Acne (Acne Vulgaris)

Basic information

description

A chronic inflammatory (red and sore) skin condition that is most common in teenagers. The skin eruptions may appear on the face, chest, and back. Acne is more common in males than in females.

frequent signs and symptoms

• Blackheads (black spots the size of a pinhead).
• Whiteheads (white spots similar to blackheads).
• Pustules (small pus-filled lesions).
• Redness and inflammation around eruptions.
• If acne is severe, cysts (larger, firm swellings in the skin), and abscesses (swollen, inflamed, tender area of infection containing pus).

causes

Oil glands in the skin become plugged for unknown reasons. Sex-hormone changes during the teen years play a role. When oil backs up, it becomes infected by bacteria normally present in glands. Contrary to commonly accepted myth, acne is not caused by dirt or foods. Cleanliness can lessen acne, but sexual activity has no effect on it.

risk increases with

• Exposure to extremely hot or cold temperatures.
• Stress; oily skin; some cosmetics.
• Endocrine disorders.
• Use of drugs, such as cortisone, male hormones, or oral contraceptives.
• Family history of acne.

preventive measures

Cannot be prevented at present.

expected outcomes

• Most cases respond well to treatment, and the acne tends to disappear after the teen years.
• Despite treatment, acne will sometimes flare up.

possible complications

• Poor self-image and emotional distress.
• Facial scars or pitting of the skin.

diagnosis & treatment

general measures

• If your skin is oily, cleanse it as follows:

Gently massage face with unscented soap for 3 to 5 minutes. Don't massage sorest places. Cleanse skin gently; don't scrub. An antibacterial soap may help.

Rinse soap off for 1 to 2 minutes.

After cleansing, use an astringent, such as alcohol, to remove oil.

Use a fresh washcloth each day. Bacteria grow in damp, wet cloths.

• Shampoo hair at least twice a week. Don't let hair hang over the face, even at night. Hair can spread oil and bacteria. Use dandruff-preventing shampoos.
• After exercise, wash the sweat and oil off as soon as possible.
• Avoid heavy, oil-based cosmetics. Use thinner, lotion-style, water-based cosmetics.
• Don't squeeze, scratch, pick, or rub the skin. Acne heals better without damage to the skin. Removal of comedones (blackheads) may be done by your health care provider.
• Don't rest your face on your hands while reading, studying, or watching TV.
• See your health care provider if home treatments don't help. Your skin will be examined, and treatment options will be discussed.
• Exposure to ultraviolet light may be a recommended treatment.
• Cosmetic surgery (dermabrasion) may be recommended to remove unsightly scars after acne heals.

medications

• Antibiotics, both oral and topical, to fight infection.
• Cortisone injections into lesions.
• 2.5%, 5%, or 10% benzyl peroxide may be helpful.
• For more severe cases, topical or oral retinoids (a form of vitamin A) may be prescribed.

Caution: If you are pregnant or planning a pregnancy, tell your health care provider before using acne drugs.

activity

No restrictions.

diet

Foods don't cause acne, but some foods may make it worse. Keep a record of the foods you eat. To discover any food sensitivities, eliminate foods from your diet that you suspect make your acne worse. Then reintroduce them one at a time. If acne flares up 2 or 3 days after a food is eaten, leave that food out of your diet.

NOTIFY YOUR HEALTH CARE PROVIDER IF

• You or a family member has acne.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Content from: Moore, Griffith's Instructions for Patients. © 2005 Elsevier Inc. All rights reserved.