Acne is one of the most common dermatologic conditions, affecting millions of individuals in the United States. It's characterized by whiteheads, blackheads and blemishes. In general, acne typically develops in teenagers; however, many adults have some degree of acne as well.
The exact cause of acne is unknown. Hormonal changes during the teenage years, as well as during pregnancy, may be contributing factors. In general, there are two types of acne:
• Noninflammatory acne, characterized by the presence of whiteheads and blackheads.
• Inflammatory acne, characterized by the presence of pimples, which may rupture to form inflammatory lesions that are raised, reddened areas on the skin called "papules."
In the majority of cases, individuals exhibit both types of acne. Acne typically occurs in the facial area, chest and back, where the sebaceous glands are the most prominent. Acne can also occur on other areas of the body as well, such as on the neck and upper arms.
There are a variety of factors that may contribute to or worsen acne. These factors can be classified as environmental, physical or emotional. Examples of these factors include:
• Oil-based cosmetic use.
• Humidity or exposure to dirt.
• Premenstrual changes or hormonal changes.
• Physical irritation from occlusive clothing, headbands, hats, helmets, etc.
• Use of certain medications, such as phenytoin, isoniazid, phenobarbital, lithium, quinine, rifampin and steroids.
There are various preventative measures that may prevent or reduce acne flare-ups. Examples include:
• To prevent the incidence of scarring, never squeeze or pick acne lesions.
• Establish a daily skin-care regimen, which includes cleansing the skin with a soft wash cloth, warm water and an appropriate facial soap at least twice a day.
• Use only oil-free skin and hair care products.
• Avoid scrubbing the skin when cleansing.
• Women should use makeup that is oil-free or labeled "non-comedogenic."
• Always cleanse skin after sweating.
• Wear daily sun protection, since some acne medications may increase the skin's sensitivity to sunlight.
In general, the goals of acne treatment are to prevent or minimize pimples, and to prevent scarring. Early treatment is best to avoid scarring. The treatment selected for acne is dependent upon the type of acne and the severity of the acne.
Your doctor may suggest one of the various topical over-the-counter products available for the management of mild-to-moderate cases of acne. Self-treatment is typically appropriate for mild acne cases, and can be easily managed and controlled by following a daily skin-care regimen and avoiding factors that may worsen acne flare-ups.
Currently, there are a variety of nonprescription skin-care products for the self-treatment of mild-to-moderate cases of acne. These products are available as medicated cleansing bars, liquids, lotions, creams, gels and pads/wipes, and they typically contain at least one of the following ingredients: benzoyl peroxide, salicylic acid, sulfur with or without resorcinol and sulfur with sodium sulfacetamide.
Benzoyl peroxide is considered the most effective and widely used nonprescription medication for both types of acne. Benzoyl peroxide kills Propionibacterium acnes (P acnes), which is the bacteria that causes acne inflammation. This medication helps remove excess oils from the skin, as well as dead skin cells that clog pores. Benzoyl peroxide may cause excessive dryness of the skin, burning and tingling. Caution should be used when applying to areas near the lips, nose and mouth, as well as areas with open scrapes or cuts. In addition, contact of benzoyl peroxide with hair and clothing should be avoided, since it may cause bleaching. You should continue treatment for at least four to six weeks, and seek medical advice if there is no improvement or if acne worsens after that period of time.