ACNE
Acne is the most common skin problem treated in the US. More than
85% of adolescents and 10% of adults have the whiteheads, blackheads or
pimples on their cheeks, chest, shoulders and back. Some people develop
more pimples than others and for these people we can offer treatment to
make them look better now and prevent permanent scarring in the future.
The typical acne lesions result from a combination of factors.
First the hair follicle becomes blocked with dead skin cells. Next, in
response to hormones like those increased with puberty, there is an
overproduction of sebum (an oily substance made in the follicles.)
Finally, a skin bacterium, Propionibacterium acnes (P. Acnes), which grows
well in the plugged up follicle, causes inflammation and a pimple.
Rubbing, scrubbing with astringents, and picking or popping the
pimples will only make them worse and make the face more irritated. Food
has no direct effect on the production of sebum so eating chocolates,
sweets or french fries will not make your acne worse. In some people
untreated acne can lead to cysts and permanent scarring.
Treatment of acne is directed at its causes. The choice of which
type to use is based on how bad it is. Treatment always starts with the
use of a mild moisturizing soap to gently wash the skin. Harsh soaps can
irritate the skin and make acne worse. There are many acne medicines
available without a prescription. If you are not satisfied with these
products then we encourage you to came in for an appointment with your
doctor.
If the severity of your acne is mild to moderate your doctor will
prescribe for you a topical cream, gel or ointment. Tretinoin (Retin A,
Differin, ect.), a topical form of Vitamin A, breaks up the blocked hair
follicles and helps to correct the overproduction of squamous cells.
Topical antibiotics, like benzoyl peroxide 2.5%-10%, erythromycin, cleocin
T or benzamycin, a combination of benzoyl peroxide and erythromycin,
decrease the amount of P. Acnes in the hair follicle by direct contact.
They may be used alone or in combination with other medications. The major
side effects of these medicines include peeling skin, dryness, facial
redness, sun sensitivity and allergic contact sensitization.
If the acne is more severe oral antibiotics such as tetracycline,
minocycline, doxycycline and erythromycin can be added to reduce bacteria
in the hair follicles and decrease inflammation. The major side effects
include stomach upset and sun sensitivity.
Finally, if the acne is very severe, Isotretinoin (Accutane) an
oral form of Vitamin A, can be used to reduce sebum production, shedding of
dead skin and inflammation. However, there are a number of very
significant side effects including birth defects in pregnant women, dry
skin, poor night vision, hair loss, muscle aches, joint pains, headaches
and sun sensitivity.
Through education about what causes acne, dispelling myths and
proper treatment your pediatrician can help you look your best now and in
the future. Arrange an appointment to talk with us about your acne.
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