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Home , Acne, Skin condition

PATIENT EDUCATION SERIES

What is acne? Can I prevent acne from washing my face Acne is the most common disorder occurring more often? during the second and third decades of life. It No. Dirt does not cause acne. It is the overproduc- is an inflammatory brought on by tion of oil (sebum) from within the skin rather than overactive sebaceous (oil glands). It usu- the surface oil/dirt that leads to acne. ally involves the face, and frequently the chest and back. At the oil glands in the skin begin What is the best way to clean my skin? producing an oily material called sebum. Sebum Wash your face twice daily with mild soap and is discharged onto the skin surface through pores. water. Don’t be too rough while washing and avoid With acne the oil glands become plugged causing , blackheads, whiteheads, and . astringents and abrasives as they can cause skin • A , or pustule, is formed when the follicle irritation and in general don’t help improve acne. wall breaks open allowing sebum and bacteria More frequent washing usually just causes more to spill into the tissue. This results in redness, drying, without improving acne. swelling, and . • A “blackhead” or open comedone is a plug of se- Additional ways: bum mixed with dead cells and bacteria. When • If you tend to have oily or you this material is exposed to the air it oxidizes might benefit from a dandruff shampoo. Most and turns dark. are good. T-gel and Sebulex are two sugges- • A “whitehead” or closed comedone is plug of tions. sebum and bacteria that has become enclosed • Also avoid face creams or oils. within a cellular sac. • If you wear make-up use dry powder or hypoal- • A is sebum, bacteria, and pus encapsulated lergenic, water-base make-up. within a thickened cell wall. • Avoid oil-based hair tonics.

What causes acne? Does stress cause acne? It is a result of overactive oil glands. Acne may be Though stress effects are difficult to quantify, some aggravated, but not caused by: feel there is a correlation, thus a healthy approach • Certain foods to life may help limit acne. This includes a good • Improper diet, adequate sleep, exercise and relaxation. • Stress • Hormonal changes occurring with the Does sun exposure improve acne? • Some medicines (e.g., some pills, Yes, moderate sun exposure is beneficial but a sun- cortisone, dilantin) burn will do more harm than good. Use of a sun- • Rarely, acne may be a symptom of an underlying screen with at least SPF 15 is recommended. Cau- medical disorder. tion* Some acne treatments ( and topical preparations) cause your skin to be hypersensitive Will I outgrow my acne? to the sun. Consult your medical provider. Often acne is worst during and begins to subside during your twenties. But for some peo- Will squeezing or picking pimples ple, acne remains throughout adulthood although cause ? often in milder form. Yes, squeezing a pimple may cause the contents of the follicle to rupture into the tissue rather than Does diet affect my complexion? being expressed to the surface of the skin. This can Foods do not cause acne, but for some individu- cause tissue damage and scarring. als certain foods may aggravate the condition. A simple test to determine which, if any, foods affect you is to eliminate one food for a few weeks. If your Sometimes a medical provider will open a pimple acne improves while off this food it is best to avoid or cyst with a special instrument designed not to it in the future. damage the tissue, but you should avoid squeezing or picking pimples. (continued...)

BROWN UNIVERSITY HEALTH SERVICES | www.brown.edu/health | 401.863-3953 What is the best treatment for acne? Hormonal treatment? There are many different ways to treat acne. Women using birth control pills often find that it What’s best for you may not work for your friend helps their acne. Your medical provider will make and vice versa. Treatment should be based on the suggestions regarding specific pill choices. Less individual condition. Although there is no cure common hormonal imbalances can be a worsening for acne there are treatments which can control it factor for some women also. Some dermatologists well. If you have been unsuccessful in your attempt use anti-androgenic medicine to treat acne such as to control your acne, it is time to seek professional . advice. Depending on the severity and type of acne you may be prescribed a medicine to be applied What is ? topically, taken orally, or both. (The original brand, Accutane, is no longer made • Topical (e.g. RETIN-A, Differin) are but there are several equivalent brands available.) effective for treating comedones (blackheads) It is only used when conventional treatments, (topi- but have limited benefit for inflammatory -le cals and oral antibiotics) have been ineffective. It sions such as pustules or cysts. causes extreme lip-drying, frequent nosebleeds, and • Topical antimicrobials (e.g. ) many other possible side effects. Pregnancy must help to reduce skin bacteria. These can provide be avoided, as it causes severe birth defects. Accu- good results for an individual with mild inflam- tane treatment is very expensive and also requires matory acne (pustules/pimples) but can be monthly blood tests and visits with the dermatolo- irritating to the skin. gist during the usual 20-week course of use. • therapy is generally reserved for in- dividuals with moderate to severe acne. Topical 4/13 antibiotics (e.g. Cleocin-T, Benzamycin) are of- ten helpful for mild cases of acne. Oral antibiot- ics (, ) have been used for years with good results and few side effects.

What are the side effects of antibiotics? • Topical treatments may cause skin irrita- tion, but generally are well tolerated. Topical (Cleocin-T) has caused rare cases of diarrhea and colitis. Tetracyclines and erythro- mycin are the most common ones used. • Gastrointestinal upset may occur with any antibiotic. • Photosensitivity is a side effect with tetracy- clines. Limit your sun exposure and wear sun- screen and protective clothing. Some individu- als with mild to moderate acne find they can decrease or go without antibiotic treatment in the summer. Consult your medical provider. • Some women experience yeast vaginitis while on antibiotics. If vaginal itching or discharge develops consult your provider. • There are other less common side effects. If you have any question or concerns don’t hesitate to ask your medical provider.

BROWN UNIVERSITY HEALTH SERVICES | www.brown.edu/health | 401.863-3953