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Definition

Acne is a skin condition characterized by Whiteheads, Blackheads, and inflamed Red Pimples.

Causes, incidence, and risk factors

Pathophysiology of AcneAcne occurs when tiny holes on the surface of the skin called pores become clogged. Each pore is an opening to a canal called a follicle, which contains a hair and an oil gland. Normally, the oil glands help keep the skin lubricated and help remove old skin cells. When glands produce too much oil, the pores can become blocked, accumulating dirt, debris, and bacteria.

The top of the plug may be white (Whitehead) or dark (Blackhead). If it ruptures, the material inside, including oil and bacteria, can spread to the surrounding area and cause an inflammatory reaction. If the inflammation is deep in your skin, the pimples may enlarge to form firm, painful cysts.

Acne commonly appears on the face and shoulders, but may also occur on the trunk, arms, legs, and buttocks.

Acne is most common in teenagers, but it can happen at any age. Most teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. However, people in their 30s and 40s may also have acne.

Acne can be triggered by

- Hormonal changes related to menstrual periods, pregnancy, birth control pills, or stress

- Greasy or oily cosmetic and hair products

- Certain drugs (such as Steroids, Testosterone, Estrogen, and Phenytoin)

- High levels of humidity and sweating

- Despite the popular belief that chocolate, nuts, and other foods cause acne, this does not seem to be true.

SymptomsAcne Skin

- Whiteheads

- Blackheads

- Cysts

- Redness around the skin eruptions

- Inflammation around the skin eruptions

- Crusting of skin eruptions

- Scarring of the skin

TreatmentAcne Skin

Take the following self-care steps to lessen the effects of acne:

Clean your skin gently with a mild soap. Remove all dirt or make-up. Wash once or twice a day, including after exercising. However, avoid excessive or repeated skin washing.
Shampoo your hair daily, especially if it's oily. Comb or pull your hair back to keep the hair out of your face.
Try not to squeeze, scratch, pick, or rub pimples. Although it might be tempting to do this, it can lead to scarring and skin infections.
Avoid touching your face with your hands or fingers.
Avoid greasy cosmetics or creams. Look for water-based or "non-comedogenic" formulas. Take make-up off at night.
If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These creams and lotions are applied directly to the skin. They may contain Benzoyl Peroxide, Sulfur, Resorcinol, or Salicylic Acid. They work by killing bacteria, drying up the oil, and causing your skin to peel.
If the pimples are still a problem, stronger medications can be prescribed.

Prescription medicines include

- Oral antibiotics (taken by mouth) such as Minocycline, Doxycycline, and Tetracycline

- Topical antibiotics (applied to the skin) such as Clindamycin or Erythromycin

- Synthetic Vitamin A derivatives called Retinoids such as Retinoic Acid cream or gel (Retin-A) and Isotretinoin pills (Accutane) **pregnant women should NOT taken as it causes severe birth defects

- Prescription formulas of Benzoyl Peroxide, Sulfur, Resorcinol, Salicylic Acid

- Birth control pills can sometimes help clear up acne. Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion.

- A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays is not recommended because it increases the risk of skin cancer.

Expectations (prognosis)Acne Skin

Acne usually subsides after adolescence, but may lasts into middle age. The condition generally responds well to treatment after a few weeks, but may flare up from time to time. Scarring may occur if severe acne is not treated.

ComplicationsAcne Skin

Possible complications include:

- Cysts

- Permanent facial scars

- Changes in skin color

- Side effects of Accutane (including liver damage and birth defects in an unborn baby)

- Side effects of other medications