Acne Treatment and Prevention
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What is acne?
Acne is a skin condition that occurs when hair follicles in the skin become clogged. Follicles are tubes that connect the pore on the surface of the skin to oil glands that secrete an oil called sebum. Sebum helps lubricate skin and hair and protects them from drying out. The sebum can clump together with dead skin cells and hair and plug the follicle. Bacteria in the plug can cause swelling and irritation in the skin.
Acne is most prevalent on the forehead, face, chest, back, and shoulders because there are a lot of oil glands in these areas.
While usually attributed to young people going through puberty, acne can happen to people of all ages, even infants.
What causes acne?
Hormones are one of the most common causes of acne. Testosterone stimulates the skin’s oil glands to produce sebum – this is why acne is so prevalent in teens, puberty increases androgen levels (males hormones including testosterone) in both adolescentboys and girls.
Medication can also cause acne. Some birth control pills can cause increased sebum production, increasing the risk of developing acne. That being said, some acne in women can be treated with birth control as well.
Corticosteroids, like prednisone, can also increase the risk of acne. Corticosteroids mimic androgens produced in the body and can cause increased sebum production in the skin.
High-glycemic foods like white breads, white rice, donuts and pastries, and potatoes can cause increases in sebum production as well.
Family history can also increase the risk of acne. If your parents had or have acne, you are at an increased risk. There is no specific gene mutation that has been identified to cause acne, however, some families tend to produce more dead skin cells which can clog pores.
What does not cause acne?
- Hygiene – acne is not caused by dirty skin
- Greasy foods do not increase the risk of having acne
- Cosmetics – especially oil-free make up, it also helps to remove makeup regularly
What are the signs of acne?
- Whiteheads (plug that remains under the skin)
- Blackheads (plug at the surface, the dark color is a reaction to the air)
- Papules (red bumps, they can be painful)
- Pustules (pimples – papules with pus on top)
- Nodules (solid lumps in the skin, often painful)
- Cystic lesions (pus-filled lumps in the skin, often painful)
Symptoms vary depending on severity of the condition.
How to start acne treatment?
Our MyCare providers will evaluate your symptoms and the history of your condition. They will ask you how long you’ve had acne, any medications you are taking, what skin products you are using, and if you have a family history of acne.
From there, they can make recommendations on how to improve your acne and write prescriptions if needed.
If you’ve been trying to manage acne on your own for several weeks without success, you may need prescription medication to clear up your skin. Acne medications can reduce oil production, promote health skin cell growth, treat skin infections, or reduce skin inflammation.
The goal of these medications are to control and clear acne, avoid scarring, and make existing scars less noticeable. It may take several weeks or months for you to see improvement in your skin, and it may take years for the acne to completely resolve. Treatments will depend on age and severity of your acne.
What are treatment options for acne?
Topical medications for acne treatment
- Retinoids and retinoid-like drugs are derived from vitamin A and help exfoliate dead skin cells. They also promote the production of new skin cells. Medications include Retin-A, Differin, Tazorac, and others.
- Antibiotics kill excess bacteria on the skin and help reduce redness. Topical antibiotics often include benzoyl peroxide. Medications include Benzaclin, Duac, and Benzamycin. Topical antibiotics may be combined with retinoids.
- Benzoyl peroxide is used to reduce the amount of bacteria that cause acne and dry the skin to prevent excess of oil in the skin.
- Azelaic acid has been shown to have antibacterial properties. Prescription options of Azelex and Fiancea are an option during pregnancy or for breast-feeding mothers.
- Salicylic acid helps prevent hair follicles from plugging up.
- Aczone is a gel used for inflammatory acne. It is used mostly in adult females.
Oral medications for acne treatment
- Oral antibiotics are used for more severe cases of acne. They are used to reduce bacteria and inflammation and are often used in combination with a topical treatments like Benzoyl Peroxide to improve results and prevent the risk of developing antibiotic resistance. Medications include tetracyclines like minocycline or doxycycline or a class of antibiotic called macrolides.
- Combined oral contraceptives are used for acne in women who also want a contraceptive. These medications contain estrogen and progestin and help lower the amount of androgens in the body. Medications include Ortho Tri-cyclen, Estrostep, and Yaz. There is an increased risk of blood clots with these medications, so it is important to thoroughly discuss all options with your Rise MyCare provider before starting these medications.
- Spironolactone is an anti-androgen agent that blocks the effects of androgens on the oil glands in the skin. It can also reduce the production of androgens by the body. It is used in women and adolescent girls if antibiotics aren’t working.