Acne is one of the most common dermatologic conditions in the world that affects millions of people. Acne can present in different ways, as bumps, pimples, whiteheads and blackheads (otherwise known as comedones), pustules, or deep cysts. Your acne can range from being mild (few/minimal breakouts or infrequent breakouts) to severe (lots of lesions or frequent breakouts). Depending on your complexion, acne may leave red or brown spots/blemishes when the lesions are resolving. Acne may also lead to acne scars, which are little indentations in the skin where old acne bumps have healed, either “ice pick” (deeper than wide) or “box car” (wider than deep) scars.
Almost every person has acne at some point in their lives. It is most common to see it in teenagers (or even earlier), but many adults suffer with acne too–sometimes even those who did not have acne as teenagers.
There are many factors that cause acne and it’s not the same for everyone. Genetics plays a big role and if your parents had severe acne then it’s likely that you’ll have severe acne. Beyond genetics, other factors that can cause acne are: 1) Hormonal fluctuations, 2) Stress, 3) Skin and hair care products, and 4) Diet.
Hormonal changes during a woman’s menstrual cycle, during puberty and even in peri-menopause and menopause can affect your acne. It doesn’t mean that there is anything wrong per se, but just that your acne is affected by hormones. Of note, women with a condition called Polycystic Ovarian Syndrome (PCOS) often have acne. Similarly, stress, which is associated with another hormone, cortisol, can make one’s acne worse.
Certain cosmetics, and skin and hair products that tend to clog pores may cause new acne or worsen existing acne. Lastly, we’re not completely certain if there are dietary factors that cause acne to flare, but it seems that minimizing foods that are known to cause inflammation in the body (and skin) is helpful in preventing acne. Accordingly, dairy and high glycemic index foods (high carb, high sugar) may make your acne worse.
Acne usually occurs on the face, but it’s not uncommon to see acne on the neck, chest, back, or buttocks. Although not always, sometimes the location of the acne bumps gives us a clue as to factors that can be causing it or making it worse. Acne breakouts on the lower face, chin, and neck tends to be hormonal–especially in adult women. Acne that specifically affects the upper chest, upper back and shoulders can be linked to sports/exercise clothing or equipment–think sports bras and football shoulder pads. Breakouts along the hairline or on the forehead can be linked to hair products or frequently wearing baseball caps, sports helmets, etc.
How do we treat it?
Various ingredients in cleaners can help with blackheads and whiteheads, pustules or oil production. We often use ingredients like benozyl peroxide or sulfur washes for pustules and red bumps. We use cleansers with glycolic and salicylic acid for oily skin and clogged pores.
We use products with a variety of medical grade and prescription ingredients that work on the various components of acne. We make your skincare treatment plan specific to the types of acne lesions you have, the oily/dryness of your skin, and your lifestyle to give you results without significant side effects (dryness, flaking, irritation, burning).
Oral medications (pills) are especially helpful and necessary with cystic acne, hormonal acne, or persistent genetic acne. Options include medications that target the hormonal factors (esp. Birth control pills or Spironolactone), antibiotic-like pills (used in a limited manner), and isotretinoin (generic for accutane). We choose an oral medication based on what we think may be causing your acne, potential side effects/safety, and the length of time you’d need to take the medicine.
Altogether, we choose a treatment regimen that is safe and effective, meets all of your needs for your acne and works with your lifestyle/schedule.
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