Sixteen-year old Sushma was worried about attending the get together party over the weekend. She was trying to think of excuses to stay at home. Sushma was avoiding meeting people for sometime now and the reason behind it was acne. Acne made her feel unattractive to the opposite sex, and all she ever thought was how to get rid of them. Acne or pimples as it is commonly called, is the most common irritating problem that most of the teenagers all over the world face. It is reported that around 17 million people in the United States have acne.
The skin has sebaceous glands or oil glands that produce sebum or oil that keeps the skin and hair lubricated. These sebaceous glands are located in close proximity to the hair follicles generally. The sebum or oil can mix with the dead skin cells and plug the hair follicles. Bacteria then acts on the plugged hair follicles producing acne which is seen more during the teenage years as sebum secretion is more during that period.
Acne is seen in areas where there are large number of sebaceous glands like the face, neck, chest, shoulders and back. The many forms of acne include comedones, papules, nodules, pustules, and cysts. Acne can occur as comedones which are also known as blackheads and white heads. When dead skin cells and oil at the surface of the skin plug the hair follicles, they turn black because of contact with air and form blackheads. When the comedones are closed and are skin colored they are known as white heads. When the hair follicles become infected and swell up with pain and appear red in color, they are known as papules. If white pus is present at the tip of a red painful bump then it is called as a pustule.
When oily secretions build up in the hair follicles, soli, painful lumps develop which are known as nodules. Cystic acne can also occur which are pus filled infectious boils that can cause scarring on the face.
Hormonal changes in the body can aggravate acne. These hormonal changes are seen in people in their teenage years, two to seven days before periods in females, due to use of medications like cortisone and during pregnancy period.
Other risk factors of getting acne include a family history of acne; problems with immune system; cosmetics applied to skin; exposure of skin to oily substances; friction caused on skin due to backpacks, tight collars, cell phones or helmet wear.
There is no best treatment of acne. The treatment of acne is aimed at reducing swelling, fighting the bacterial infection, increasing the new skin generation, and reducing the production of oil from the sebaceous glands.
Topical acne lotions containing ingredients like sulfur, resorcinol, salicyclic acid, benzoyl peroxide are applied on to mild acne. These lotions help in fighting bacterial infection, shedding of dead skin cells and drying up of the oil. The application of these lotions can have side effects like dryness, flaking and skin irritation which go away after a therapy of one month. If these lotions do not work stronger topical applications are recommended that include adapalene (Differin),Tretinoin ( Avita,Renova, Retin A); Tazarotene (Avage, Tazorac); combination of benzoyl peroxide and Clindamycin (Duac, Benzaclin, Acanya); combination of erythromycin and Benzoyl peroxide (Benzamycin).
To reduce side effects like redness, peeling and burning sensation of the skin one should apply the lotions for a short period and then wash it away. The dosage of lotion should be gradually increased.
To reduce severe case of acne, oral antibiotics are prescribed which have to gradually taper as symptoms reduce as they cause antibiotic resistance to bacteria. Side effects of taking oral antibiotics includes skin sensitivity to sun; discoloration of skin; stomach upset; dizziness and reduces the oral contraceptive action.
For cystic acne that cause scarring antibiotics are not enough. A drug known as isotretinoin (accutane) is prescribed. This drug needs careful monitoring by the dermatologist as it has side effects like nose bleeds, dry eyes, mouth, nose, lips and skin accompanied by itching; sensitivity of skin to sunlight; birth defects in child if taken during pregnancy; increase in level of cholesterol and even a risk of the patient going into depression and committing suicide.
The other various acne treatments available include taking oral contraceptives in women ; light and laser therapy; peeling of acne with chemicals; filling acne scars with collagen or fat; Dermabrasion which involves removing skin’s top layer with rotating brush;
Microdermabrasion which involves blowing crystals onto the affected surface and skin surgery which involves cutting off the acne scars surgically. Acne scars may disappear gradually, but in some, interventions may be needed for acne scar removal.
One can prevent acne or reduce the acne outbreaks by following certain self-care measures.
Teenagers should not keep worrying about acne all the time and get self conscious. They should realize that it is a natural stage of growing up and every teenager in the world has faced it at one time or the other. By taking good self-care measures and taking the appropriate treatment in time one can keep acne away.