Introduction

Acne is the most common skin condition in the United States with an estimated 40-50 million Americans being affected at any one time. Acne is also the eighth most common disease affecting more than 660 million people worldwide. It is well known that acne is quite common in teenagers and young adults (due to an increase in hormones such as estrogen and testosterone); however, acne can also occur at any age even as young as less than 1 years old. Adults well into their 50’s may also develop acne with more women suffering from it than men. There are many myths that surround acne and how it is best treated. For example, many people believe that acne should be able to “run its course”, allowing acne to clear on its own. Yet, this may not be the best advice, for acne without treatment could result in scars and dark spots once the acne has cleared.

Causes

Acne develops over the skin when hair follicles become clogged with an oily skin secretion (known as sebum) as well as with dead skin cells. Normally, dead skin cells rise to the surface of the pore where they are subsequently shed from the body. Over-production of sebum may cause the dead skin cells to congeal inside the pore where they may become trapped rather than rising to the surface. A few well-documented causes of acne are, but not limited to: genetics (thought to account for 80% of all cases), excessive growth of the bacterium P. acnes (bacteria normally found on the skin), hormone changes, stress, and diet.

Symptoms

Acne may develop anywhere on the skin but generally develops on the face, neck, shoulders, chest, upper arms, and buttocks. Also, acne can appear in many forms and not just as pustules (i.e. pimples). For example, someone with acne may have: blackheads, whiteheads, papules, cysts, and/or nodules. Numerous studies have shown that some common symptoms in people who have acne are possible scaring and dark spots, which may cause anxiety, depression, and low self-esteem as a result of their appearance.

Diagnosis

We will begin by examining your skin to identify if you have acne and not a similar-looking but different skin condition. If you have acne, we will note the type (or types) of acne and we may grade the acne on a scale from 1-4 based off the severity; grade 1 being mild acne and grade 4 being severe acne.

Treatment

Many treatment options for acne are available, including medications, medical procedures, and lifestyle changes. Over-the-counter (OTC) or prescription medications such as benzoyl peroxide, salicylic acid, azelaic acid, and retinoids; are commonly used and can be directly applied to the skin (topical treatments). Antibiotics can also be used as a topical treatment or as an oral medication. Other types of oral medications that have been shown to be effective are birth control pills for women and Isotretinoin.  This medication is generally prescribed only for severe cases of acne due to the greater potential of side effects. Medical procedures that have been effective in treating acne are, but not limited to: chemical peels, laser & other light therapies, and a procedure known as drainage/extraction; which is typically for removing large acne cysts. Lifestyle changes such as eating fewer simple carbohydrates as well as limiting the amount of chocolate and salt has been shown to reduce acne.

We do recommend that you have your acne treated. Treatment may prevent new breakouts as well as avoid scarring or dark spots that may remain on your skin. If someone in your family has a history of acne cysts and nodules, we recommend that you seek treatment if you develop acne. Treating acne before cysts and nodules appear may also prevent scars from developing.