Acne is a skin condition that causes pimples or "zits." Whiteheads, blackheads, and red, inflamed patches of skin (such as cysts) may develop.
This skin condition is one of the most common disorders there is, with an estimated 80 percent of all people having an outbreak at some point in their lives.
Acne is most common in adolescents and young adults however it can appear at later ages, especially in women.
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.
There is no way to prevent acne and there is no cure. 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 much better today because there are so many more options for treating acne,” said Sarah Taylor, MD, dermatologist with Wake Forest Baptist. “While over-the-counter 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.”
Although non-prescription acne medications aren’t necessarily all that new, improved or much different from each other, they can be effective on mild acne.
“Over-the-counter products can work in many cases,” said William Huang, MD, dermatologist. “But no matter what the TV ads may say, they take time, usually 6 to 8 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.”
When to See a Dermatologist
The National Institutes of Health recommends contacting a skin specialist if:
- Non-prescription measures don’t help after a couple of months
- The acne is bad (with, for example, a lot of redness around pimples, or the appearance of cysts), getting worse or spreading
- Scars develop as the lesions clear up
Dermatologists generally don’t treat many patients with mild acne, because those problems can be cleared up by proper use of consumer products and 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 over-the-counter products or prescriptions from the regular doctor.”
Dermatologists have 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 medication – which are frequently “coupled” in a single lotion, gel or other delivery substance – in combination with oral antibiotics to address multiple causes and effects of acne.
“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.”
As with many types of treatments, consistency is the key to treating acne. Our dermatologists work with patients to find methods of ensuring they follow instructions and use acne medications properly and consistently.