Free Advice: Acne

Acne Treatment Recommendations

Acne (acne vulgaris) is caused when the pore openings on the face, neck, back, chest and arms become plugged with to much oil (sebum) production made by the oil glands. Increased oil (sebum) is produced particularly during adolescence when the sex hormones are elevated and the oil glands have increased in size.  As the pores become plugged with the excess oil and loose skin, blackheads, whiteheads, pimples, and even deeper lumps, (cysts or nodules) occur. The oil is irritating to the surrounding skin causing redness seen in the pimples and pustules. Bacteria can also more readily grow in this environment further aggravating the acne.

Acne affects mostly teenagers; however, the disease can affect both men and women into their 40's.  While acne usually clears up after several years even if untreated, you need not wait to outgrow it. Untreated acne can leave lifelong scars. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring.  I consider acne to be 75% inherited from one's parents, 12% caused from not cleansing the face and 12% caused from diet.

Treatment: Wash your face with a facial cleanser or soap and warm water twice a day. Washing too often may actually make your acne worse. There are many cleansers, select the one for you that is right for your skin type, whether it be dry, oily, or sensitive.  Removing your makeup each night to keep the pores from becoming plugged. Avoid removing makeup by roughly wiping the make up off.

Benzoyl Peroxide (BP): Benzoyl peroxide acts as an antibacterial agent against P. acnes, a bacteria, and it is most effective against inflammatory acne consisting of papules, pustules and cysts. BP causes mild desquamation to scaliness, peeling and cracking. The drying does not cause wrinkles.  Start with the lower strength (2.5% or 5%) preparations first. The stronger strengths (5% & 10%) can be irritating. A gel is usually more drying and stronger than a lotion or a cream. A BP wash that is put on briefly then washed off is a good way to start as a BP gel, lotion or cream that is left on the skin can bleach clothing or the sheets on the bed.

Salicylic Acid:  Salicylic acid a beta hydroxy acid is a mild acid that works as a keratolytic agent (removes the tops layers of skin and opens clogged pores). Salicylic acid is both safe and efficacious for treatment of acne vulgaris, oily skin, textural changes, melasma, and post-inflammatory hyperpigmentation in patients of most skin types. Start with a 1-2% preparation.

Glycolic Acid: Glycolic acid is an alpha hydroxy acid that is derived from the sugar cane plant and is compatible with the skin due to its molecular structure. It acts as a keratolytic (removes top layers of skin and opens clogged pores.) It has been shown in clinical studies to improve acne and the hyperpigmentation that is present with acne.  Start with the lower strength (2.5% or 5%) preparations first.  Strengths above 5% may be irritating. A gel is usually more drying and stronger than a lotion or a cream.

Shampooing:  Regular shampooing is also recommended as oil from your hair can make acne worse particularly around your hairline. If your hair is oily, you may want to wash it more often.

Shaving: Men with acne who shave should try both an electric and a safety razor to see which is more comfortable. If you use a safety razor, soften your beard thoroughly with soap and warm water before applying shaving cream. To avoid nicking pimples, shave as lightly as possible. Shave only when necessary and always use a sharp blade and a good quality shaving cream.

Cosmetics: Work with cosmetics that are oil free and water based. Use products that say they are "non-comedogenic" (should not cause whiteheads or blackheads) or "non-acnegenic" (should not cause acne). Cosmetics that have a light green tint may help hide the redness of acne. When using hair spray cover your face. Hair spray may plug the pores.

Diet:  Diet is controversial; however, many dermatologists feel certain foods can aggravate acne for some people.  I believe excessive dairy products, soft drinks or other foods with sugar, excessive nuts and oily food can aggravate acne in some people.

Sunlight: A tan can mask your acne, but the benefits are temporary. Since sunlight ages the skin and can cause skin cancer, you should not sunburn, "bake in the sun" or use sunlamps. Choose a sunscreen that is oil-free, such as a gel sunscreen or water based sunscreen.

Prescription Rx: If the above OTC (over the counter) preparations do not control your acne you may need to see a dermatologist and medical prescriptions may be necessary.