Acne

It's the scourge of the teenage years - acne. Not only are you going through everything else, but your face is breaking out. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the same thing that causes all the other things a teen goes through is a factor in acne - in other words - hormones. Those hormones, called androgens, cause the oil glands to start making more oil. The oil plugs up the hair follicles in the skin, and the result is acne. (Read about "Skin")

Who gets acne

Acne is the most common skin disease in the United States. If you are between the ages of 12 and 25 the odds are huge you'll get acne. In fact, 85 percent of people in that age range have some form of acne, according to the American Academy of Dermatology (AAD). It affects both males and females but tends to be worse in males because they have more skin oils and higher levels of androgens.

Causes

As already stated, the basic cause is skin oils clogging up hair follicles. NIAMS says that heredity also seems to play a role, with children of acne sufferers having more serious problems. And according to the American Academy of Family Physicians (AAFP), your immune system (Read about "The Immune System") can also make things worse. It may be more sensitive to bacteria (Read about "Microorganisms") that can get trapped in hair follicles.

Acne starts as a "whitehead" when the follicle gets plugged up with oil and skin cells. If the plug makes it to the surface of the skin, the air turns it black and it becomes a "blackhead." AAFP points out that a blackhead is not caused by dirt. If a wall of the follicle breaks open then the area swells and turns red. If it happens at the skin surface, you have a pimple. If it happens deep in the skin, nodules or cysts can form.

Treatment

AAD says most people can control their acne by taking care of their skin at home. Here are some tips, compiled from AAD, AAFP and NIAMS:

• Wash your face gently with a mild cleanser. Since acne is not caused by dirt, hard scrubbing with a strong detergent soap can make things worse.
• Leave your skin alone. Don't try to squeeze the pimples, blackheads or whiteheads. Squeezing could cause them to rupture below the skin and result in scarring. The treatment of scars is more complicated but there are possible treatments, including various surgical methods. (Read about "Plastic Surgery")
• Be careful with cosmetics. Choose ones that are labeled noncomedogenic (that means the product will not clog pores) and oil free.
• Moisturizers add oil and that's something you don't need. Watch out especially for lipstick with moisturizers.
• Shave carefully. Use an electric razor or a sharp safety razor making sure the beard is softened well with soap and water before applying shaving cream.
• Watch out for the sun. A tan may make the skin seem better and drier for a while, but it's temporary. The sun can result in premature aging and skin cancer. (Read about "Skin Cancer") In addition, some medications for acne make your skin much more sensitive to sun.

Medications

The first treatments tend to be over-the-counter topical medications. NIAMS says there are four basic types: benzoyl peroxide, resorcinol, salicylic acid and sulfur.

Benzoyl peroxide is considered best for attacking the P. acne bacteria and helping to reduce oil production. The other three are considered effective for breaking down blackheads and whiteheads. None of the medications works right away and it can take from 4 to 8 weeks before you notice any change in the skin.

There are also prescription versions of benzoyl peroxide that a doctor may suggest. A doctor may also choose to give you antibiotics or a retinoid.

People with very serious acne are sometimes treated with a drug called isotretinoin. It is a very strong but effective medication for severe acne. It is taken orally from 16 to 20 weeks, and according to NIAMS, acne goes away in close to 90 percent of patients. However, the acne can and does return in some people. Isotretinoin is taken orally and is a strong drug that can have side effects that need to be considered in consultation with your doctor. Potential side effects can include gastrointestinal issues (Read about "Digestive System"), psychological changes and sensory changes. In addition, isotretinoin causes serious birth defects. (Read about "Birth Defects") Women need to start taking precautions a month before starting the drug and continue those precautions a month after stopping the drug. The Food and Drug Administration (FDA) requires that woman who might be prescribed the drug have two negative pregnancy tests before the drug is prescribed and have a negative test once a month while taking it.

Adult acne

If you aren't a teenager but you still get acne, you aren't alone. Once again, the causes are basically the same - clogged hair follicles. AAD says there are some differences though. Teens tend to get acne in what is called the t-zone, the forehead, nose and chin. Adults tend to get acne along the jaw, lower cheeks, chin and neck. Women also seem to be impacted more in adulthood by hormonal fluctuations. (Read about "Polycystic Ovary Syndrome")

Although there are many things that can trigger acne, there's one thing experts say does not. Both the AAFP and AAD say the role of greasy food and chocolate in acne is greatly exaggerated. In fact, research has shown that they have little if any impact on acne.

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