Acne Can’t Be Prevented or Cured, But It Can Be Treated Effectively
Acne just won’t go
The skin condition characterized
by unsightly blemishes remains one of the most common disorders there is, with
an estimated 80 percent of all people having outbreaks at some point in their
lives. Acne doesn’t discriminate by gender or race, and although it’s most
common in adolescents and young adults, it can appear at later ages, especially
in women. There’s no way to prevent acne, there’s no cure and today’s over-the-counter
remedies contain the same basic ingredients as those on drugstore shelves decades
And acne won’t just
go away: Not treating it can actually make things worse.
But acne can be treated
effectively. Recent advances in medications and approaches to care have significantly
reduced the effect acne once had on both skin and self-esteem.
“Things are so much
better today because there are so many more options for treating acne,” said
Sarah Taylor, MD, a dermatologist with Wake Forest Baptist Health. “While OTC
products are pretty much the same as they have been for years – just different
concentrations of benzoyl peroxide and salicylic acid in various forms such as
cleansers, gels and creams – the prescription world has really changed in the
past 10 years or so. We’re much better equipped to deal with all different
types of acne.”
Acne occurs when the
skin’s pores become clogged. Each pore opens to a hair follicle containing a
gland that produces oil called sebum, which helps keep skin soft. These
follicle-gland units are largest and most numerous on the face, upper back and
chest. When the glands produce too much oil, the pores can become blocked. As a
result, dirt, bacteria and dead skin cells can build up in the pores, forming
the whiteheads, blackheads, pimples and other lesions that are commonly
referred to as zits.
What triggers this
process isn’t clear. Hormonal changes are associated with the excess production
of oil – thus partially accounting for acne flare-ups in teens and pregnant
women – and heredity can be a factor, but research has shown that acne is not
caused by dirty skin or by eating chocolate, pizza or greasy foods.
non-prescription acne medications aren’t necessarily all that new, improved or much
different from each other, they can be effective on mild acne.
can work in many cases,” said William Huang, MD, another Wake Forest Baptist
dermatologist. “But no matter what the TV ads may say, they take time, usually
six to eight weeks. You’re not going to have that overnight, ‘here today, gone
tomorrow’ phenomenon. That can be frustrating, especially for teenagers. Acne
can cause them a lot of stress and affect their emotional well-being, so they
want something that works right away, but we don’t have anything like that.”
generally don’t treat many patients with mild acne, because those problems can
be cleared up by the proper use of consumer products or measures prescribed by
a pediatrician or family doctor. Rather, Taylor said, “We tend to see people
whose acne is out of control and has not been helped by OTC products or
prescriptions from the regular doctor.”
Institutes of Health recommends contacting a skin specialist if:
measures don’t help after a couple of months.
acne is bad (with, for example, a lot of redness around pimples, or the
appearance of cysts), getting worse or spreading.
develop as the lesions clear up.
the expertise and ability to prescribe stronger medications required to deal
with more severe cases.
Among the most widely
successful strategies they employ is prescribing different topical medications –
which are frequently “coupled” in a single lotion, gel or other delivery substance
– in combination with oral antibiotics to address multiple causes and effects
“Just like with any
condition, there isn’t a magic bullet,” Huang cautioned. “The treatment depends
on the severity of the acne, the type of acne, where it’s located, and the
patient’s individual preference and motivation for treatment. But these multilayered
approaches that are tailored to the individual patient do work well.”
Dermatologists today also
have advanced ways to treat scarring, including chemical peels,
microdermabrasion and laser technologies. And they’re generally more cognizant
of the psychological damage that acne can inflict.
“Whether it’s because
of personal experience or familiarity with studies that have been done on the
subject, I’d say dermatologists as a whole are much more sensitive to the psycho-social
aspects of acne than in the past,” Huang said. “For me personally, it’s
something I can relate to.”
“Some teenagers are very
confident and self-assured even if their face looks terrible, so they’re easy
to deal with,” Taylor said. “But then there are kids who become very depressed
and withdrawn and may isolate themselves. With them I try to be hopeful and optimistic,
upbeat and positive, to tell them that I know it’s hard having this condition
and to show some sympathy. Or empathy, really, because I had acne, too, when I
was a teen.”
No matter how
understanding dermatologists are, they – like other clinicians – face the
problem of getting patients to follow their instructions.
definitely highest right before and right after doctor visits,” Huang said. “But
it falls off over time, and that can really hinder the effectiveness of any treatment.”
To combat this,
dermatologists are turning to new devices. Research studies, some conducted at
Wake Forest Baptist, have found that tools such as Web-based surveys, email
reminders and encouraging text messages can help increase teenage patients’ proper
use of acne medications.
“Consistency is the whole key to
treating acne,” Taylor said. “So anything that can promote that has to be a