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Acne

Who gets acne?

Acne, pimples, zits, cysts.  No matter how you describe it nobody wants to deal with acne.  It’s more than skin deep.  The psychological effects of acne need to be considered in how aggressive acne is treated.  It is not uncommon for patients to not want to take pictures with a group of friends or even look at themselves in the mirror.  And acne is not just limited to teenagers.  Many adults well into their 30s and 40s still deal with acne.  Although there is no cure for acne there are many, many good treatment options. 

What causes acne?

Acne, which can appear anywhere on the body can be caused by hormones, clogged pores, inflammation, and bacteria.  Sometimes it’s a combination of all four.  Most people are familiar with what acne looks like.  You can have a closed comedone, which is called a white head.  Even though you shouldn’t, these are the ones people like to pop.  Another form is a blackhead, which is a closed comedone.  Then you have the red bumps called inflammatory papules, nodules, or cysts.  These are the ones that can be tender and take a long time to go away.  It’s possible to have all of these at one time or some people are more prone to whiteheads than inflammatory papules or vice versa.  Females may notice that their acne gets worse around their menstrual cycle, but remains relatively clear the rest of the month.

Another common cause of acne is from microtrauma; we call this acne mechanica.  Football players that wear shoulder pads may notice they develop acne where the shoulder pads sit.  Women may notice acne worsen or develop on their bra strap area.  Treatment does not really change for this type of acne, but can be harder to treat because the area is constantly irritated by repeated microtraumas.  

Does eating junk food cause pimples?  We don’t think so.  Diet and acne are not clear cut.  There is a correlation between consumption of a lot of dairy and teenage acne.  Whether this is specifically the dairy or its role on the hormones in our body is unclear.  It can’t hurt to decrease your dairy intake to see if it makes a difference.  In general, if you notice a worsening of acne with certain foods or drinks; avoid them.  It’s not uncommon for acne to run in families.  If your mom, dad, brother, sister had bad acne you are at greater risk of having acne, too.  

Treatment Options

Treatment for acne can include topical medications (Differin, Retin-A, Epiduo, Clindamycin, Aczone), oral medications (Doxycycline, Minocycline, Azithromycin), and even a combination of the two.  Usually acne requires multiple therapies at one time so don’t be surprised if you are prescribed a cream to use in the morning, a different one for at night, and possibly an oral medication to take once or twice a day.  

Remember, above we mentioned that acne can be caused by hormones, clogged pores, inflammation, and even bacteria.  This is why multiple treatments are needed so we are attacking each of the problems.  If your acne is not responding to typical prescription treatments or you present with nodulocystic acne a medication called isotretinoin or “Accutane” may be required.  This is a five or six-month course of treatment, but can-do wonders in treating acne.  In regards to females, sometimes oral contraceptives or other treatments affecting hormones may be of benefit; such as spironolactone.  

It might get worse before it gets better.

Anytime that you start a new acne treatment you may notice things get worse before they get better.  Acne does not develop overnight, thus treatments will not work overnight.  It typically takes 4 to 6 weeks to start seeing real improvement in your skin.  Signs things are improving maybe be less redness, pimples resolve quicker and fewer are appearing.  Also, remember less is more with certain topical acne treatments such as Retin-A.  You may notice you get red, irritated, peeling skin if you use too much of the medication or use it too frequently.  We will not only prescribe you the appropriate acne medications, but we will make sure you know how to use it correctly to get the best outcomes.

Before Accutane

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After Accutane

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