- Acne is the result of overactivity of oil glands at the base of hair follicles.
- Hormone changes during teenage years cause oil glands to become overactive.
- Family background (heredity) plays a role in oily skin, and in increasing sensitivity of
the skin to hormonal changes.
- Skin cells can "plug" skin pores causing "whiteheads" and, with
pigment, "blackheads."
- A "pimple" is an oil gland that is infected with bacteria, resulting in an
inflamed area with pus formation.
- Acne is NOT caused by eating oily foods, soft drinks, or chocolate.
- Although there is no true "cure" for acne, proper skin care, skin gel, oral
antibiotics, and other oral medications are available to control the more severe forms of
acne.
Introduction
Teenage years are ones filled with excitement, change, and the feeling by each and
every teen that they are "different." There is one aspect of the teen years,
however, that unfortunately is shared by most if not all teens, and this is acne. Whether
your teen's acne is mild or severe, your teenager deserves the very best information
available to help understand and control this most frustrating condition.
What causes acne?
Pimples (acne) are the result of over activity of the oil glands, which are located at
the base of the hair follicles, especially on the face, back, chest, and shoulders.
When these oil glands become plugged up, the overactive oil glands become red and
inflamed. There are many theories about acne, many of which are myths! Scientific research
seems to indicate that there are four key factors involved in the acne process:
- Natural hormones that are produced by the body throughout life undergo a drastic
increase during the teen years. These hormones carry out many healthy jobs in the body of
a rapidly developing teen. However, they also cause the oil glands to become overactive.
- Family background or heredity plays a very important role as well. If many members of a
teenager's family had or now have acne, it is likely that the problem of oily skin has
been inherited and the teen's skin will be more sensitive than most people's to the
effects of the hormones generated by the body.
- If the skin cells that line the oil glands or pores are present in unusually large
numbers, they tend to stick together, clogging the openings to the pores. These
"plugs" can be plain white (whiteheads) or if they contain mixtures of skin
cells plus skin pigment, they can be darker in color (blackheads).
- When bacteria are present on the skin, they tend to infect the oil glands. Bacteria
thrive on this oil, growing readily beneath the skin cells and leading to infection. This
produces redness and pus formation (the classic "pimple"), or in more serious
cases, the infection spreads into deeper skin layers and causes cysts. Cystic acne is a
deeper infection of the skin and is more likely to lead to permanent scarring.
What doesn't cause acne?
Myths are often perpetrated that consumption of rich oily foods, soft drinks,
chocolate, and many other foods commonly eaten by the average teen cause acne. This has
clearly been proven to be FALSE, though this myth remains the one most commonly held!
Likewise, acne does not indicate that the teen's face is too dirty. As noted above,
blackheads are colored by skin pigment cells, not dirt. Furthermore, "impure
thoughts" or being a "bad person" have yet to be implicated as causes of
acne!
What makes acne worse?
It is known that squeezing or "popping" pimples tends to force the oil and
bacteria into the deeper skin layers, making cysts more likely to occur. It is these cysts
that are more likely to cause scarring, the most serious complication of acne. Excessive
scrubbing of the skin actually irritates the skin and increases the number of loose skin
cells, leading to increased pore clogging. Anything that puts pressure on, or rubs the
skin excessively will aggravate acne. These include headbands, straps securing helmets,
hats, hair, and even the teen's own hands, if they are used to support the cheek or chin
while in class or watching television. Certain medications, especially hormones taken
orally or by injection can increase acne as a side effect. Females often observe that
their acne increases before or during their menstrual periods, as a result of the
increased hormones present at this time. Every teen knows that stress and tension can
induce acne flare ups.
What's a teen to do?
Clearly, we cannot change our heredity or normal hormones. Although there is no true
"cure" for acne, there are many things that can be done to control acne. While
acne usually improves or resolves by early adulthood, it can persist throughout adulthood.
The following hints can help acne sufferers of all ages:
CORRECT SKIN CARE
a) Excessive face washing is discouraged in that harsh scrubbing, especially with
abrasive soaps and/or cloths, increases the plugging of the oil glands. Using a mild soap
two or three times a day is desirable. The recommended washing procedure entails gently
massaging the soap into the skin with the finger tips. Hot water for washing, cool water
for rinsing, followed by gently patting the skin dry with a soft cloth is recommended.
Special "acne soaps" are not generally necessary unless advised by your doctor.
b) There are currently available very effective over-the-counter medications previously
available only by prescription. The most effective and safe are the benzoyl peroxides. The
gel form, in the lower 5% strength is generally recommended for initial use. The gel is
applied to all affected areas, (including those problem areas which may be forgotten, such
as the chest, shoulders, and back!) once daily. Covering the entire area where pimples
occur and not limiting application to existing pimples is advised. Frequency of use can be
increased to twice a day after a week or so if the skin is not too red or dry. It should
be noted that some peeling and dryness is supposed to occur with use of the benzoyl
peroxides. However, if the effect is excessive, the average teen will stop using the
medicine. It is best to allow thirty minutes to pass between washing and the application
of the gel. It is important to remember that regularly used acne medicine does not produce
positive effects for up to four to six weeks in most people. After this time period, the
strength of the gel can be increased to the 10%, if necessary.
WHEN TO SEE THE DOCTOR
If acne persists after consistent careful cleansing of the skin and regular use of the
benzoyl peroxides, it is generally time to see the doctor. Medications can be prescribed
that are even more effective at unplugging the pores. An example of these are retinoic
acid drugs, such as tretinoin (RETIN-A). Antibiotics taken orally, such as minocycline
(MINOCIN) can help decrease the oil-eating bacteria on the skin. Other antibiotics are
used directly on the skin, such as clindamycin (CLEOCIN) or erythromycin (ATS GEL or
T-STAT solution). For the most severe cases, a "miracle" medication called
isotretinoin (ACCUTANE) exists. This medication is a pill, and is prescribed for the most
severe cystic forms of acne. Like most strong medicines, there are potential side effects,
including eye, bowel and liver problems. ACCUTANE can cause deformity of the fetus and
should never be given in pregnancy. This drug should be prescribed and closely monitored
by a doctor trained in its use.
