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What is Acne?

Acne occurs when skin cells build up, plug the opening of a hair follicle (or pore), and cause oil (or sebum) to accumulate in the pore. In some cases, the clogged pore forms a blackhead or whitehead. But when the excess skin cells and oil mix with bacteria, the pore can become inflamed and form a pimple. Acne can occur on the face, chest, back, shoulders, and arms.

Acne can be mild, moderate, and severe. Mild-to-moderate acne includes whiteheads, blackheads, papules, and pustules. Severe acne includes nodules and cysts. In some cases, acne can cause scarring and permanently change the structure of the skin.

Types of Pimples Include:

  • Whiteheads (closed comedones)
    Whiteheads appear white on the surface and result from a completely blocked pore that traps oil, bacteria, and dead skin cells
  • Blackheads (open comedones)
    Blackheads occur when a pore is partially blocked, trapping some oil, bacteria, and dead skin cells. Unlike whiteheads, blackheads slowly drain to the surface of the skin. They appear black when contents of the clogged pore mix with air
  • Papules
    Papules are inflamed, red, tender bumps with no opening to the skin surface
  • Pustules
    The most common pimples, pustules are inflamed, red circles with white or yellow pus-filled centers
  • Nodules
    Painful and sometimes long lasting, nodules are large, hard inflamed areas under the surface of the skin. Nodules can recur and cause scarring
  • Cysts
    Acne cysts are similar to nodules because they are painful and can cause scars. Unlike nodules, cysts are filled with pus

Who Gets Acne?

Many people get acne. For example, acne affects 40 to 50 million people of all ages, genders, and ethnic backgrounds in the United States each year. As many as 75 percent of people aged 11 to 30 years have acne at some time in their lives. It also can occur in people age 40 years and older.

What Causes Acne?

Hormonal changes that increase the production of oil in the skin cause acne. Although hormonal changes are especially pronounced during adolescence, they occur throughout our lives and peak at certain times such as menopause. It is during peak hormonal changes that acne tends to be its worst.

Factors that Aggravate Acne Include:

  • Stress
  • Family history
  • Sun exposure
  • Hormonal changes and hormonal disorders such as polycystic ovary syndrome (PCOS)

Acne Treatment

The good news is that there are effective treatments to help manage and minimize acne!
It is important to get treatment for acne when it first appears. Early treatment can prevent acne from worsening and scarring. Since many factors can cause acne, treatment often involves combination therapy.
To determine which treatment is best for you, your dermatologist will examine your skin carefully, review your medical and family history, ask what prescription and over-the-counter medications and cosmetics you use, and ask about your skin care habits.

Treatment for Acne can Include:

  • Topical medications such as benzoyl peroxide, retinoids, and antibiotics
  • Oral medications such as antibiotics, antiandrogens, and isotretinoin
  • Cortisone injections
  • Chemical peels
  • Laser therapy 
  • Broad-band light therapy
  • Counseling to manage feelings of self consciousness, isolation, and depression associated with acne