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Acne is a common skin condition of the pilosebaceous unit affecting both males and females. The skin is composed of hundreds of hair follicles which contain oil glands also known as sebaceous glands. These glands function to secrete oil to naturally lubricate the skin’s surface. Acne occurs when this oil is overproduced and becomes trapped, allowing bacteria to grow.
Acne occurs when this oil is overproduced and becomes trapped, allowing bacteria to grow. This leads to clogged pores and inflammation of the skin known as whiteheads, blackheads, pimples, pustules, or cysts. White heads (closed comedones) are tiny white bumps on the skin when the oil and bacteria stay below the skin’s surface. Black heads (open comedones) occurs when the pore opens to the surface and turns black or brown in color from oxidation from the sun. Pimples and pustules occur due to inflammation and becomes swollen causing red bumps sometimes containing pus. Cysts and nodules tend to be deeper and painful, and are more likely to leave scars after healing. It is important not to pick or squeeze the lesions to prevent scarring and worsening of acne. Besides over production of sebum or oil in the follicle, there is altered proliferation and differentiation of keratinocytes or epithelial cells, leading to plugging of the pores on the skin surface. The cause of this is unknown.
Acne affects primarily the face, chest, back, neck and upper arms. Other areas of involvement include inside the ear, posterior ear, and the ear lobes.
Acne typically begins at puberty, between the ages of 15-18 in both sexes. Men tend to have more widespread involvement than women. Acne tends to subside around age 25, but adults can continue to have acne breakouts, well into their 40’s. Women may experience a flare of acne a week or so before their menses.
Acne is caused by many factors including stress, hormonal imbalance, family history, and cosmetics. Some foods have also been implicated, however it is difficult to conduct food studies. Using oil free products, water based or non-comedogenic products, which mean they do not plug the pores is recommended as with cleansers, moisturizers or sun screens. Acne is not a condition caused from having dirty skin, over washing can irritate and make acne worse.
There is no cure for acne; it is best controlled with a combination of oral and topical medications. Therapy begins with taking a thorough history of all product used in the past and present including prescribed and over the counter products. A history of oral and topical steroid use, psychiatric medication and birth control pills should be obtained. Cosmetic use including hair products that are oil based should be avoided. Bronzer, pressed power, powder blush, concealers, oil based liquid foundation, cover ups should be avoided. Menstruation irregularity and abnormal hair growth in women in a male pattern of distribution may indicate a hormonal imbalance and GYN work up may be indicated. Treatment should be applied to the entire face, rather than limited areas, to prevent future lesions from developing. Scrubbing the face and over washing should be avoided to prevent irritation. Patients should be informed that the condition may get worse before they experience clearing. Seeing a dermatologist who can tailor a treatment regimen specifically toward your skin’s needs and following the instructions of your dermatologist is key to seeing resolution of the problem.
If you have questions about acne call our office in Attleboro to schedule an appointment. At your visit Dr. Hines will work with you to discuss treatment options and help you treat your condition with an individualized plan.
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