Acne
Acne is one of the most common skin conditions that has affected almost everyone. It starts as small white bumps (comedones) and can progress to large pustules, nodules, and sometimes large, painful, deep cysts. Acne can appear almost anywhere but primarily affects the face and back.
Signs or Symptoms
Signs of acne include:
Oily skin
White and black spots (comedones)
Small red papules filled with pus (pustules)
Deep painful nodules sometimes with pus (cystic acne)
Scarring
Discoloration that takes months to resolve (post inflammatory hyperpigmentation)
Possible Causes
Acne is multifactorial, meaning that many things contribute to it. For many, it starts in their teenage years when their body undergoes a series of hormonal changes (progesterone in females and testosterone in males). It is important to realize that not just teenagers can get acne.
Things that cause acne include:
Chemical exposures
Excessively oily skin
Athletic training or excessive sweating (hyperhidrosis)
Items being used on the skin
Hormonal changes and imbalances
Bacteria (P. acnes)
Treatment Options
The first step to getting clear skin is cleaning the skin. A quality, mild soap should be used every evening to clean the skin. Strong moisturizers should be used to keep the skin hydrated and healthy. Over the counter products such as salicylic acid and benzoyl peroxide are good places to start when treating acne.
When over-the-counter products don’t work, it is best to make an appointment to see a dermatologist. First-line care often includes adding a topical retinoid to use at night. These products promote new skin growth for a clean appearance, and they clear pores that have been occluded.
For stubborn lesions, we then consider a stronger combination of topical medications, oral antibiotics (like minocycline), chemical peels, and oral isotretinoin (Accutane).
For adult females, the oral medication, spironolactone, is very helpful at clearing difficult lesions.