WHAT IS ACNE AND WHY DO I HAVE PIMPLES?

The medical term for “pimples” is acne. Most people get at least some acne, especially during their teenage years. Why you get acne is complicated. One common belief is that acne comes from being dirty. This is not true; rather, acne is the result of changes that occur during puberty.

Your skin is made of layers. To keep the skin from getting dry, the skin makes oil in little wells called “sebaceous glands” that are found in the deeper layers of the skin. “Whiteheads” or “blackheads” are clogged sebaceous glands. “Blackheads” are not caused by dirt blocking the pores, but rather by oxidation (a chemical reaction that occurs when the oil reacts with oxygen in the air). People with acne have glands that make more oil and are more easily plugged, causing the glands to swell. Hormones, bacteria (called P. acnes) and your family’s likelihood to have acne (genetic susceptibility) also play a role.

Skin Hygiene
Washing your face is part of taking good care of your skin. Good skin care habits are important and support the medications your doctor prescribes for your acne.

  • Wash your face twice a day, once in the morning and once in the evening (which includes any showers you take).
  • Avoid over-washing/ over-scrubbing your face as this will not improve the acne and may lead to dryness and irritation, which can interfere with your medications.
  • In general, milder soaps and cleansers are better for acne-prone skin. The soaps labeled “for sensitive skin” are milder than those labeled “deodorant soap.”
  • “Acne washes” may contain salicylic acid. Salicylic acid fights oil and bacteria mildly but can be drying and can add to irritation, so hold off using it unless recommended by your doctor. Scrubbing with a washcloth or loofah is also not advised as this can irritate and inflame your acne.
  • If you use makeup or sunscreen make sure that these products are labeled “won’t clog pores” or “won’t cause acne” or “non-comedogenic,” which means it will not cause or worsen acne.
  • Try not to “pop pimples” or pick at your acne, as this can delay healing and may lead to scarring or leave dark spots behind. Picking/popping acne can also cause a serious infection.
  • Wash or change your pillow case 1-2 times per week, especially if you use hair products.
  • If you play sports, try to wash right away when you are done. Also, pay attention to how your sports equipment (shoulder pads, helmet strap, etc.) might rub against your skin and be making your acne worse!

Acne Medications
If you have acne and the over the counter products are not working, you may need a prescription medication to help. Your doctor will tell you if you are one of those people. The good news is that acne treatments work really well when used properly.

WHAT CAN I DO TO HELP THE ACNE GO AWAY?

Some lifestyle changes can be beneficial in helping acne as well. Stress is known to aggravate acne, so try to get enough sleep and daily exercise. It is also important to eat a balanced diet. Some people feel that certain foods (like pizza, soda or chocolate) worsen their acne. While there aren’t many studies available on this question, strict dietary changes are unlikely to be helpful and may be harmful to your health. If you find that a certain food seems to aggravate your acne, you may consider avoiding that food.

HOW SHOULD I USE MY ACNE MEDICATIONS?

Acne is a common condition that may vary in severity. A number of topical and/or oral medications can be used for its treatment. Two to three months of consistent daily treatment is often needed to see maximal effect from a treatment regimen. That is how long it takes the skin layers to shed fully and recycle or “grow out.” Remember that acne medications are supposed to prevent acne, and the goal is maintaining clear skin. Talk to your doctor if you are not using your acne medications as you had originally discussed. Let them know any problems you are having. Common reasons for people to not use their medications include the following:

  • I used the medication prescribed by my doctor before and it did not work then; why should I use it again now?
  • The medication I was prescribed cost too much!
  • I did not like the way the medication felt on my skin. For example, it left my skin too dry or too greasy!
  • The medication was too hard to use!
  • I can’t remember to do it!
  • The medication had side effects that I did not like!
  • The acne plan was too complicated; I need something simpler to do!

TIPS FOR USING YOUR ACNE MEDICATIONS CORRECTLY

  • Apply your medication to clean, dry skin.
  • Apply the medicine to the entire area of your face that gets acne. The medications work by preventing new breakouts. Spot treatment of individual pimples does not do much.
  • Sometimes it is the combination of medicines that helps make the acne go away, not any single medication. Just because one medication may not have worked before does not mean it won’t work when used in combination with another.
  • The medications are not vanishing creams (they are not magic!) – they take weeks to months to work. Be patient and use your medicine on a daily basis or as directed for six weeks before you ask whether your skin looks better. Try not to miss more than one or two days each week.
  • Don’t stop putting on the medicine just because the acne is better. Remember that the acne is better because of the medication, and prevention is the key.

PREGNANCY AND ACNE TREATMENT

If you are pregnant, planning pregnancy or breastfeeding, please discuss with your doctor as your acne medication regimen may need to be altered.

© 2014 The Society for Pediatric Dermatology