Acne

Acne Basics

Acne is believed to be the most common skin condition in the country. Many people grow up hearing that pimples are the result of eating too much chocolate, touching your face, or some other cause. In reality, acne is a complex condition with a variety of contributing factors. The four main factors that contribute to this condition are excess oil production, oil or dead skin cells that block hair follicles, bacteria, and inflammation. Breakouts can develop at any age but they are especially common during puberty when sebaceous glands activate.

All of the factors, however, lead to the same result: plugged follicles, which fill with bacteria and specialized cells sent in to fight that bacteria. Your skin is covered with these follicles, which are small pockets that open to the surface via a tiny opening known as a pore. They are connected to oil glands. As long as the pore remains clear, materials—such as oil and naturally occurring bacteria on the skin—can pass freely out of the follicle.

However, when oil mixes with dead skin cells, the resulting substance can “gum up” pores, closing off the follicle and trapping bacteria inside.

Bacteria eat natural oils—called “sebum”—and multiply in the follicle, prompting an immune response that involves white blood cells attacking the bacteria. With no way out, the bacteria and white blood cells gradually fill the available space, then start to bulge out on the surface. This is what creates the telltale bump of a pimple or pustule.

There are several things that are known to trigger or worsen the condition, including hormonal changes, greasy or oily substances, certain types of medications (such as drugs containing corticosteroids), emotional stress, consuming certain foods, friction and pressure on the skin, and menstruation. If is believed that if you have a family history of this condition, you may have a higher risk of developing it. Complications such as pitted skin, thick scars, and other skin changes such as hyperpigmentation may occur because of the condition.

Types of Acne

There are many ways acne can develop, ranging in severity from tiny and barely noticeable spots to large and painful lesions. Breakouts can develop anywhere on the face and body, but they are most common on the forehead, chest, shoulders, and back because oil glands are most abundant on these areas.

Whiteheads and Blackheads

Some clogged pores trap oil and dead cells in a follicle, but don’t catch bacteria or lead to inflammation. If such a filled follicle is closed off from the surrounding air, the material inside appears light in color, resulting in what is known as a whitehead. If the pore is open to the air, a chemical reaction causes the substance in the follicle to darken. This is known as a blackhead.

Papules and Pimples

Trapped oil, skin cells, bacteria, and white blood cells that cause visible bumps on the surface are the next stage “up” in terms of severity. Red bumps are called papules, and they can appear just about anywhere on the face, as well as parts of the body, such as the chest, back, and buttocks. Pimples are bumps with a light-colored center, indicating that the material inside the follicle is visible.

Nodules and Cysts

If a follicle ruptures, the mix of bacteria, oil, and cells can leak out into the surrounding tissue, causing a larger lesion beneath the surface. Nodules are hard, inflamed pockets of material than can be painful to the touch and cause large, red bumps to appear on the skin. Cysts are similarly deep types of acne, but are softer and filled with pus. Both of these severe types can cause scarring and require professional dermatological help.

What Treatments Are Available for Acne?

The best “treatment” for acne is prevention. At Dermatology Group of Arkansas, we educate patients on ways to reduce the risk of future breakouts. Regular, gentle cleaning is ideal for removing excess oil and dead skin cells so there’s less material on the face to potentially close off follicles.

The first step for treating acne will usually be to create a good, consistent skincare routine. Patients may also then try to identify their triggers. Some patients, however, develop acne problems even despite consistent at-home regimens designed to keep skin clean and clear. For anyone struggling with pimples and worse, there are options.

Treatments are uniquely tailored to each individual, and the most suitable option depends on the type of lesion. Less invasive treatments will usually be effective for superficial acne lesions, while more involved treatments that penetrate deeply into the skin layers may be required for severe forms of this condition.

Many patients respond well to prescription medications such as antibiotics and retinoids, like Retin-A ^® and Differin^® . For severe acne, Accutane^® , a vitamin A derivative that has been used by millions of people, is quite effective when taken consistently for five to seven months.

At Dermatology Group of Arkansas, we can also use the Forever Clear^® device to target acne with three different types of light: blue broadband light to kill p. acnes bacteria deep in the pores, yellow broadband light to reduce inflammation and redness, and infrared light to heal the skin. The three-step treatment is ideal for addressing ongoing outbreaks and reducing future chances of pimples from forming.

For some patients, chemical peels may help to reduce acne problems by opening pores and generally keeping the surface of the skin free of dead cells and excess oil.

It is important to not try to pop or pick at acne-related bumps—known as comedones—at home. Squeezing a blocked follicle can rupture the walls and lead to increased inflammation and a more severe problem. In some cases, as with nodular lesions, there is not even material that can come out when the bump is pressed. Dermatologists are specially trained in resolving acne issues as effectively as possible with minimal signs of damage.

Who is a Good Candidate for Acne Treatments?

If you have persistent and pronounced acne that hasn’t responded to other treatment methods, you may be a good candidate for professional acne treatments.