Acne: Causes, Self-Care Steps and When to Be Seen

What it involves

MedlinePlus describes acne as a skin condition that causes pimples, with whiteheads, blackheads, and red, inflamed bumps or patches that can become cysts. It starts when pores clog with a mix of oil and skin cells and, if bacteria get trapped, the immune system reacts. It is most common in teenagers, but anyone can get it, and it tends to run in families.

Who this is for

• Patients whose acne has not cleared after several months of over-the-counter care
• Patients with deep, painful, or cystic breakouts or with scarring
• Adults with new acne, including breakouts tied to hormones or a new medicine
• Patients whose acne is affecting their mood or confidence

What to expect

• Questions about when it started, what you have tried, and your medicines and skin products
• A look at your face, chest, and back to see the type and pattern of breakouts
• A plain plan that starts with daily skin care and adds treatment only as needed
• Follow-up to see how the plan is working, since results take weeks

What can set acne off

MedlinePlus lists several triggers, and one of them often surprises people:

• Hormonal changes tied to puberty, menstrual periods, pregnancy, birth control pills, or stress
• Greasy or oily cosmetics and hair products
• Certain medicines, including steroids, testosterone, estrogen, and phenytoin
• Heavy sweating and humidity
• Touching, resting on, or rubbing the skin too often

Food and acne

MedlinePlus says research does not show that chocolate, nuts, or greasy foods cause acne. It adds that diets high in refined sugars or dairy may be related to acne in some people, but calls that connection controversial. So there is no single food to cut that will clear the skin, which is a point worth discussing instead of guessing.

Self-care that comes first

MedlinePlus advises washing gently once or twice a day, and after exercise, with a mild nondrying soap, and looking for water-based or noncomedogenic cosmetics. It says to avoid scrubbing, to shampoo oily hair daily, and to keep hair off the face. Squeezing, picking, or rubbing pimples can lead to infection, slower healing, and scarring. If those steps are not enough, it suggests over-the-counter products with benzoyl peroxide, sulfur, adapalene, or salicylic acid, applied sparingly.

What a provider can add

MedlinePlus says that if pimples are still a problem, a provider can prescribe stronger options. Those include antibiotics taken by mouth or applied to the skin, vitamin A derivatives such as tretinoin, prescription-strength benzoyl peroxide or azelaic acid, and, for women whose acne is hormone related, spironolactone or birth control pills in some cases. The skin overview in the skin conditions guide explains how rashes and bumps are sorted at a visit.

Treatments done by specialists

MedlinePlus also names procedures such as photodynamic therapy, chemical peels, dermabrasion for scars, and draining or injecting cysts with cortisone, and mentions isotretinoin for cystic acne with scarring, which requires close monitoring and regular blood tests. None of these is a service this practice lists, so they would be handled through a dermatology referral if your provider thinks they fit.

How long it takes and when to ask for help

MedlinePlus says acne often responds well to treatment but that results can take 6 to 8 weeks, and flares come and go. It advises contacting a provider if self-care and over-the-counter medicine have not helped after several months, if acne is very bad with cysts, if it is getting worse, if scars develop as it clears, or if it is causing emotional stress. Untreated severe acne can scar.

Sources

• MedlinePlus — Acne
• MedlinePlus — Acne health topic