Nearly everybody gets an occasional pimple or blackhead. However, some people suffer daily with chronic breakouts and multiple blemishes. Active acne breakouts tend to be painful both physically and emotionally to some degree for everybody who experiences them. If you have experienced a bad acne flare-up in the past, or if you suffer from acne daily, you know the feelings of social phobia and low self-esteem that accompany breakouts. Becoming educated about the true causes of acne as well as effective treatments can help you battle this stubborn condition.
According to the American Academy of Dermatology, acne affects approximately 40 to 50 million Americans, making it the most prevalent skin disorder in the United States. Approximately 85 percent of the population suffers from acne at some point. The most common areas affected are the face, neck, back and chest. Acne affects a large portion of teenagers, with over 40 percent kids suffering by their mid-teens from acne or scarring severe enough to warrant dermatological treatment.
Non-inflammatory acne consists of blackheads and whiteheads. A blackhead forms when the pore becomes clogged but remains open. The black color occurs because of melanin, or skin pigment, reacting with the air, and is not simply dirt inside the pore. A whitehead forms when the pore becomes completely clogged. The dead skin cells and sebum, or oil produced by the skin, produce the small white bump characteristic of a whitehead. Blackheads and whiteheads often cause little physical discomfort.
Inflammatory acne causes the classic red bumps that most people associate with acne. Inflammatory acne occurs when skin bacteria, called P. acnes, becomes trapped inside clogged pores and multiplies. Papules and pustules often occur in mild to moderate cases of acne. Papules are small, red bumps that occur when the wall of the blocked pore ruptures close to the surface of the skin. A papule will often turn into a pustule when the body begins to fight the infection, resulting in the white head characteristic of pimples. Milder inflammatory acne blemishes may cause mild physical discomfort.
A more severe inflammatory acne blemish can develop when trapped bacteria cause the wall of the blocked pore to rupture deep in the skin. This typically causes a nodule or cyst to form. A nodule feels like a large, firm lump under the skin. A nodule forms when the pore, or follicle, break occurs deep and allows bacteria and debris to spill into the middle layer of skin and infect other pores. Cysts, the most severe form of a pimple, occur when the pore bursts deep within the skin and a membrane forms around the infection. Cysts can cause permanent scarring. Nodules and cysts tend to be very painful to the touch and may take longer to heal than other acne lesions.
Milder cases of acne may only require over-the-counter treatment for satisfactory results. Non-inflammatory acne often responds well to salicylic acid treatment. Cleansers, lotions and toners containing salicylic acid prevent dead skin cells from building up and clogging pores. Salicylic acid does not reduce oil production or kill bacteria. For people with mild inflammatory acne, benzoyl peroxide helps reduce excess oil and fights bacteria. Benzoyl peroxide may cause excessive skin dryness, particularly in people with dry or combination skin.
Moderate to severe acne often requires prescription medications to achieve satisfactory results. Dermatologists often use antibiotics to treat moderate inflammatory acne. Antibiotics like erythromycin, tetracycline or clindamycin fight bacteria and reduce inflammation and breakouts. Severe or cystic acne may warrant treatment with isotretinoin after other treatments have failed. Isotretinoin is an oral medication derived from vitamin A that effectively treats even very severe cases of acne. The medication involves a long list of risks and side effects including depression, nosebleeds, dry skin, dry mucous membranes, chest pain and bone pain. For patients who are able to complete a four-month course of treatment, acne is often eradicated without requiring additional treatments.
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