All about ACNE

Source: Times of India

Acne. Zits. Pimples. Blemishes. No matter what you call them, acne can be distressing and annoyingly persistent. Acne lesions heal slowly, and when one begins to resolve, others seem to crop up.

Hormones likely play a role in the development of acne, making the condition most common in teenagers. But people of all ages can get acne. Some adult women experience acne due to hormonal changes associated with pregnancy, their menstrual cycles, or starting or stopping birth control pills.

Depending on its severity, acne can cause emotional distress and lead to scarring of the skin. The good news is that effective treatments are available — and the earlier treatment is started, the lower your risk of lasting physical and emotional damage.

Symptoms

Acne typically appears on your face, neck, chest, back and shoulders, which are the areas of your skin with the largest number of functional oil glands. Acne can take the following forms:

·         Comedones (whiteheads and blackheads) are created when the openings of hair follicles become clogged and blocked with oil secretions, dead skin cells and sometimes bacteria. When comedones (kom-uh-DOE-neze) are open at the skin surface, they're called blackheads because of the dark appearance of the plugs in the hair follicles. When comedones are closed, they're called whiteheads — slightly raised, skin-colored bumps.

·         Papules are small raised bumps that signal inflammation or infection in the hair follicles. Papules may be red and tender.

·         Pustules are red, tender bumps with white pus at their tips.

·         Nodules are large, solid, painful lumps beneath the surface of the skin. They're formed by the buildup of secretions deep within hair follicles.

·         Cysts are painful, pus-filled lumps beneath the surface of the skin. These boil-like infections can cause scars.

When to see a doctor
Acne usually isn't a serious medical condition. But you may want to seek medical treatment from a dermatologist for persistent pimples or inflamed cysts to avoid scarring or other damage to your skin. If acne and the scars it may have left are affecting your social relationships or self-esteem, you may also want to ask a dermatologist if your acne can be controlled or if your scars can be diminished.

Causes

Three factors contribute to the formation of acne:

·         Overproduction of oil (sebum)

·         Irregular shedding of dead skin cells resulting in irritation of the hair follicles of your skin

·         Buildup of bacteria

Acne occurs when the hair follicles become plugged with oil and dead skin cells. Each follicle is connected to sebaceous glands. These glands secrete an oily substance known as sebum to lubricate your hair and skin. Sebum normally travels up along the hair shafts and then out through the opening of the hair follicle onto the surface of your skin. When your body produces an excess amount of sebum and dead skin cells, the two can build up in the hair follicle and form together as a soft plug.

This plug may cause the follicle wall to bulge and produce a whitehead. Or, the plug may be open to the surface and may darken, causing a blackhead. Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected. Blockages and inflammation that develop deep inside hair follicles produce lumps beneath the surface of your skin called cysts. Other pores in your skin, which are the openings of the sweat glands onto your skin, aren't normally involved in acne.

It's not known what causes the increased production of sebum that leads to acne. But a number of factors — including hormones, bacteria, certain medications and heredity — play a role.

Contrary to what some people think, greasy foods and chocolate have little effect on acne. Studies are ongoing to determine whether other dietary factors — including high-starch foods, such as bread, bagels and chips, which increase blood sugar — may play a role in acne.

Acne isn't caused by dirt. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse. Simple cleansing of the skin to remove excess oil and dead skin cells is all that's required.

Risk Factors

Hormonal changes in your body can provoke or aggravate acne. Such changes are common in:

·         Teenagers, both in boys and girls

·         Women and girls, two to seven days before their periods

·         Pregnant women

·         People using certain medications, including cortisone

Other risk factors include:

·         Direct skin exposure to greasy or oily substances, or to certain cosmetics applied directly to the skin

·         A family history of acne — if your parents had acne, you're likely to develop it too

·         Friction or pressure on your skin caused by various items, such as telephones or cell phones, helmets, tight collars and backpacks

Preparing for an appointment

If you have acne that's not responding to home and over-the-counter treatments, make an appointment with your doctor. Early, effective treatment of acne reduces the risk of scarring and of lasting damage to your self-esteem. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of skin conditions (dermatologist).

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

·         Write down your key medical information, such as other conditions with which you've been diagnosed and any prescription or over-the-counter medications you're taking, including vitamins and supplements.

·         Write down key personal information, including any major stresses or recent life changes.

·         Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Below are some basic questions to ask your doctor about acne. If any additional questions occur to you during your visit, don't hesitate to ask.

·         What treatment approach do you recommend for me?

·         If the first treatment doesn't work, what will you recommend next?

·         What are the possible side effects of the medications you're prescribing?

·         How long can I safely use the medications you're prescribing?

·         How soon after beginning treatment should my symptoms start to improve?

·         When will you see me again to evaluate whether my treatment is working?

·         Is it safe to stop my medications if they don't seem to be working?

·         Are there any self-care steps I can take to improve my symptoms?

·         Do you recommend any changes to my diet?

·         Do you recommend any changes to the over-the-counter products I'm using on my skin, including soaps, lotions and cosmetics?

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

·         When did you first develop acne?

·         Does anything in particular seem to trigger an acne flare, such as stress or — in girls and women — your menstrual cycle?

·         What medications are you currently taking, including over-the-counter and prescription drugs as well as vitamins and supplements?

·         Are you sexually active, and if so, do you use birth control?

·         In girls and women: Do you have regular menstrual periods?

·         In girls and women: Are you pregnant, or do you plan to become pregnant soon?

·         What types of soaps, lotions, hair products or cosmetics do you use?

·         How is acne affecting your self-esteem and your confidence in social situations?

·         Do you have a family history of acne?

·         What treatments have you tried so far? Have any been effective?

Lifestyle and home remedies

You can avoid or control most acne with good basic skin care and the following self-care techniques:

·         Wash problem areas with a gentle cleanser. Products such as facial scrubs, astringents and masks generally aren't recommended because they tend to irritate skin, which can worsen acne. Excessive washing and scrubbing also can irritate skin. If you tend to develop acne around your hairline, shampoo your hair frequently.

·         Try over-the-counter acne lotion to dry excess oil and promote peeling. Look for products containing benzoyl peroxide or salicylic acid as the active ingredient.

·         Avoid irritants. You may want to avoid oily or greasy cosmetics, sunscreens, hairstyling products or acne concealers. Use products labeled "water-based" or "noncomedogenic." For some people, the sun worsens acne. Additionally, some acne medications can make you more susceptible to the sun's rays. Check with your doctor to see if your medication is one of these, and if so, stay out of the sun as much as possible and anytime you have to be in the sun, use sunscreen that doesn't clog your pores.

·         Watch what touches your face. Keep your hair clean and off your face. Also avoid resting your hands or objects, such as telephone receivers, on your face. Tight clothing or hats also can pose a problem, especially if you'll be sweating. Sweat, dirt and oils can contribute to acne.

·         Don't pick or squeeze blemishes. Picking or squeezing can cause infection or scarring. If you need aggressive treatment, see your doctor or dermatologist.

Alternative Medicine

Research suggests that over-the-counter (OTC) gels containing 5 percent tea tree oil may be an effective treatment option for mild to moderate acne. Tea tree oil may take longer to work than do OTC products with benzoyl peroxide as the active ingredient, and may cause mild skin irritation in some people.

Other studies suggest that taking the following supplements may help treat acne:

·         Zinc

·         Guggul

·         Brewer's yeast

More research is needed to understand the potential role of these and other dietary supplements in the treatment of acne.

Always talk with your doctor before trying a natural remedy. Dietary supplements can cause side effects and may alter the safety and effectiveness of certain medications.

Prevention

Once your acne improves or clears, you may need to continue your acne medication or other treatment to prevent new acne breakouts. In some cases, you might need to use a topical medication on acne-prone areas, continue taking oral contraceptives or attend ongoing light therapy sessions to keep your skin clear. Talk to your doctor about how you can prevent new eruptions.

You can also prevent new acne breakouts with self-care measures, such as washing your skin with a gentle cleanser and avoiding touching or picking at the problem areas. Other acne-prevention tips include:

·         Wash acne-prone areas only twice a day. Washing removes excess oil and dead skin cells. But too much washing can irritate the skin. Wash areas with a gentle cleanser and use oil-free, water-based skin care products.

·         Use an over-the-counter acne cream or gel to help dry excess oil. Look for products containing benzoyl peroxide or salicylic acid as the active ingredient.

·         Avoid heavy foundation makeup. Choose powder cosmetics over cream products because they're less irritating.

·         Remove makeup before going to bed. Going to sleep with cosmetics on your skin can clog tiny openings of the hair follicles (pores). Also, be sure to throw out old makeup and clean your cosmetic brushes and applicators regularly with soapy water.

·         Wear loosefitting clothing. Tightfitting clothing traps heat and moisture and can irritate your skin. Also, whenever possible, avoid tightfitting straps, backpacks, helmets or sports equipment to prevent friction against your skin.

·         Shower after exercising or doing strenuous work. Oil and sweat on your skin can trap dirt and bacteria.