What is Acne?

Acne is a disease of the follicular unit caused by many factors, including hormones and inflammation. It affects many people differently and can be as unique as your own skin composition. It is characterized by inflammation, red bumps, white-heads, black-heads, cysts, nodules, discoloration, and even scars. Acne often affects the face and upper trunk. Acne can affect newborns and infants but usually begins at puberty. Over 75% of teenagers have acne. As hormone production rises, lesions often become worse. Males tend to have worse acne at this stage. Some women experience acne for the first time in their 30’s even though they never had teenage acne. Other women may have flares prior to menses. Acne may be caused from medications as well.  Acne can be a source of embarrassment and even depression. There is wide variability in age at onset, contributing factors, and resolution.

 

Does Diet affect acne?

The relationship between diet and acne is controversial. Around the 1900s, diet was thought to be directly related to this condition and was commonly altered during management strategies. This fell out of favor in the 1960’s through the turn of the century. More recently however, dermatologists and dietitians have revisited the idea of nutrition in pathogenesis and management of acne. Evidence suggests a relationship between diet and acne does exist. Compared with other dietary factors, there is more convincing evidence that diets with a high glycemic load and refined sugar ingestion may worsen acne. Dairy ingestion appears to be weakly associated.

 

Acne Facts

  • Acne is NOT a dirty skin problem
  • Excessive scrubbing may dry the skin and actually worsen your condition
  • Pressure and friction can worsen acne (helmets, tight clothing, etc)
  • Picking acne or popping lesions may cause permanent scars, do NOT pop, pick, or scratch!
  • Long hair rubbing your face and back can worsen acne
  • Hair products can worsen acne
  • Cosmetic products and sunscreens can worsen acne (we recommend ‘non-comedogenic’ products)
  • Medications can cause acne (containing iodides, corticosteroids or androgenic steroids)
  • Use your acne treatment medication exactly as directed
  • Note that many treatments are designed to use as field treatment to prevent new lesions not simply treating acne you see, so use these medication where you want to avoid future acne lesions too!
  • Acne does not clear up in one or two weeks, stick to it!

How is Acne treated?

There is not a single treatment for acne since it is so variable. Mild acne is often treated with exfoliating cleansers (such as salicylic acid or glycolic acid). Sometimes more potent medications such as benzoyl peroxide or topical retinoids are required. Occassionally, topical antibiotics or even systemic antiobiotics are needed. Hormonal acne may respond to spironolactone and/or birth control pills in some women. Not every type of acne will respond to all modalities. Moderate to severe acne will often require a combination regimen. Severe nodular and scarring acne may require systemic retinoids such as Accutane (Isotretinoin).

While some of these medications are very safe others require monthly monitoring and even blood work. Using over the counter acne products may help in the right scenario. However if over the counter products are used incorrectly (strength, frequency of use, duration or timing of application), then they could lead to irritation, hyperpigmentation, dryness, new rash, or worsening of your acne. DSI recommends that you consult your provider to find out which acne treatment, or combination of acne treatments, is best for you.

For more information, visit the American Academcy of Dermatology

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