Learning About Acne

Acne, often thought to be only a teenager's skin problem, is actually a condition that can affect adults both male and female, although it generally begins during puberty. Taking a proactive approach to treating acne is very important. How you look after your skin every day, along with the treatment you and your doctor select are key steps in your fight to eliminate pimples, preventing scarring and eliminating your acne.

There are a number of acne medications that can be used to treat your acne including over-the-counter acne products like Panoxyl?, or prescription drugs including topical treatments, Accutane? and hormone therapies.

For more information about medical treatments, click on the appropriate treatment above. If you want to learn more about your acne, read one of the recent articles we have featured here:

Hormonal treatments for acne: How they work Hormonal treatments, including oral contraceptives, have long been recognized by dermatologists to be an effective treatment option for women who have acne, no matter how severe. Read Hormonal Treatment of Acne: How They Work

Acne Myths: Chocolate And Sex Causes Acne! Have you been told that you shouldn't eat chocolate because it causes acne? Or how about French fries? Pizza? Wrong! Those are just myths, and while some foods can make acne worse for some people, researchers have found that it does not cause it! Read Acne Myths: Chocolate and Sex Causes Acne!

The Big Squeeze On Acne: A Discussion About Acne Scars. We all aspire to a smooth, clear complexion. When pimples arise, the need to flatten them out and squeeze is understandable. Unfortunately, this may lead to short and long-term problems such as persistent redness, large brown stains (hyperpigmentation) and scarring (loss of skin substructure). Stains and scars are often confused by patients - stains are pale or brown flat marks, whereas scars can be seen as indentations or pock marks in the skin. It is now recognized that scars can also develop from small, as well as, large lumpy pimples. Read The Big Squeeze on Acne: A Discussion About Acne Scars.

Acne: Pinpoint the Trigger While acne commonly develops during the preteen and early teen years, it can also arise in young adulthood and persist for years. Studies show women feel more frustrated by acne than men do - adult women even more so than teenage girls. Why? Dealing with a chronic disorder typically associated with puberty can lead to great frustration. But, don't despair if you have acne, effective treatment is available. Read Acne Treatment: Pinpoint the Trigger

The Big Squeeze on Acne: A Discussion About Acne Scars

We all aspire to a smooth, clear complexion. When pimples arise, the need to flatten them out and squeeze is understandable. Unfortunately though, this may lead to short and long-term problems such as persistent redness, large brown stains (hyperpigmentation) and scarring (loss of skin substructure). Stains and scars are often confused by patients - stains are pale or brown flat marks whereas scars can be seen as indentations or pock marks in the skin. It's now recognized that scars can also develop from small as well as large lumpy pimples.

For both scars and stains, the best treatment is avoidance - that is, preventing the acne in the first place or at least treating it early and avoiding picking or squeezing the spots.

To treat acne and prevent new scars from forming, you should remember:

You should get help for your acne as soon as you notice it as early treatment minimizes the severity of acne and the risk of scarringEffective acne treatments are availableYou can control and cover the visible lesions and avoid embarrassmentIt is common to have stains and mild scars from acne. Stains will generally improve with time and can be helped to improve more quickly with skin care treatments such as topical retinoids, alpha-hydroxy acids and therapeutic exfoliating facials. For many of those with mild scars, they may not even be aware of it - some of these may improve over time. However, severe scarring may be more difficult to treat.

There are a number of types of scars caused by acne. (Pictures can be found at Types of Acne Scars)

Ice pick scars - Deep pits, that are the most common and a classic sign of acne scarring.Box car scars - Angular scars that usually occur on the temple and cheeks, and can be either superficial or deep, these are similar to chickenpox scars.Rolling scars - Scars that give the skin a wave-like appearance.Hypertrophic scars - Thickened, or keloid scars.Ideally, acne should be quiescent or controlled before treating scarsTreatments for scars depend on the specific scar typeTreatment also depends on your skin type.Embarrassment from is most often due to facial scars - effective treatment can lead to an improvement in self-image and confidenceScars on the chest and back will also respond to treatmentThere are several non-surgical treatment options that may be appropriate for your acne scars:

Skin Camouflage/Cover-up: For patients with active acne, acne staining, and scars - effective camouflage foundation can improve the appearance of the skin rapidly. Choose products that are non-comedogenic and non-acnegenic and have your tones matched by a skin-care expert to achieve that matte, flawless appearance.

Topical Creams: (Tretinoin): Can improve your acne, reduce staining and improve fine scars by causing gentle exfoliation and by encouraging collagen production.

Chemical Peels (AHA peels): Can improve overall skin tone and luster, but do little for scars, it works best if you get a series of at least six peels, having one every 1-2 weeks.

Skin Fillers/injectables: Materials are injected into the depressed area of the scar to elevate it to the level of the normal surrounding skin. This treatment is best for scars with smooth shoulders such as thumbprint or rolling scars. Evaluating whether individual scars will respond to fillers is easily done by placing slight tension at the scar edge - if this improves the appearance of the scars, fillers will help. There are temporary and permanent fillers - examples are: Artecoll?, Zyplast?, Restylane?, and HylaForm?.

Non-ablative collagenosis: New laser and radiofrequency devices are being evaluated for enhancing collagen formation in deeper skin layers without damaging the skin surface. It is possible that these treatments may also prove useful in acne scarring.

1. Microdermabrasion: It uses very fine aluminum crystals to achieve light exfoliation of the skin. This is helpful for staining and very fine scars. It also works best if you get a series of at least 6, having one every 1-2 weeks.

2. Photorejuvenation: Using laser or broadband visible light, 5-6 treatments that are performed every 3-4 weeks. This treatment improves mild acne scarring by causing new collagen formation.

3. Scar Revision: Surgical removal (excision) of acne scars is especially effective for ice pick and boxcar scars. The excision may be in the form of a punch that is closed with sutures that are removed about 7 days later. The end result is replacement of a circular scar with a linear suture scar.

Another technique called subcision uses a sharp instrument to undercut the tethered bases of scars. In this case, the overlying skin is not cut so there is no need for sutures. Further improvement can then be achieved by injecting filler substances into the subcised regions.

4. Resurfacing: a) Ablative Laser Treatments: - Laser resurfacing (CO2 laser, Erbium Yag laser): These resurfacing lasers remove the surface layer of skin and cause a zone of heat injury. The healing process allows for reformation with younger less scarred skin and deeper layer of new collagen formation.

b) Dermabrasion: - This is a mechanical procedure in which a rapidly rotating wire or brush is used to strip off the surface irregularities of skin. Felt by most experts to be the most effective primary treatment for extensive scarring, it can be used in conjunction with fillers and excision.

The Unseen Impact of Acne: There is help for those suffering.

Acne is universal. At some time or another we all experience this annoying disease. As teenagers we are frustrated with unsightly blemishes, and as adults, we are dismayed that we can still get acne. Acne has a predilection for affecting the face - a primary site for others to gauge our attractiveness. Facial involvement with acne is an ongoing source of embarrassment and concern - especially for those in the formative years of physical growth, self-image development and socialization.

When the pore openings on the face, neck, back, chest, and arms become plugged with skin debris, oil produced by the deeper oil glands becomes trapped - resulting in blackheads and whiteheads. As inflammation develops, we start to see red pimples and even deeper lumps, (cysts or nodules). These inflamed spots can then lead to scarring and staining of the skin. (Read about Acne Basics)

Oil production increases during adolescence when the sex hormones are elevated and the oil glands have increased in size. Acne becomes less frequent in the early and mid -20's, although some patients can have persistent breakouts into their 40's and beyond.

While the physical features of acne are readily apparent to us all, the emotional and social impact of acne is often underestimated by non-sufferers. This can be manifested as anxiety, depression, and social withdrawal. Previous studies have shown that those with acne are dissatisfied with their appearance, embarrassed, self-conscious and lack self-confidence. Problems with social interactions with the opposite gender, appearances in public, and with strangers have also been observed.

The mental stress of sufferers with acne can be greater than that associated with other chronic diseases such as asthma, epilepsy, diabetes, back pain, arthritis, and heart disease. Acne patients also have a greater tendency to significant levels of depression and anxiety.

Of particular note is one study in which 18 per cent and 44 per cent of acne patients, respectively, reported serious depression and anxiety. To further illustrate the depth of despair experienced by those living with this condition, six per cent of patients in one study reported thinking about committing suicide.

Acne can also affect one's ability to earn a livelihood. A previous study has shown that those with acne were more likely to be unemployed than those unaffected. A recent Canadian study also observed that those with more severe acne were more likely to be unemployed than those with lesser involvement. It is uncertain whether these findings are due to the patient's psychosocial impairment or the negative response by potential employer's to those affected by acne.

Effective therapy for acne can help reverse both the physical features of acne and the unseen psychological and social impact of this condition. With appropriate treatment, we frequently observe improvement in self-esteem and confidence. From the initial visit where patients may appear withdrawn and sullen, improvement with therapy is typically associated with a more positive outgoing disposition. Studies have demonstrated that effective acne therapy can help reverse feelings of shame, embarrassment, anxiety, and inadequacy.

If over the counter preparations do not control your acne you may need to see a dermatologist and medical prescriptions may be necessary. Available treatments currently available include:

Topical prescriptions Antibiotic pills Hormone pills Isotretinoin pills Light and photodynamic therapy. With targeted treatments individualized to acne severity and specific patient needs, there is every likelihood that acne can be significantly improved - allowing one to regain his or her confidence to lead a better, more productive life.

If you or someone you know is suffering silently, feeling there is no hope, turn to a dermatologist or a doctor to discuss the types of treatments available. You can also learn more at www.acnecuretreatment.chrischel.com