Myths and Truths about Teenage Acne

Acne is one of the most common skin disorders.  It may not be life threatening, but the development of acne can be devastating during adolescence, when it most frequently occurs.

First, check you own knowledge regarding acne with the following quiz:

True or False

1.     Acne is caused by poor hygiene

2.     Using an astringent and scrubbing the face will help clear up blackheads

3.     Acne is worsened by the increased production of the hormones of puberty

4.     Oral antibiotics are the only way to clear severe acne

5.     Makeup can be used to camouflage acne without worsening it

6.     Chocolate causes acne

7.     People with dry, non-oily skin don’t get acne

8.     The first sign of acne may be small, non-inflamed bumps on the skin

9.     Certain jobs or sports can flare acne

10.   Blackheads are caused by dirt stuck in the pores.

For answers…click here

Acne vulgaris is a disorder of the hair follicle and the attached sebaceous gland.  Although the exact cause of acne is not known, we so know that during puberty, there is an increased production of hormones called androgens.  These androgens stimulate the sebaceous glands to produce more sebum (a greasy substance).  In addition, the cells lining the hair follicle may shed more rapidly and stick together and thus block the hair follicle in people with acne.

Blackheads (open comedones) and whiteheads (closed comedones) are the two initial acne lesions.  The black in a blackhead is not dirt but rather dried oil and shed skin cells in the opening of a hair follicle.

Whiteheads, not blackheads, are responsible for most of the problems in acne and are often the first sign of acne in “prepubescent” children.  These usually are small, skin colored, slightly raised bumps just beneath the skin surface.  The openings of these follicles are usually tiny and don’t allow the contents to escape the surface.  Build up of the contents can results in rupture of the follicle leading to the tender red bumps and “pus” bumps seen in more severe acne.

It helps to understand how acne lesions develop so one can attack acne appropriately.  For instance, the main treatment of comedones is to help clear the dead skin cells from the pore linings.  Most dermatologists consider medications containing tretinion (an example is Retin-A) as the treatment of choice for comedones but other medicines such as benzoyl peroxide or salicylic acid containing products may help.  Many over-the- counter acne products have these last two ingredients and are a good place to start for mild acne.

It is important to know that scrubbing the face does not get rid of blackheads and can actually irritate the skin, making the acne worse.  Washing the face with a mild cleanser twice a day or after exercise is sufficient.

You’ll be pleased to know that consumption of certain foods does not cause acne.  Studies have been performed showing that chocolate does not cause it.  On the other hand, jobs such as working over the “French fryer” at a restaurant can worsen or cause it.  In general, a person with acne should read the labels of anything he/she puts on his/her skin.  Creams, lotions, sunscreens and cosmetics can be used but should have “will not cause acne”, “nonacnegenic” or “noncomedogenic” somewhere on the label.  Also, avoid contact with hair products (mousse, gels, spray) on the face.

Other factors can flare acne.  One of the most common causes is stress.  Many students flare at test or exam time.  A less often thought of factor is friction.  The spot where the telephone rubs the cheek or chin or the site where a sports helmet or mask rubs the face may break out more easily.

Acne inflamed red bumps or “pus” bumps may need treatment with additional therapy.  One way to treat this is to decrease the load of proprionibacterium on the skin.  A common, usually harmless skin bacterium, proprionibacterium can get down into the pores and cause increased inflammation in acne.  Benzoyl peroxide has antibacterial properties, but often, oral antibiotics are needed to control more severe cases.

Accutane is a vitamin A derivative taken by mouth that is highly effective against acne.  Unfortunately, it has several potential side effects and thus is often used only for the most severe or treatment- resistant acne.

This is just a short overview of acne and its therapy.  Your primary care physician or dermatologist may be able to help you with more detailed questions and guide you in the treatment of acne.