Understanding Teen Acne

Are over-the-counter acne products not cutting it? According to the American Academy of Dermatology, virtually anyone’s acne, no matter how severe, can be treated.

Exactly what causes acne? Acne develops when cells and natural oils block tiny hair follicles in the skin. Bacteria work their way into the plugged up follicles and start multiplying. When the body’s immune cells move in to attack the bacteria, the results of the battle are the classic symptoms of acne -- swelling, redness, and pimples. Acne medications help by interrupting this process in different ways. Some over-the-counter and prescription acne creams help by unplugging the follicles. Others, such as antibiotics, kill the bacteria that move into the follicles.

For mild to severe acne, a doctor might recommend prescription treatments that are "topical," which means they go on your skin. Topical treatments for teenage acne come in different forms, including creams, lotions, gels and pads. Some teen girls have acne that’s linked to hormones called androgens. To treat this sort of acne, a doctor might recommend birth control pills or spironolactone.

For best results take the acne treatment as prescribed. It's important to stick to the doctor’s acne treatment. Stop using other acne treatments. If a doctor has prescribed an acne treatment, don't also use other treatments or home remedies. They’re unlikely to help and they could even make the acne worse.

Stick with it. Acne treatment won’t work immediately. It can take six to eight weeks before you see some benefit. It may take as long as six months to clear the skin altogether.
Do your part. Follow the doctor’s skin care advice, particularly when it comes to cleansing and using moisturizer.
Work with a doctor. If treatment isn’t working, don't give up. It may take some time to hit on the right approach. Schedule an appointment with a doctor to discuss other options. Remember: With the right treatment, almost every case of acne can be cured.

http://www.momlogic.com/2008/09/acne_kills_teen_selfesteem.php

WHAT IS ACNE? Part 2

So the clogged pore is the primary event in acne.  Sometimes that is all there is - so retinoids, like Retin-A, Tazorac (the most potent), or differin and extractions are all that is needed.

However, most cases of acne show inflammatory (red) lesions, including some large painful cysts.  These are controlled by application preventively of topical antibiotics, benzoyl peroxide, and particularly effective in females - Aczone.  Additionally, oral medications can be used for one of 3 purposes:

1. Anti-inflammatory effects - doxycycline derivatives (they probably don't yield their benefits by killing bacteria);
2. Blocking testosterone in females - birth control pills or spironolactone; and
3. Preventing inflammatory lesions - Accutane type drugs.

Three pearls of wisdom for acne therapy:

1. Washing does not help acne (sorry Mom) - dirt has nothing to do with it and chemicals in soap are off the face in a minute so they have no time to penetrate;
2. Topical medications can be more effective than pills because they are delivered only to the target (skin and then into blood stream); and
3. You need to apply preventively: all over the place where you expect pimples.

Time, not usually medications, get rid of existing pimples. 80-90 % of patients are doing very well within a month on these regimens.

WHAT IS ACNE? Part 1

A lot is known.  It is due to the interaction between the oil glands in the skin and the male hormone, testosterone.  That is why we don't get it until after puberty: our testosterone is not high enough. 

The problem is, however, not with the testosterone (except in females with polycystic ovaries or those males supplementing) but in the genetic table set in the oil glands - when stimulated by testosterone they produce excessive oils (at least deep in the pores).

These excessive oils are digested by bacteria, corynebacterium acne; the free fatty acid produced from the digestion then irritates the nearby hair follicles yielding an abnormal product, parakeratin, which clogs the pores. Blackheads and whiteheads (grade 1 acne) are composed of parakeratin. Retinoids topically help prevent parakeratin.

More about retinoids, stages 2, 3, and 4 (zits - big & small) and rationales of treatment in ACNE Part 2 - coming soon to a computer screen near you!