What is Acne?
Acne or acne vulgaris is a very common skin disease for people of all ages from babies to older adults. Acne is characterized by areas
on the skin with blemishes such as blackheads, whiteheads, papules, pustules, pimples and nodules. Causes of acne include hormonal activity,
genetics, bacteria and increased stress. Several types of acne treatments are available depending on the type and severity of ones acne and their
medical history including topical and oral acne medication.
Symptoms of acne can range from small to large areas on the skin with blemishes such as blackheads, whiteheads, papules, pustules, pimples
and nodules. These areas may become pink or reddish in color and become raised known as pimples or pustules. Raised red spots may become
infected and form a white center called a whitehead. Blackheads are formed when the surface is exposed causing the center to darken.
Lumps underneath the skin that can be red and sensitive to the touch are called cysts. Acne appears on the face, but it
can appear on the back, chest, neck, shoulders, upper arms and buttocks.
Causes of Acne
Acne causes can include hormonal activity,
genetics, bacteria and
increased stress. Acne occurs when a hair follicle or pore gets plugged with
a combination of oil called sebum and dead skin cells. An overproduction of oil, unbalanced shedding of dead skin and buildup of bacteria can all
be factors of clogged pores. These plugged pores allow bacteria to thrive. Normal riddance of dead skin cells occurs and the body sheds the cells
from the pores. The sebaceous glands in the hair follicle secrete the oil, sebum, that naturally travels up along the hair shaft and out of the hair
follicle opening to lubricate the hair and skin. Overproduction of either sebum or dead skin cells can cause clogged pores that turn into acne.
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.
Who gets Acne?
As a common skin disease, over 40 million people in the United States have acne. Anyone at any any age can get acne. The majority of people who suffer
from acne are teenagers or young adults. Newborn babies can get acne as well. Acne rosacea is another form of acne that middle aged adults can get.
Acne Treatment Options (not limited to): +Acne Extraction
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, it 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 acne bacterium that grows inside clogged pores that swell up and form pimples on the skin.