ACNE

Acne is a very common skin problem.  9 out of every 10 teenagers will develop acne. Sometimes, younger children and even infants and toddlers can develop acne. Acne can usually be treated with good skin care and medication, when needed.

Causes:

Acne is primarily a reaction to hormone changes during puberty. In general, acne is not caused by foods, although eating a healthy diet is good for your skin and can help your acne. It is not caused by dirt or poor hygiene. Some medications may cause acne or make it worse, such as oral or topical corticosteriods.

Symptoms:

The types of skin lesions seen in acne include comedones, also known as "whiteheads" and "blackheads", inflamed papules, pustules, inflamed nodules and cysts. Nodules and cysts may be painful. Acne may cause scarring when severe.

Treatment:

The most important step in treating acne is good skin care. Do not pick or squeeze the pimples. Try not to touch your face and do not lean your face on your hands. Tight caps and hats may also make your acne worse. Do not use hair grease or other greasy products near your face. Some acne medicines may make your skin more sensitive to the sun, so don't forget to use sunscreen.

Most acne can be treated with topical (skin) medications, although sometimes oral (by mouth) medications may be needed.  Severe acne may not respond to typical treatments. A medication called isotretinoin may be prescribed by a dermatologist in this case.

It usually takes 6-8 weeks before you will see improvement in your skin. If you do not use your medications as instructed, your acne will not get better as expected. Follow up appointments are very important so your doctor can see how the medications are working and whether you are having any side effects from the medications. Not every patient’s acne will get better with the same medication. Your doctor may need to adjust the medication several times, and you may need to use more than one medication. You may still have occasional break-outs even while on medication; this is normal.

When to call your doctor:

If you develop significant irritation, redness, or peeling while using your acne medication.

If you develop severe headaches, abdominal pain, rash, joint pain, nausea/vomiting, trouble breathing and/or vision problems while taking oral medications such as tetracycline, minocycline or doxycycline.

Referral to a specialist:

Most patients with acne can be appropriately managed by their primary care provider as long as the treatment plan is followed and you see your primary care provider for follow-up as recommended.  Referral to a dermatologist is indicated only when a patient has severe acne and is at risk of scarring or when a patient has tried several topical and/or oral (by mouth) medications for at least several months with no improvement in their acne.

Special Instructions:

·       Wash your face twice a day with a gentle facial cleanser. Products such as Dove, Cetaphil, Purpose, Aveeno, and Neutrogena work well. If you need to use a face cream or moisturizer, use one made for the face such as Cetaphil, Eucerin, or Neutrogena and preferably one which contains an SPF sunscreen. If you wear make-up or cosmetics, choose ones that are labeled “non-comedogenic” or “won’t cause acne."

·       Do not use “buff puffs,” scrubbing sponges, wash cloths, astringents, alcohol or scrub-type cleansers on your skin.  Use only your hands to wash your face.  Be gentle, do not rub.  Pat your face dry with a towel. 

·       Topical (skin) medications such as tretinoin, Retin-A, adapalene, Differin, Tazorac, benzoyl peroxide, clindamycin, Duac, BenzaClin, Epiduo, Ziana, Acanya, and Aczone:  Apply topical medication 30 minutes after washing your face to prevent stinging.  If the doctor has prescribed one medication to be used in the morning and a different medicine to be used in the evening, it is important that you follow these directions exactly.  If your skin is burning or irritated, stop treatment and call your doctor for advice. You may need to occasionally skip using your medication for a day if your skin starts to get irritated. Products that contain benzoyl peroxide may bleach or stain towels and clothing so apply carefully after getting dressed and wash hands thoroughly after applying.

·       Oral (by mouth) medications such as tetracycline, doxycycline,  or minocycline may be prescribed. Take these medications exactly as instructed.  Do not skip doses.  Take these medications with a full glass of water and do not lie down for 30 minutes afterwards. Call your doctor if you develop severe headaches, persistent blurry vision, severe abdominal pain, a new rash, or severe joint pains.