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Acne is a common skin condition that affects most teenagers to some extent. However, this disease is not restricted to any age group; adults in their 20s-- even into their 40s-- can develop acne. While acne usually clears up after several years even if it goes untreated, you need not wait to outgrow it. Untreated acne can leave lifelong scars that can affect your self-image.

Acne consists of blackheads, whiteheads, pimples, and sometimes, deeper boil-like lesions called nodules. It's most common on the face, but can also occur on the back, chest, shoulders and neck. While acne is not a fife threatening condition, it can be upsetting and disfiguring. When acne is severe, it can lead to serious and permanent scarring. Even less severe cases can be followed by scarring.

How Acne Forms

Research on the causes of acne links it to the changes that take place as young people mature from childhood to adolescence (puberty). Rising hormone levels during puberty cause the sebaceous (oil) glands of the skin to get bigger. This growth occurs in areas where acne is most common (the face, upper back, and chest). It is activated by male-type hormones found in both males and females.

The sebaceous glands make an oily substance called sebum which reaches the surface by emptying through the opening of the follicle on to the skin surface. The glands are connected to a hair-containing canal called a follicle. The oil's material seems to stimulate the lining of the wall of the follicle. The cells shed more rapidly and stick together, plugging the openings of the skin surface. Also, the mixture of oil and cells helps bacteria in the follicles grow. These bacteria produce chemicals that can cause the wall of the follicle to break. When the wall is broken, sebum, bacteria and shed skin cells escape. This is the process by which pimples and large bumps are formed.


Acne is not a disease caused by dirt. The blackness of a blackhead is not dirt, but is due mostly to dried oil and shed skin cells in the openings of the hair follicles. For the normal care of your skin, you should wash your face with soap and warm water twice a day. It's important not to wash too often as this may actually aggravate your acne. Regular shampooing is also recommended. If your hair is oily, you may want to wash it more often. Your dermatologist will advise you on the best face and hair washing routine.

Men with acne who shave should try both an electric and a safety razor to see which is more comfortable. If you use a safety razor, soften your beard thoroughly with soap and warm water. To avoid nicking pimples, shave as lightly as possible. Shave only when necessary and always use a sharp blade.


Acne is not primarily caused by the foods you eat. Dermatologists have differing opinions on the importance of diets in the management of acne. One thing is certain, following a strict diet will not by itself clear your skin. On the other hand, a few people find that their acne seems to become worse when they eat certain foods. If that's the case, foods that clearly worsen your acne should be avoided.


Acne may improve after you've been out in the sun. Sunlight only helps temporarily. In the long run, sunlight may actually worsen acne. Too much sun over many years could cause premature aging of the skin and skin cancer.


Treatment of acne is an ongoing process if it is to be controlled successfully. The therapy your dermatologist will recommend will vary according to your type of acne. Your dermatologist must find out first if your skin condition is routine acne. Occasionally, an acne-like rash can be due to another cause -- such as makeup or lotions you've used or oral medication. It's important to help your dermatologist by providing him or her with a history of what you are using on your skin and taking internally.

Many non-prescription acne lotions and creams can help milder cases of acne. However, many of them will make your skin dry if used too often. If you use these products, follow the manufacturer's instructions carefully. When buying makeup, make sure it's "noncomedogenic" or "non-acnegenic".

Noncomedogenic means that using the cosmetic should not result in the formation of whiteheads and blackheads. Cosmetics should be removed every night with soap and water.

Your dermatologist may prescribe topical preparations (creams or lotions) to help unblock the pores and reduce the bacteria. These may produce some drying and peeling. Your dermatologist will advise you on the correct use and how to handle any side effects.

Your physician may open pimples or remove blackheads and whiteheads Don't pick, scratch, pop or squeeze your pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation and scarring may result.

Antibiotics taken by mouth are often prescribed for moderate or severe cases, especially when there is a lot of acne on the back or chest. The antibiotics are used to reduce the bacteria in the follicle. There are also antibiotic preparations that can be applied to the skin. These are used in less severe cases of acne. When large red bumps are present, the dermatologist may inject a medication directly into the bumps.

In cases of severe acne, other drugs may be used orally. These may include female-type hormones and other medications that decrease the male-type hormones. Another oral medication, isotretinoin (Accutane), is sometimes used to treat severe acne that has not responded to other methods of treatment. Patients using Accutane must thoroughly understand the side effects of the drug. Frequent follow-up visits with the dermatologist are necessary to monitor its side effects. Prevention of pregnancy is a must, since the drug can cause severe birth defects if taken during pregnancy.

Proper care is necessary

No matter what special treatments your physician may use, remember that you must continue proper skin care until the tendency to have acne has passed. There is no instant or permanent cure for acne, but it is controllable and proper treatment may prevent permanent scars.
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Publication:Pamphlet by: American Academy of Allergy and Immunology
Article Type:Pamphlet
Date:Mar 1, 1993
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