Acne: Words to Know
Androgen:
A male sex hormone found in both males and females.
Anti-androgen:
A drug that slows down the production of androgens.
Antibiotic:
A drug that kills bacteria.
Comedo:
A hard plug that develops in the pores of the skin composed of sebum and dead skin cells. The mildest form of acne.
Comedolytic:
Drugs that break up comedos and open clogged pores.
Isotretinoin:
A drug that decreases sebum production and dries up acne pimples.
Sebum:
An oily material produced by sebaceous glands that keeps the skin moist.
Tretinoin:
A drug that increases the rate at which skin cells are formed and die.
CAUSES
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The exact cause of acne is not known, however, several risk factors have been identified.
• Age. Because of the effect of sex hormones, teenagers are quite likely to develop acne.
• Cosmetics. Make-up and hair sprays that contain oils can make acne worse.
• Diet. Acne is not caused by diet, but some foods can make the disease more serious.
• Disease. Hormonal disorders can increase the severity of acne problems in girls.
• Drugs. Acne can develop as a result of using certain drugs, such as tranquilizers, antibiotics, oral contraceptives, and anabolic steroids. Steroids are synthetic hormones that may sometimes be abused by athletes to increase the size of their muscles.
• Environment. Acne can become worse as a result of exposure to oils, greases, and polluted air. Sweating in hot weather can also make the condition worse.
• Gender. Boys are more likely to develop acne and tend to have more serious cases than girls.
• Heredity. Acne is more common in some families than in others.
• Hormonal changes. Acne can flare up during menstruation, pregnancy, and menopause. Menopause is the period in a woman’s life when her body stops producing certain hormones.
• Personal hygiene. Strong soaps, hard scrubbing, and picking at pimples can make acne worse.
• Stress. Emotional stress can contribute to acne.

SYMPTOMS

Acne is often not apparent to an observer. Inflamed pores, however, can cause pain or itching. The most troubling aspect of acne for many people is the scarring that can occur. And, while acne may not be very noticeable, individuals tend to be sensitive about their appearance. Teenagers especially may become concerned about the way other people react to them.

DIAGNOSIS

People with acne are often treated by family doctors. More serious cases are referred to a dermatologist (a specialist in skin disorders) or an endocrinologist (a specialist in hormonal disorders).
Because of its appearance, acne is not difficult to diagnose. A doctor takes a complete medical history, which includes questions about skin, diet, medication use, and other factors associated with risk for acne. He or she conducts a physical examination of the face, upper neck, chest, shoulders, back, and other affected areas. The doctor determines the number and type of blemishes, whether they are inflamed or not, whether they are deep or near the surface of the skin, and whether there is scarring or skin discoloration.
Laboratory tests are not done unless the patient appears to have a hormonal disorder. In that case, blood tests and other tests may be ordered. Most insurance plans cover the cost of diagnosing and treating acne.

ANTI-ACNE DRUGS
Brand Name (Generic Name) and their pssible common side effects:

Accutane (isotretinoin) > Dry skin, dry mouth, conjunctivitis
Benzamycin > Dry and itchy skin
Cleocin T (clindamycin phosphate) Dry skin
Desquam-E (benzoyl peroxide) > Itching, red and peeling skin
Erythromycin topical (A/T/S, erycette, t-stat) > Burning, dry skin, hives, red and peeling skin
Minocin (minocycline hydrochloride) > Headache, hives, diarrhea, peeling skin, vomiting
Retin-A (tretinoin) > Darkening of the skin, blistering, crusted, or puffy skin

Several surgical or medical treatments may be used to reduce acne or the scars caused by the disease.
• Chemical peel. A chemical known as glycolic acid is first applied to the skin. When it dries, it is peeled off, taking the top layer of skin with it. This treatment helps reduce scarring.

• Collagen injection. Shallow scars are filled in by injecting collagen, a skin protein, beneath the scars.
• Comedo extraction. A special tool is used to remove a comedo from a pore.
• Dermabrasion. The affected skin is first frozen with a chemical spray. Then it is removed with a brush or sandpaper-like instrument.

• Intralesional injection. Anti-inflammatory drugs are injected directly into inflamed pimples.
• Punch grafting. Deep scars are removed and the area repaired with small skin grafts.

Alternative treatments for acne focus on proper hygiene and diet. Patients are advised to keep their skin clean and oil-free. They are also encouraged to eat a well-balanced diet high in fiber, zinc, and raw fruits and vegetables. They should also avoid alcohol, dairy products, caffeine, sugar, smoking, processed foods, and foods high in iodine, such as table salt.

Some doctors recommend the use of herbs to supplement the diet. Some herbs that have been used in the treatment of acne include burdock root, red clover, and milk thistle. Additional nutrients that may help to control acne include B-complex vitamins and chromium. Chinese herbal treatments that are recommended include cnidium seed and honeysuckle flower. Another herbal treatment is tea tree oil. The proper dose of these substances can be recommended by physicians or nutritionists.

Acne cannot be cured. However, it can be controlled in about 60 percent of patients with the drug isotretinoin. Improvement usually takes at least two months, and the problem may recur after treatment has been stopped. Inflammatory acne that results in the formation of scars may require one of the more aggressive treatments already described.

PREVENTION

There are no sure ways to prevent acne. However, the following steps tend to reduce flare-ups ofthe condition:
• Gently wash—do not scrub—the affected areas once or twice every day.
• Avoid rough cleansers.
• Use makeup and skin moisturizers that do not produce comedos.
• Shampoo often and wear hair away from the face.
• Eat a well-balanced diet and avoid foods that trigger flare-ups.
• Give dry pimples a limited amount of sun exposure unless otherwise directed by your doctor.
• Do not pick or squeeze pimples.
• Reduce stress.