Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum (the oil that helps keep skin from drying out) and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders.
Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle.
Keratinocytes, a type of skin cell, line the follicle. Normally, as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore. This prevents the keratinocytes from shedding and keeps the sebum from reaching the surface of the skin. The mixture of oil and cells allows bacteria that normally live on the skin to grow in the plugged follicles and cause inflammation —swelling, redness, heat, and pain. When the wall of the plugged follicle breaks down, it spills the bacteria, skin cells, and sebum into nearby skin, creating lesions or pimples.
For most people, acne tends to go away by the time they reach their thirties, but some people in their forties and fifties continue to have this skin problem.
Who Gets Acne?
People of all races and ages get acne, but it is most common in teens and young adults. When acne appears during the teenage years, it is more common in males. Acne can continue into adulthood, and when it does, it is more common in women.
Types of Acne
Acne causes several types of lesions, or pimples. Doctors refer to enlarged or plugged hair follicles as comedones. Types of acne include:
- Whiteheads: Plugged hair follicles that stay beneath the skin and produce a white bump.
- Blackheads: Plugged follicles that reach the surface of the skin and open up. They look black on the skin surface because the air discolors the sebum, not because they are dirty.
- Papules: Inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch.
- Pustules or pimples: Papules topped by white or yellow pus-filled lesions that may be red at the base.
- Nodules: Large, painful solid lesions that are lodged deep within the skin.
- Severe nodular acne (sometimes called cystic acne): Deep, painful, pus-filled lesions.
The following factors may increase a person’s risk for developing acne:
- Hormones. An increase in androgens, which are male sex hormones, may lead to acne. These increase in both boys and girls normally during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy can also cause acne.
- Family history. Researchers believe that you may be more likely to get acne if your parents had acne.
- Medications. Certain medications, such as medications that contain hormones, corticosteroids, and lithium, can cause acne.
- Age. People of all ages can get acne, but it is more common in teens.
Acne Treatment Options
Topical Medications
- Benzoyl peroxide: Kills acne-causing bacteria.
- Salicylic acid: Exfoliates and reduces inflammation.
- Retinoids: Regulate oil production and cell turnover.
- Antibiotics: Reduce bacterial overgrowth.
Oral Medications
- Antibiotics: For moderate to severe acne.
- Hormonal therapy: For women with hormonal imbalances causing acne.
- Isotretinoin: A strong retinoid for severe, resistant acne.
Procedures
- Chemical peels: Exfoliate and remove the top layer of skin.
- Extractions: Manually remove blackheads and whiteheads.
- Laser therapy: Targets acne-causing bacteria and reduces inflammation.
- Microneedling: Creates tiny punctures in the skin to stimulate collagen production and improve scarring.
Lifestyle Changes
- Cleanse your face regularly: Use a gentle cleanser twice daily.
- Wear sunscreen: Sun damage can aggravate acne.
- Manage stress: Stress can increase oil production and worsen acne.
- Eat a healthy diet: Limit processed foods, sugary drinks, and dairy products.
Other Considerations
- Consult a dermatologist: A dermatologist can diagnose your acne and recommend the best treatment options.
- Be patient: Acne treatment can take time to show results.
- Follow instructions carefully: Use medications and follow procedures as directed.
- Avoid over-the-counter products without consulting a doctor: Some products can irritate the skin and worsen acne.
Dr. Muñoz recommends Accutane, also known as isotretinoin. Approved by the FDA in 1982, it is a powerful oral medication used to treat severe acne. It is a retinoid, which means it works by regulating the production of oil in the skin and reducing inflammation.
How Accutane Works
Reduces oil production in the skin, prevents the formation of new acne lesions, and reduces inflammation.
Benefits
- Effective for severe acne that has not responded to other treatments
- Can provide long-term acne clearance
- May improve skin texture and appearance
- Lower risk of scarring compared to other acne treatments
If your acne is not responding to the usual treatments, find out if is right for you! Contact Vista Dermatology today.
