Acne is a skin condition that often occurs during adolescence when changing hormone levels contribute to the formation of pimples, whiteheads and blackheads. Acne is the most common skin condition in the United States, affecting 40 to 50 million people, according to the American Academy of Dermatology (AAD). While it is not uncommon to experience occasional outbreaks, some people are plagued with frequent acne, which can be challenging to treat.
Pores are openings in the skin that are found anywhere a hair grows. Oil glands found at the base of hair follicles produce sebum, an oil needed to prevent skin from becoming too dry. If the glands produce too much oil, all of it may not be able to reach the surface of the skin. The excess oil backs up in the pores and mixes with skin cells found in the hair follicles, plugging the pore openings. Bacteria normally found on the skin surface begins to grow in the clogged follicles and causes an inflammation that results in acne.
The type of acne that develops due to a clogged pore depends on the level of the oil plug. Blackheads and white heads, also called comedos, are the mildest forms of acne and occur when the oil plug forms just beneath the skin surface. Whiteheads are white bumps on the skin that occur when the pore remains closed, while blackheads, or black spots on the skin, occur when the plugged follicle is exposed to air. The dark appearance of the blackhead is due to changes in the oil when it is exposed to the air. Pimples occur when the clog happens deeper in the hair follicle. When the blockage is at this level, a raised red spot filled with pus forms on the skin's surface. If the blockage is very deep within the hair follicle, a hard, painful cyst or nodule develops.
Frequent acne is common during the teenage years when the body experiences an increase in the production of male sex hormones called androgens. These hormones, present in both boys and girls, can cause an enlargement of oil glands, resulting in increased oil production that contributes to clogged pores. Fluctuating hormone levels may also occur with the use of birth control pills or during pregnancy. Chronic, persistent acne in adult women may develop due to hormonal influences, according to Diane S. Berson, M.D., assistant professor of dermatology at the Weill Medical College of Cornell University. Dr. Berson spoke at the July 2004 summer scientific session of the AAD and explained that nearly half of all women notice acne flare-ups and oily skin in the week before menstruation. Acne can run in families and can occur with the use of oily sunscreens, moisturizers and makeup.
Over-the-counter creams, ointments and pads containing benzoyl peroxide, salicylic acid, acetone, resorcinol, sulfur or alcohol can be used to treat acne. Benzoyl peroxide works by killing bacteria and removing extra oil and dead cells from the skin. Acetone and alcohol are helpful in removing oil and dirt, while resorcinol and sulfur break down skin cells that can clog pores and reduce extra oil. Salicyclic acid is used to help prevent clogged pores and causes whiteheads and blackheads to break up. Washing the skin and hair daily can help reduce oil on the skin that contributes to acne.
Frequent or chronic acne may require treatment by a dermatologist, who may recommend the use of oral or prescription-strength topical medications to open clogged pores. Topical medications may be prescribed in conjunction with antibiotics used to relieve inflammation and kill bacteria. Severe, cystic acne that does not respond to other acne treatments can be treated with isotretinoin, an oral medication that decreases bacterial growth by reducing oil gland size. Isotretinoin can cause serious birth defects, and women of childbearing age must use reliable birth control if they are taking the drug. Corticosteroid injections can also be helpful in treating stubborn cases of acne.
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