Acne is a common skin problem affecting many teenagers and adults. Dr. Carmel Anderson, our local dermatologist sees many acne patients each day. It usually begins at the time of puberty due to changes in hormone levels and increased activity of male sex hormones, like testosterone. These hormones are present in females as well. Acne can unfortunately continue into adulthood or even begin in adults. It affects 95% of people in Western societies and unfortunately is incurable. Usually acne clears up by the time we reach our thirties, although it can unfortunately last well into our forties and fifties. While it is not a life-threatening problem, acne can lead to permanent scars and psychological damage.

Acne happens when a hair follicle or “pore” within the skin becomes plugged with oil (sebum), trapping a certain type of bacteria and allowing it to grow. Testosterone increases sebum production. The culprit bacterium in acne is Proprioniibacterium acnes. At first either whiteheads or blackheads form, a.k.a. “comedones.” Whiteheads (closed comedones) are from sebum and bacteria trapped below the surface of the skin. Blackheads (open comedones) occur when the trapped bacteria and sebum partly open to the air. The reaction of the skin to these bacteria is inflammation, creating redness and a pimple can be the result. Deeper areas of inflammation can create cysts or nodules, which may be painful and look like a bump on the skin surface and are filled with pus.

People often wonder what they can do to prevent acne. There are myths out there that certain foods like chocolate and junk food high in processed sugar and fat cause acne. Whether or not a link between diet and acne exists is controversial. No studies have shown a true link between specific foods and this common skin problem, but individually people may notice that certain foods make their acne worse. According to Dr. Anderson, our Western diet does seem to be unfortunately linked to worsening acne. There are entire groups of people who have diets with a low glycemic index, i.e. high in fruits and vegetables and eat no processed or deep fried foods that do not have a single hint of acne. Dr. Anderson also related that dairy products low in fat may actually have more potential to worsen acne, making skim milk a possible culprit. Another myth is that stress causes acne. Stress does not cause acne, but will make acne worse if you already have it. Dirt on the skin does not cause acne either. In fact, scrubbing your skin too much can make acne worse by irritating your skin more. Sun exposure does not make acne better. A tan will temporarily make acne appear less blotchy, but this is all it does. The risks of tanning far outweigh the benefits of smoothing blotchy skin, such as skin cancer, wrinkles, and premature aging.

Acne can be dealt with, but is not curable. You can control it. Before discussing acne treatments, it must be understood that it takes time for acne to clear. On average, six to eight weeks are necessary for early results to be noticed. Also, not everyone’s acne is the same and will not necessarily respond the same to treatment.

A gentle skin cleanser should be used twice a day. You should talk to your skin specialist about which one is best for your skin type. Avoiding hands on facial skin is best. Picking and touching acne-infected skin can cause spread to non-infected areas. Any cosmetics used should be “non-comedogenic” and you can find this on the labels. Topical medications (put on the skin) can be used in less severe cases of acne, but oral (by mouth) antibiotics or other medications may be needed. There are exciting new treatments like Blu-U light treatments or glycolic acid peels that can be used as well. To deal with scarring, there are many options out there. Again, talk to your skin specialist to find out what would be best for you.