acne problems

[mortal]

"You shouldn't wash your face several times a day - it takes away the natural oils of the face, drying it out, and your skin will then try to replenish the oils, potentially causing more acne."

Acne is caused by oily skin. I could wash my face every five minutes for a year and still have oily skin.

Whatever another internet know it all.

[Asger]

Pop 'em!!

[Wushu24]

From SkinCarePhysicians.com - SkinCarePhysicians.com was developed by the American Academy of Dermatology specifically for patients and health professionals to use as a resource for up-to-date information on the treatment and management of skin diseases.

Acne Myths

Myth #1: Acne is caused by poor hygiene. If you believe this myth, and wash your skin hard and frequently, you can actually make your acne worse. Acne is not caused by dirt or surface skin oils. Although excess oils, dead skin and a day's accumulation of dust on the skin looks unsightly, they should not be removed by hand scrubbing. Vigorous washing and scrubbing will actually irritate the skin and make acne worse. The best approach to hygiene and acne: Gently wash your face twice a day with a mild soap, pat dry--and use an appropriate acne treatment for the acne.

Myth #2: Acne is caused by diet. Extensive scientific studies have not found a connection between diet and acne. In other words, food does not cause acne. Not chocolate. Not french fries. Not pizza. Nonetheless, some people insist that certain foods affect their acne. In that case, avoid those foods. Besides, eating a balanced diet always makes sense. However, according to the scientific evidence, if acne is being treated properly, there's no need to worry about food affecting the acne.

Myth #3: Acne is caused by stress. The ordinary stress of day-to-day living is not an important factor in acne. Severe stress that needs medical attention is sometimes treated with drugs that can cause acne as a side effect. If you think you may have acne related to a drug prescribed for stress or depression, you should consult your physician.

Myth #4: Acne is just a cosmetic disease. Yes, acne does affect the way people look and is not otherwise a serious threat to a person’s physical health. However, acne can result in permanent physical scars--plus, acne itself as well as its scars can affect the way people feel about themselves to the point of affecting their lives.

Myth #5: You just have to let acne run its course. The truth is, acne can be cleared up. If the acne products you have tried haven’t worked, consider seeing a dermatologist. With the products available today, there is no reason why someone has to endure acne or get acne scars.

Acne Treatment
Today, virtually every case of acne can be resolved. The key to getting rid of acne lesions and preventing new ones from forming lies in knowing that:

Resolution takes time.
What works for one person may not work for another.
A dermatologist’s help may be required.
Resolution takes time. Treatments that promise “fast,” miraculous” or “overnight” results often capture the attention of acne sufferers hoping for quick resolution. However, the fact remains that acne does not clear overnight. On average, 6 to 8 weeks are needed to see initial results. Once acne significantly improves or clears, continued treatment is needed to keep acne from re-appearing. If acne does not improve in 6 to 8 weeks, treatment may need to be adjusted as not every acne treatment clears every case of acne.

What works for one person may not work for another. What is an appropriate treatment for one person may not clear another’s acne because many factors affect resolution, including the cause(s) of the acne, a person’s skin type and the kind of acne lesions present.

A dermatologist’s help may be required. Causes of Acne
Acne develops when one or more of the following occurs: excess sebum production, rapid production of P. acnes, skin cells shed too quickly and/or release of inflammatory substances. For treatment to work it must interfere with what is causing the acne. Today’s acne treatments do one or more of the following:
Decrease sebum production
Reduce P. acnes (bacteria)
Normalize skin shedding
Eliminate inflammation

With so many factors affecting clearance and a multitude of treatment options available (some only by prescription), a dermatologist’s help can make a difference. Before prescribing treatment, dermatologists consider several factors, including the severity of the acne, types of lesions present, co-existing conditions, as well as the patient’s age, skin type, lifestyle and motivation.

The knowledge gained from considering these factors allows dermatologists to create effective individualized therapy that will resolve the patient’s acne over time and prevent new lesions from forming.

Sometimes a dermatologist may combine two or more treatment options. A patient may be instructed to use one medication in the morning and the other at night. Or, two medications may be combined in one prescription medication. Due to possible side effects, over-the-counter medications should not be combined unless directed by a dermatologist or other medical practitioner.

Acne responds especially well to early treatment. Dermatologists recommend that acne be treated early to maximize effectiveness as well as help prevent scarring.

Reference
Thiboutot, D. “New Treatments and Therapeutic Strategies for Acne.” Archives of Family Medicine 2000: 9:179-187.

More Information
Acne Severity

Treating Mild Acne
Treating Moderate to Moderately Severe Acne
Treating Severe Acne
Acne Therapies

Over-the-Counter Products
Physical Procedures for Treating Acne
Prescription Medications for Treating Acne
Acne Skin Care Guidelines

[zachsan]

you kids and yer high-falutin facts. here's a fact: don't mess with a macho american cowboy.

[daodejing]

Make an appointment to see a licensed medical proffessional. They will prescribe something as appropriate.

Mortal, thank you for agreeing with me, but your tone sounds like disagreement. I wrote that acupuncture won't help but an herbal prescription from a licensed O.M. practitioner will help, so you then felt the need to restate that acupuncture wasn't going to do anything.

Incidentally, are you getting kickbacks from the acutane people?

[Swordless]

Myth #3 surprises me a little, as it always seemed that the more stressed out I was the more acne I had, but maybe it was a psychological thing. I would also recommend Aveeno soap (at any Wal~Mart) for mild Acne (and Backne as well)

[Wushu24]

Yeah, I think elsewhere on the site they do mention stress might cause the release of certain hormones which could aggravate acne, but since there's no proof of it yet, they said stress itself does not cause acne.

[Inevitable]

whoa, thanks alot guys, been to a dermatologist a couple time's and kept giving me a cream but never really worked so i had enough of that. haven't heard about acutane, is that perscription only, or over the counter.
and for the proactive wasn't to sure if it would work or not, and for the price i wasn't looking to forward to buying it and finding out that it doesn't work, but now it seems that i might be buying that knock of from wal-mart and giving it a try.

again thanks alot

[daodejing]

Unless they FDA released it into the OTC market recently, I beleive acutane is prescription only.

[LeiYunFat]

Originally posted by Inevitable
whoa, thanks alot guys, been to a dermatologist a couple time's and kept giving me a cream but never really worked so i had enough of that. haven't heard about acutane, is that perscription only, or over the counter.
and for the proactive wasn't to sure if it would work or not, and for the price i wasn't looking to forward to buying it and finding out that it doesn't work, but now it seems that i might be buying that knock of from wal-mart and giving it a try.

again thanks alot

The knock off is pretty good. I have never bought a Proactive kit, ever. The only reason I use it now is because someone gave it to me. However, I still like to use the Wal*Mart solution, because I like the feel of it's step 2 better than the Proactive's step 2.

And it's no gimmick (the Proactive method), it really worked for me.





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[doc]

There are many myths concerning the formation and treatment of acne. Before we get to those, it's probably best to talk about the anatomy and pathophysiology.

The skin is made up of layers; the outermost layer, the one that you feel, is basically a layer of dead and living epithelial cells. As the skin cells below form and grow, they cause the cells above them to die and flake off. In order to keep the skin from drying out, which would make it more susceptible to infection and disease, glandular structures that open into channels (pores) in the skin, are present. These glandular structures produce an oily substance called sebum. They generally open up into the channels that carry the hair follicles to the surface. Sweat glands also have pores that open up onto the surface of the skin.

Pimples form when the sebum blocks off the pore, either because of over production of the oily substance, or because of blockage, by dirt or collapse, of the pore itself. One the pore gets blocked off, you have a condition whereby there is an enclosed space. Anytime you have an enclosed space in the body that has bacteria naturally living there, presents a problem. The bacteria start breaking down substances around them and secreting enzymes; eventually you get signs and symptoms of an infection (abcess). The infection heals once the enclosed cavity is opened to the surface, thus allowing the infectious material to escape.

Blackheads are blocked pores that are not yet infected; they form when the sebum is being secreted from the pore in a slow fashion. The pore technically is not completely blocked; the sebum is being advanced out of the pore albeit in a slow fashion. The blackish color of the sebum is because of the breakdown of melanin in associated skin cells, and, because of the exposure of air to the sebum. These will eventually subside, either by the plug eventually being expelled from the skin, or, by complete blockage of the pore with resultant underlying infection. Remember, the pores contain, as does the surface of the skin, bacteria (stapylococcal epidermidis and propionibacterium acnes), and once the pore becomes enclosed, you have a set up for infection.

If the pore becomes closed, sebum accumulates in the pore, and forms a whitehead. The technical name for whiteheads is a closed comedome; an open comedome is a blackhead.

A papule is a lesion, either red (inflammatory) or non-inflammatory, that has not yet presented as a whitehead. The clogged sebum has caused a buildup which has not yet presented on the surface of the skin. A nodule is a cystic structure which can attain sizes from two to five cm in diameter. These skin abcesses can easily lead to atrophic depressed (pits) or hypertrophic (keloid) scars.

Now, lets get more technical about the formation of these things.

Androgens are hormones that undergo an increase in secretion during puberty, both in men and women. They are responsible for the secondary sexual characteristics in men (increase facial hair, etc), and for an increase in other sexual characteristics (desire, etc). Androgens cause sebaceous glands to produce larger amounts of sebum. The bacteria (mentioned above) contain substances called lipases, which break the sebum down into its component parts of fatty acids. Sebum and fatty acids irritate the hell out of the pilosebaceous unit (the hair follicle in the pore); a sterile inflammatory response occurs, which leads to an irritation of the nearby skin cells. Skin cells start shedding; this hyperkeratinization leads to plugging of the pore. As the sebaceous glands continue to pour sebum into this obstructed pilosebaceous unit, the fatty acids and sebum continue to accumulate, along with the sterile inflammatory response; clinically, you get a pimple (whitehead comedome). If there is an exit to the surface of the skin for this mass of fatty acids and sebum, you get a blackhead comedome. The black color arises because of the presence of tyrosinase in the pore; it interacts with with tyrosine and oxygen to form melatonin.

If the walls of the pore break, the fatty acids, bacteria, sebum, keratin, etc can rupture into the surrounding lower layer of the skin (dermis), causing an infection, resulting in a papule (red spot), pustule (pimple) or nodule (cystic abcess). Scar formation occurs when rupture of these structures occurs, the extent of which depends upon the nature of the individual, and the extend of the lesion and disease.

Factors that cause an increase in sebum production therefore can cause an increase in acne. Hormonal changes, which lead to changes in androgen levels, emotional changes, stress (which also cause hormonal changes), increasing dirt or bacterial levels on the skin (putting the hands on the face is a large factor), genetic predisposition, race (low incidence in Asians and Negroes), sex (usually more severe in males because of higher androgen levels), medications (steroids, lithium, hydantoin all increase acne) and occupation (exposure to dioxin and mineral oils). Surprisingly, foods don't seem to be a contributing factor, though, it is commonly thought that oily fatty foods (ice cream, pizza) and chocolate can be a cause. Medical studies have shown that foods are not relevent, however, some people do notice an association.

Treatment should consist of topical antibiotics, to diminish the bacterial population of the skin. Prescription therapies that include clindamycin and erythromycin are effective. Over the counter therapies that contain benzoyl peroxide are very effective, if used regularly. Topical retinoids (vitamin A) are also very effective (Tretinoin); these require regular use, and occasionally, time (months) to be effective.

For severe acne, oral antibiotics (Keflex, Tetracycline) are indicated. In non-pregnant females, the use of oral estrogens with progesterone can be used to control acne. Accutane is very effective for severe acne, however, its use is contraindicated in pregnancy.

Personally, I also suggest the avoidance of rich fatty foods. Even though the medical system does not support that, there is enough anecdotal evidence to show otherwise. Washing the face on a regular basis is important; the use of benzoyl peroxide over the counter substances is very helpful. There are some new cleansing products from Clearasil and Johnson & Johnson (Clear and Dry) which, if used regularly (two to four times per day) are very effective. I personally strongly suggest that approach. It cleans the skin, removing excess keratin and oil, while diminishing the bacterial population. Keeping your hands away from your face is key. More severe cases should be treated by a dermatologist. Sometimes dermatologists will use micro bovie devices to burn the comedomes, thus leading to early resolution.

Squeezing pimples is fraught with danger, even though, the expulsiion of the contents from the pore will lead to early resolution. Improper squeezing can cause further infection, such as cystic acne, as the infectious contents are squeezed deeper into the skin. Also, squeezing pimples that live in the center of the face (the famous pimple triangle, which contains the nose and upper lip area), can lead to venous transmission of infectious contents to the brain, with resultant brain abcess (it's rare, but not a good thing to have). Gentle suction is better than squeezing.

Control of stress is also important. Getting out of your teenage years will help too.

[doc]

Just as an aside, I've personally found an advantage to acne.... It was a long time ago.

Back in college, we discovered that when women had pimples, they were, umm, "primed". That was the time to throw a party.

Androgens cause pimples. They also cause "horniness". Now the interesting thing about women, is that when the live together, they start to menstruate together after a while. Their hormones start to go into sync for some unknown reason (not scientific, just observation, LOL). So, when one started to develop her monthly dose of acne (increased androgens, etc, etc), we knew that her friends probably were undergoing this "beneficial" hormonal change too.

Good time to party. Just an aside. Ah, the benefits of a medical education...

[zachsan]

oh you high-falutin doctors and your respect for anectodal evidence.

anyway, doc, the guys who didn't go to medical school solved that particular problem by simply throwing a party every night of the month, so that when the time was right, whenever that may be, it was covered. i like that particular approach. more expensive, yes, but what do you really need that money for? "books"?

[Inevitable]

whoa thats alot of text there doc, but very informative, thanks

[doc]

Hey, there's more to pimples than squeezing them, lol. Just like girlfriends.