Acne is a very common skin disorder that causes the formation of comedones (whiteheads and blackheads) on the skin and is one of the most common dermatologic condition that we see, not only affecting adolescents, but also affects young adults and adults. These occur when a pore containing an oil gland is blocked or becomes clogged with dead skin cells. The underlying follicle may become inflamed from the blockage and by skin bacteria called P. acnes that proliferate in the sebum (oily substance) that accumulates in the plugged follicle. When large quantities of infected sebum accumulate deep in the skin, this can result in the formation of acne cysts. These cysts appear as swollen, painful red lumps. This type of acne causes the most severe scarring.

Hormonal changes that occur during puberty are the leading cause of acne outbreaks. Adult acne may be the result of continuing hormonal imbalances. Skin care products that clog pores or contribute to oily skin can also promote the formation of pimples. There is no evidence that avoiding chocolate or other foods will limit or prevent acne.

Acne Treatments

Keeping your pores clear of dead skin and excessive oil is helpful for controlling acne. You may be able to do this successfully with over-the-counter remedies such as facial washes containing salicylic acid or benzoyl peroxide. However, many people struggle to find the right skin care regimen without some expert advice. Moderate to severe acne may not respond to OTC treatments. You may wish to discuss the following topics with your dermatologist:

  • How to use acne-controlling cleansers and astringents to clear pores, exfoliate dead skin, and reduce oil on the skin without overdrying
  • Whether antibacterial creams or gels that kill P. acnes bacteria will help limit the formation of pus filled pimples
  • If products such as Retin A may help control inflammation and redness
  • Whether topical or oral antibiotics are advisable for reducing sebum production and skin bacteria
  • If estrogen-containing birth control pills may help regulate hormones and cut down on outbreaks
  • Whether newer treatments such as blue light therapy are worth a try

Patients with severe, ongoing cystic acne that does not respond to other available treatments may wish to discuss the use of isotretinoin drugs (Claravis or Amnesteem). These medications have significant side effects, so they are only used as a last resort.

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