Acne

Alternative names

Definition

Acne is a skin condition characterized by whiteheads, blackheads, and inflamed red pimples ("zits").

Causes, incidence, and risk factors

The condition occurs when tiny holes on the surface of the skin, called pores, become plugged. 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 blockage or plug is often called a comedone.

The top of the plug may be white ( whitehead ) or dark ( blackhead ). If the comedone 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 an age, even as an infant. Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. It may persist into a person's 30's and 40's.

Acne tends to run in families and 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.

Symptoms

Signs and tests

Treatment

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

• Clean your skin gently with a mild, non-drying soap (like Dove, Neutrogena, or Basics). 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. Avoid tight headbands.
• Try not to squeeze, scratch, pick, or rub the 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, a dermatologist can prescribe stronger medications and discuss other options with you.

Expectations (prognosis)

Complications

• cysts
• permanent facial scars
• changes in skin color
• damage to self-esteem, confidence, personality, and social life
• side effects of Accutane (including liver damage and birth defects in an unborn baby)
• side effects of other medications

Calling your health care provider

Update Date: 10/10/2003