azithromycin.
• Birth control pills that contain estrogen or medication that decreases the effects of male hormones (antiandrogens) may help some women with acne.
• Corticosteroid injections may be used to treat large, painful acne lesions. These injections can ease the pain and help clear a large lesion more quickly.
• For severe nodular cystic acne that resists other treatments, a medication called isotretinoin, also known by it’s brand name Accutane, may be prescribed. This is the only medication approved by the U.S. Food and Drug Administration (FDA) to treat cystic acne, but because of the possibility of serious side-effects including severe birth defects for children born to mothers taking the drug, there is a strict risk-management program called iPLEDGE that patients taking the drug must participate in. The iPLEDGE program requires birth control for female patients who can get pregnant for at least 1 month before, during, and 1 month after stopping treatment and pregnancy tests before, during, and after treatment.

Today, there are many effective treatments for acne, but no one treatment or combination of treatments is right for everyone. Nor does any specific treatment work for everyone. If you do not see the results you want after four to eight weeks, be sure to tell your dermatologist.

Call 509-735-1100 to schedule your medical appointment to start treating your acne today.

For more information

• AcneNet – The American Academy of Dermatology’s comprehensive online acne information resource.
• iPLEDGE – More information for current or prospective isotretinoin (Accutane) users.