Causes of Acne

Acne is primarily a reaction to hormone changes during puberty. In general, acne is not caused by foods, although eating a healthy diet is good for your skin and can help your acne. It is not caused by dirt or poor hygiene. Some medications may cause acne or make it worse, such as oral or topical corticosteroids.

Symptoms of Acne

The types of skin lesions seen in acne include:

• Comedones, also known as “whiteheads” and “blackheads”
• Inflamed papules
• Pustules
• Inflamed nodules and cysts, which may be painful

Acne may cause scarring when severe.

Treatment of Acne

The most important step in treating acne is good skin care.

• Do not pick or squeeze the pimples.
• Try not to touch your face. Do not lean your face on your hands.
• Do not use hair grease or other greasy products near your face.
• Some acne medicines may make your skin more sensitive to the sun, so don’t forget to use sunscreen.

Tight caps and hats may also make your acne worse.

Most acne can be treated with topical (skin) medicines, although sometimes you may need oral (by mouth) medicines. Severe acne may not respond to typical treatments. You may need to get a special medicine from your dermatologist in this case.

It usually takes six to eight weeks before you will see a change in your skin. If you do not use your medications correctly, your acne will not get better. Follow-up visits are very important.

During these visits the doctor will:

• See how the medications are working
• Check to see if you are having any side effects from the medications

Not every patient’s acne will get better with the same medicine. Your doctor may need to adjust the medicine several times, and you may need to use more than one medication. You may still have occasional breakouts even while taking your medicine; this is normal.

When to Call Your Doctor

Call your doctor if you have any of the following while using your acne medicine:

• Irritation
• Redness
• Peeling

For those taking oral medicines, such as tetracycline, minocycline or doxycycline, call your doctor if you have any of the following:

• Severe headaches
• Abdominal pain
• Rash
• Joint pain
• Nausea / vomiting
• Trouble breathing
• Vision problems

Referral to a Specialist

Most patients with acne can be treated by their primary care provider as long as the treatment plan is followed and the patient is seen for follow-up as recommended. Referral to a dermatologist is needed only when a patient has:

• Severe acne and is at risk of scarring
• Tried several topical or oral (by mouth) medications for at least several months with no improvement in the acne

Special Instructions for Acne

• Wash your face twice a day with a gentle facial cleanser. Products like Dove, Cetaphil, Purpose, Aveeno and Neutrogena work well. If you need to use a face cream or moisturizer, use one made for the face such as Cetaphil, Eucerin or Neutrogena and preferably one that contains an SPF sunscreen. If you wear make-up or cosmetics, choose ones that are labeled “non-comedogenic” or “won’t cause acne."
• Do not use “buff puffs,” scrubbing sponges, wash cloths, astringents, alcohol or scrub-type cleansers on your skin. Use only your hands to wash your face. Be gentle; do not rub. Pat your face dry with a towel.
• For topical (skin) medicines such as tretinoin and benzoyl peroxide:
• Apply topical medication 30 minutes after washing your face to prevent stinging.
• If the doctor has prescribed one medication to be used in the morning and a different medicine to be used in the evening, it is important that you follow these directions exactly.
• If your skin is burning or irritated, stop treatment and call your doctor for advice.
• You may need to occasionally skip using your medication for a day if your skin starts to get irritated.
• Products that contain benzoyl peroxide may bleach or stain towels and clothing. Apply carefully after getting dressed and wash hands thoroughly after applying.
• Oral (by mouth) medicines such as tetracycline, doxycycline or minocycline may be prescribed.
• Take these medicines exactly as instructed.
• Do not skip doses.
• Take these medicines with a full glass of water and do not lie down for 30 minutes afterward.
• Call your doctor if you develop severe headaches, persistent blurry vision, severe abdominal pain, a new rash or severe joint pains.