Column: June Is Acne Awareness Month

[Column written by contributor Dr. Daniela Kroshinsky]

June is Acne Awareness Month, so we wanted to take this opportunity to answer some of the most commonly asked questions about proper skin care.

What is acne?

Acne is a common skin condition that causes your skin to break out in pimples [also called zits] and other kinds of bumps. Acne is most often on the face but can be found on other parts of the body such as the chest and back. Most people get at least some acne, especially during their teenage years. Acne can begin at age 8 or 9 and usually gets better by the mid-20s, though adult acne exists. Acne can be mild, moderate or severe.

What causes acne?

To keep your skin from getting dry, your skin makes oil in little wells called sebaceous glands that are found in the deeper layers of the skin. People with acne have glands that make more oil and are more easily plugged by oil and dead skin. This causes the sebaceous glands to swell and creates an environment for specific bacteria [called C. acnes] to grow. Hormones [like the shifts when your body is changing during puberty, the window of time when people develop physically from a child to an adult] and your family’s likelihood to have acne also play a role.

What does mild acne look like?

With mild acne, you can see small bumps on your skin called blackheads and whiteheads. These are caused by dead skin cells and oil in the pores and hair follicles. There can also be few small red pimples. Mild acne usually does not leave scars but can leave discoloration.

What does moderate to severe acne look like?

With moderate to severe acne, you see larger pimples on the skin. These can have pus [a gluey white liquid] inside that you can see. There may also be bumps that are about the same size as the pimples, but without pus inside. These are signs of a kind of acne that goes deeper into the skin and sometimes the pimples can hurt. Severe acne can have these features as well as larger red bumps called cysts.

Moderate to severe acne is more likely to leave scars on your skin which can be hard to correct. If you get treatment early follow your treatment plan, you can keep acne from scarring your skin.

What can make acne worse?

• Repeatedly pushing, touching, picking, or scrubbing areas where you have acne. This can happen if you wear tight hats or helmets a lot.

• Oil and grease in moisturisers, hair products, and/or makeup. Try to use these as little as possible or avoid them close to your face.

• Oils in the hair. Try to pull your hair back from your face as much as possible.

• Squeezing pimples and scratching the skin with fingernails. This can lead to scarring.

• Cyclical hormone changes like with menstrual cycles, or periods.

• Polycystic ovary syndrome, a medical condition that causes irregular periods, acne, and increased hair growth.

• Some medicines taken for other problems can cause acne or breakouts that look like acne. Some of these medicines are lithium, steroids like prednisone, and bromides or iodides, which are in some sedatives and cough medicines. Make sure you tell your doctor about all the medicines you are taking.

Do certain foods make acne go away?

There is no specific diet that will make your acne go away.

How can doctors treat acne?

You do not have to live with acne! You can help control acne with a good skin care routine and different kinds of medicine. There are several options for medicines depending on how severe the acne is. Your doctor will help you choose the best one for you based on the kind of acne you have. The types may change depending on what phase of acne you are experiencing in your life.

Skin care

• Wash your face twice a day, once in the morning and once in the evening [including any showers you take] with a gentle, alcohol-free soap or over-the-counter acne wash.

• Use over-the-counter [a medication or product you can get without a prescription] acne washes with salicylic acid or benzoyl peroxide a few times a week. These washes fight oil and bacteria but can be drying and irritating. Start using them a few times per week and build up to more frequent use as your skin gets used to them.

• Avoid over-washing or over-scrubbing your face. This will not improve your acne. It may also lead to dryness and irritation, which can affect how well your acne medication works.

• Try not to pop pimples or pick at your acne. Picking or popping can delay healing and lead to scarring or dark spots. It can also cause a serious infection.

• If you play sports, try to wash your skin and sports equipment or uniform right away when you are done. Remove any tightly fitting wet clothing as soon as possible.

• Do not use moisturisers and cosmetics if you do not need to. If you use them, choose products that are labelled oil-free and non-comedogenic [will not block your pores].

• Be patient. Do not stop using the medications your doctor gave you if you do not see results right away. It can take up to three months for your skin to start getting better.

• Apply sunscreen [SPF 45 or above] every day after applying your acne medication. Sunscreen is important not only for protecting your skin in general, but also because acne medications can make your skin more sensitive, and it can prevent dark marks from getting darker.

Medications

• There are many types of medication to treat acne, including prescriptions from your doctor or over-the-counter. When used properly, acne treatment works well. If you have acne and over-the-counter products are not working, you may need a prescription to help.

• You may need a combination of medicines to treat acne. If one medication did not work on its own, it may work better in combination with another. Your doctor can help find a combination that works for you.

• Some kinds of acne treatment are helpful for prevention. Keep using these types of medications even if your acne is better. This will help prevent new or more acne from forming in the future.

- Daniela Kroshinsky, MD, MPH – Director of Pediatric Dermatology at Mass General for Children. Dr Kroshinsky noted that others also contributed to this article

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