Common Skin Disorders | Acne | Bed Sores | Calluses and Corns | Dry Skin | Keratosis Pilaris | Pityriasis Rosea | Psoriasis | Rosacea | Sebaceous Cysts
Sebaceous glands are located in the dermis (the middle layer of skin) and secrete oil for the skin.
What is acne?
Acne is a chronic disorder of the hair follicles and sebaceous glands. Acne causes clogged pores which leads to pimple outbreaks, cysts, infected abscesses (areas of pus), and, sometimes, scarring.
Acne is very common -- nearly 17 million people in the US are affected by this condition. Acne most often begins in puberty. During puberty, the male sex hormones, called androgens, increase in both boys and girls, causing the sebaceous glands to become more active and, thereby, increasing the production of oil.
How does acne develop?
The sebaceous glands produce oil (also called sebum) which normally travels via hair follicles to the skin surface. However, dried oil, dead skin cells, and bacteria can cover the hair follicles, blocking the oil coming from the sebaceous glands. When follicles become plugged, skin bacteria (called Propionibacterium acnes, or P. acnes) begin to grow inside the follicles, causing inflammation. Acne progresses in the following manner:
Eventually, the plugged follicle bursts, spilling oil, skin cells, and the bacteria onto the skin surface. In turn, the skin becomes irritated and pimples or lesions begin to develop. The basic acne lesion is called a comedo or comedone.
Acne can be superficial (pimples without abscesses) or deep (when the inflamed pimples push down into the skin, causing pus-filled cysts that rupture and result in larger abscesses).
What are the different types of acne?
| acne vulgaris | most common type of acne; usually begins during puberty |
| chemical acne | caused by exposure to certain chemicals and oils |
| chloracne | caused by exposure to chlorinated hydrocarbon chemicals |
| tropical acne | caused by hot and humid conditions; often occurring in young Caucasians who are unaccustomed to these conditions |
What causes acne?
Rising hormone levels during puberty can cause acne. In addition, sometimes acne runs in families. Other causes of acne may include:
Acne can be aggravated by squeezing the pimples or by scrubbing the skin too hard.
Research has shown that chocolate or greasy food do not cause acne, nor does dirty skin cause acne.
What are the symptoms of acne?
Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands:
The following are the most common symptoms of acne. However, each person may experience symptoms differently:
The symptoms of acne may resemble other dermatologic conditions. Consult a physician for diagnosis.
Treatment of acne:
The goal of acne treatment is to minimize scarring and relieve symptoms. Specific treatment will be determined by your physician based on:
Treatment may include drug therapy to treat acne. Depending upon the severity of acne, topical medications (medications applied directly to the skin) or systemic medications (medications taken orally) may be prescribed by a physician. In some cases, physicians may recommend a combination of both topical medications and systemic medications.
Topical medications to treat acne:
Sometimes prescription topical medications are prescribed to treat acne. Topical medication can be in the form of a cream, gel, lotion, or other solution for the skin. Examples include:
| Benzoyl Peroxide | kills the bacteria (P.acnes) and reduces oil production |
| Antibiotics | helps stop or slow down the growth of P. acnes and reduces inflammation |
| Tretinoin | stops the development of new acne lesions (comedones) and encourages cell turnover, unplugging pimples |
| Adapalene | decreases comedone formation |
| Azelaic acid | helps stop or slow down the growth of P. acnes and reduces inflammation |
Systemic medications to treat acne:
Systemic medications are often prescribed to treat moderate to severe acne. Oral antibiotics used to treat acne may include:
Treatment for severe, cystic, or inflammatory acne:
Isotretinoin, an oral drug, may be prescribed for patients with severe, cystic, or inflammatory acne to prevent extensive scarring. Isotretinoin reduces the size of the sebaceous glands that produce the skin oil, reduces skin cell shedding, and affects the hair follicles, thereby reducing the development of acne lesions. Isotretinoin can clear up acne in 90 percent of patients.
However, the drug may have some side effects. It is very important to discuss this medication with your physician.
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