Acne: Patient Information
What is acne?
Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s - even into their 40s - can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.
Who gets acne?
Close to 100% of people between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple, regardless of race or ethnicity. Many of these young people are able to manage their acne with over-the-counter (nonprescription) treatments. For some, however, acne is more serious. In fact, by their mid-teens, more than 40% of adolescents have acne severe enough to require some treatment by a physician. In most cases, acne starts between the ages of ten and thirteen and usually lasts for five to ten years. It normally goes away on its own sometime in the early twenties. However, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults.
Acne affects young men and young women about equally, but there are differences. Young men are more likely than young women to have more severe, longer lasting forms of acne. Despite this fact, young men are less likely than young women to visit a dermatologist for their acne. In contrast, young women are more likely to have intermittent acne due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics. These kinds of acne may afflict young women well into adulthood.
Acne also has significant economic impact. Americans spend well over a hundred million dollars a year for nonprescription acne treatments, not even taking into account special soaps and cleansers. But there are also the costs of prescription therapies, visits to physicians and time lost from school or work.
(Adapted from American Academy of Dermatology, AcneNet)
Home Care Recommendations
- Topical medications should be applied to dry skin.
- Try to avoid abrasive soaps, cleansing granules, astringents, and vigorous scrubbing.
- Under normal circumstances, wash no more than two times a day with your fingertips or a soft wash cloth.
- Patients who are treated with acne medications often develop dry skin. Use fragrance- free, non-comedogenic, oil-free moisturizers. These moisturizers will not clog pores and therefore should not cause black- or whiteheads.
- For patients who choose to use makeup to cover their acne lesions, a water-based, non-comedogenic makeup should be used. Avoid oil-based cosmetics. Use makeup sparingly.
- Do not cover acne with bandages or tight fitting clothing.
- If a topical retinoid or photosensitizing antibiotics are prescribed, recommend staying out of the sun as much as possible and stress the use of sunscreens.
Acne Myths and Facts
MYTH: Any acne medication works immediately.
FACT: It can take at least eight weeks of a prescribed treatment regimen for the patient to see any improvement. Acne may even get worse before it gets better.
MYTH: Acne is a result of poor hygiene.
FACT: As a result of this myth, people tend to over wash their skin, often scrubbing hard with abrasive cleansers. Cleaning the skin too often may aggravate acne and cause flare ups. Wash face twice per day with a mild soap; pat dry and use appropriate acne treatment. Acne is not caused by dirt or surface oil.
MYTH: Washing many times a day will diminish acne.
FACT: Under normal circumstances, wash no more than two times a day with mild soap and lukewarm, not very hot or very cold water.
MYTH: Washing with abrasive soaps, cleansing granules, astringents, vigorous scrubbing, or a buff puff will clear up acne on the face.
FACT: Using your fingertips or a soft wash cloth is best.
MYTH: Picking your acne will make it go away.
FACT: This may cause scarring. Do not pick at acne lesions.
MYTH: Once acne has cleared up, it will be gone forever.
FACT: There is no cure for acne. If acne medication is discontinued, acne will probably flare.
MYTH: Stress causes acne.
FACT: Stress alone does not cause acne but may exacerbate psychological reaction to the acne. Acne is caused by overactive oil glands stimulated by androgens mixing with dead skin cells. This is particularly true during the teenage years when androgen production is at its highest.
MYTH: Eating chocolate and sugar will cause acne.
FACT: There is no evidence to support this. Certain foods may make some patients' acne worse and obviously should be avoided. No specific food has been proven to worsen acne. No diet has been shown to be beneficial.
MYTH: Teenagers are the only ones affected by acne.
FACT: Acne affects adults as well as children. The body produces androgens throughout life. The circumstances around adult acne may be a little different than in teens, particularly in women. Women between 18 and 40 years may have breakouts that occur most frequently when they are premenstrual.
(Adapted from National Clearinghouse Guidelines/Acne Management)