Acne

What is acne?

Acne is a common disorder affecting the hair follicles and oil producing glands of the skin. It consists of white heads, blackheads, pustules, nodules and even cysts. Acne is most commonly located on the face, but can occur in other locations such as the chest and back. Acne affects more than 85% of teenagers at some point. Many adults also suffer from acne, including adults who experienced little to no acne as teenagers. This scenario is especially common in females and is referred to as female adult onset acne.

What causes acne?

Acne is due to a variety of causes. It starts when oils from the skin and dead skin cells or other substances clog a pore. This small bump is called a comedone which is what people refer to as a whitehead or blackhead. If the comedone doesn't resolve, bacteria (specifically Cutibacterium acnes or C. acnes) begin to feed off  the oil and dead skin cells which in turn produces inflammation. This leads to larger pustules and in more sever cases, nodules and cysts. Acne formation is also heavily influenced by hormones. This is a reason why teenagers more frequently experience acne as their increased hormone levels cause excess oil production.

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Acne can be influenced by diet, although foods such as chocolate or greasy foods commonly associated with acne don't usually have an effect. Dairy products, specifically skim milk, as well as foods with a high glycemic index (foods that quickly raise blood sugar) seem to have the biggest effect in worsening acne. 

How is acne treated?

There are many different treatments for acne and the choice is both dependent on patient preference and the severity of the acne. Mild cases can be treated with topical medications such as topical antibiotics, retinoids such as tretinoin that help exfoliate the skin to prevent clogging of pores, and even topical antihormonal therapies. Chemical peels such as salicylic acid peels performed in the office are also a safe and effective treatment for acne.

 

More severe cases may require oral medications for patients that are motivated and willing to take a pill. Oral antibiotics are an option although we try to limit their use to prevent side effects and risk of antibiotic resistance. Female patients can take pills such as birth control or spironolactone to alter the effects of hormones on the skin. Unfortunately any oral hormonal-based therapies cause unwanted side effects in males, so they are only an option for female patients. 

 

Accutane (isotretinoin) is an excellent option for those with severe acne or those who have failed to improve with other treatments. It is also the only acne treatment that can actually cure acne by changing the structure of the skin. Other treatments simply help reduce acne with the hopes that the patient eventually outgrows their acne. Most of the supposed risks of Accutane such as depression and suicide have been greatly overstated. In fact studies show teenagers taking Accutane have lower rates of depression and suicide than those not taking Accutane. This is probably due to the fact that acne itself can cause or worsen depression. 

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For those wanting a more "natural" approach, we carry the Epionce line of products. Epionce incorporates many botanical ingredients into their products and have shown high efficacy in treating patients with acne and other conditions. Use of Epionce products in conjunction with chemical peels can be a safe and effective way to treat acne in those hoping to avoid taking pills or using prescriptions. For more information, click on the following links to the pages on our website: Epionce and Chemical Peels.

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Why should acne be treated?

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Untreated acne can lead to significant inflammation, pain, and even scarring. Once acne scars form, the consequences of acne can be permanent. This is why it is important to treat acne in its early stages. Your dermatologist will consider all factors and will counsel you on the different options to help personalize a treatment plan that is right for you.