Acne is the most common skin condition in the United States and is the term for plugged pores (blackheads and whiteheads), pimples and deeper lumps (cysts or nodules) that occur on the face, neck, chest, back and shoulders. While not a life threatening condition, acne can be upsetting and a source of emotional distress. Acne can also lead to serious and permanent scarring. Most people who have acne are teenagers or young adults, however acne can occur at any age.
Acne appears when our pores become clogged with dead skin cells. Normally, these dead skin cells rise to the surface of the skin to shed the cells. However in acne, the body starts making lots of sebum (oil) and the dead skin cells stick together inside the pore. When the pore is clogged with dead skin cells, this attracts bacteria named Propionibacterium acnes. This bacteria flourishes in an oily environment and multiplies very quickly. With bacteria trapped in the pore, your skin becomes red and tender.
Aggravation of acne by food varies from person to person. Many acne patients can eat chocolate without trouble; others find that even a few pieces of chocolate cause new pimples. Chocolate, nuts, soft drinks, and root beer are the most common offenders. A few people who drink large quantities of milk find that this worsens their acne.
Remember to keep your skin clean and wash with a mild cleanser twice daily. Avoid harsh scrubbing and astringents. Although sometimes difficult to do, don’t squeeze or pick at blemishes. You may use oil free sunscreens and moisturizers, and choose skin care products labeled “non-comedogenic” which means the product won’t clog your pores. The goal of acne treatment is to heal existing lesions, stop new lesions from forming and prevent acne scars. Treatment options vary, depending on what type of acne you have. Mild cases may respond to topical treatment alone. Moderate and severe acne may be treated with oral antibiotics, injections of cortisone, oral contraceptives and spironolactone for women with acne, chemical peels, light treatment and laser surgery. Isotretinoin is used in severe cases of acne refractory to treatment.
Should acne scarring be already present prior to treatment or be a residual of treatment, your dermatologist can treat these scars by a variety of methods. Combination skin resurfacing with lasers, dermabrasion, chemical peeling, and electrosurgery can improve scar appearance. Soft tissue fillers, such as Restylane® or Juvederm®, can elevate scars. Acne scars may also be revised by microexcision, subcision, and punch grafting.