Acne is the most common skin condition in the United States. Acne is caused by a combination of bacteria, hormones, and clogged pores. Acne appears on the face, but it can appear on the back, chest, neck, shoulders, upper arms and buttocks. Acne can cause more than blemishes. Studies show that people who have acne can have low self-esteem, depression, dark spots on the skin, and scars. At Dermatology Associates of Wisconsin, we are experts in acne skin care treatment.
A person who has acne can have any of these blemishes: blackheads, whiteheads, papules, pustules (what many people call pimples), cysts, and nodules. Most people who suffer from acne are teenagers or young adults, but acne can occur at any age. Newborn babies can get acne. Men and women get acne. Some women get acne when they reach middle age.
Acne appears when a pore in the skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (oil that keeps our skin from drying out), the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore. Sometimes bacteria that live on our skin also get inside the clogged pore. Inside the pore, the bacteria have a perfect environment for multiplying very quickly. With many bacteria inside, the pore becomes inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule appears.
Treatment Options (not limited to):
Action: Benzoyl Peroxide helps open up clogged pores and helps kill bacteria in the pores.
+Topical Retinoids (Retin A, Differin)
Use: Gels and creams should be applied to the entire face (usually in the morning) to help treat existing acne and help prevent future acne. Benzoyl Peroxide washes should be lathered up and left on for about 10 seconds.
Side Effects: Benzoyl Peroxide can cause mild facial irritation (redness or stinging). This can usually be corrected by using a mild moisturizer (Lubriderm, Neutrogena) one or two times per day. If moisturizers do not help, use the medication every other day for 3 weeks and then move back up to every day. This usually corrects the problem. Benzoyl Peroxide can bleach washcloths, shower curtains, and pillow cases, so be sure to wash it off your hands after using.
Action: Retinoids prevent skin cells from sticking to one another so that pores don't get clogged. It helps to treat existing acne, but more importantly, helps to prevent future acne formation.
Use: Wash your face with a mild soap (CeraVe, Cetaphil, Neutrogena), and dry thoroughly. Apply retinoid to your entire face (usually at bedtime). Do not apply any other creams to your face (especially benzoyl peroxide or other acne medications/washes) because they can inactivate the retinoids.
Side Effects: Retinoids can cause mild facial irritation (redness or stinging). This can usually be corrected by using a mild moisturizer (CeraVe, Cetaphil, Lubriderm, Neutrogena,) one or two times per day. If moisturizers do not help, use the medication every other day for 3 weeks and then move back up to every day. This usually corrects the problem. Sun exposure can increase the facial irritation in some patients. Using an SPF 15 sunscreen on the face and moisturizers should prevent any problems in sensitive individuals.
Action: Antibiotics kill the bacteria that cause red pimples (inflammatory papules) and deep, blind pimples (acne cysts). Topical antibiotics work for superficial acne. However, if you have deeper acne, oral antibiotics are usually required.
Use: Topical antibiotics are applied to the entire face 1 or 2 times per day as directed. They can be applied after Benzoyl Peroxide. Antibiotic pills are usually taken 2 times a day (before breakfast and before bed). Tetracycline must be taken on an empty stomach or it will not be absorbed. Other antibiotics work better if you take them on an empty stomach, but can be taken with food if necessary.
Side Effects: Rarely people get mild dryness or irritation, usually no side effects
Tetracycline: Can cause upset stomach in about 10% of patients. It makes you a little more sensitive to the sun. If you are going to be out in the sun for longer than 20 minutes, sunscreen SPF 30 or greater should be applied. In women, it can increase the frequency of yeast infections. Theoretically, may make birth control pills less effective.
Minocycline: Can cause lightheadedness in a small number of people. Long term use can lead to some of the medicine being deposited in the skin. This shows up as small blue spots in the mouth, on the face, and in scars. It almost always goes away when you stop the medicine. In women, it can increase the frequency of yeast infections. It, theoretically, may make birth control pills less effective. Rarely, people may develop "lupus-like" symptoms with muscle and joint aches and fatigue.
Doxycycline: The old Doxycycline and generic Doxycycline are absorbed in the stomach and have a high incidence of sun sensitivity. The new Doxycyline (Doryx – brand) is a pellet that by-passes the stomach and is only absorbed in the small intestine. This has almost completely eliminated the sun-sensitivity side effect. Some people get a little light headed. It, theoretically, may make birth control pills less effective. It does not get deposited in the skin or give the rare "lupus-like" symptoms that could potentially be seen with Minocycline. It is generally taken one time per day. It is not known if it is as effective as Minocycline however.
Erythromycin: Can cause upset stomach in about 25% of patients. If this happens, try taking it with food or taking an antacid (Tums, Rolaids) when the symptoms develop. In women, it can increase the frequency of yeast infections. It, theoretically, may make birth control pills less effective.
Accutane can potentially "cure" acne, but is a very expensive therapy. There are some significant side effects that must be endured. Accutane is a teratogen, which means that it can cause birth defects if you become pregnant while taking the medication or within 4 weeks of stopping the medication. Therefore females of childbearing potential must be on birth control during therapy. Lab tests are drawn on a monthly basis during therapy to monitor for potential serious side effects. Monthly appointments are required by law to obtain a prescription for Accutane. Average length of therapy is 5 months.
+Blue Light Therapy
If you are a woman and you become pregnant, stop all of your acne medicine immediately and contact your dermatologist.
If you have any questions or problems with your acne medication, please feel free to contact your dermatologist.
Blue light acne treatment uses light without drugs or antibiotics, to treat hard to control acne, including acne vulgaris. The blue light kills the acnes bacterium that grows inside clogged pores that swell up and form pimples on the skin.