ACNE

General Information

DEFINITION--A chronic inflammatory skin condition characterized by skin eruptions on the face, chest and back.

BODY PARTS INVOLVED--Skin.

SEX OR AGE MOST AFFECTED--Adoles-cents (more common in boys). May occur throughout life.

SIGNS & SYMPTOMS

• Blackheads (black spots the size of a pinhead).
• Whiteheads (white spots similar to blackheads).
• Pustules (small pus-filled lesions).
• Cysts (larger and firm swellings) and abscesses (swollen and inflamed areas with pus) with severe acne.
• Redness and inflammation around eruptions.

CAUSES--Oil glands in the skin become plugged for unknown reasons, but sex-hormone changes during adolescence play a role. When oil backs up, it becomes infected by bacteria normally present in glands. Contrary to myth, acne is not caused by dirt or masturbation. Cleanliness can lessen it, but sexual activity has no effect on it.

RISK INCREASES WITH

• Exposure to extremely hot or cold weather.
• Stress.
• Oily skin.
• Endocrine disorders.
• Use of drugs, such as cortisone, male hormones or oral contraceptives.
• Family history of acne.
• Cosmetics (some).

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Surgery (dermabrasion) to remove unsightly scars after acne heals.
• Exposure to ultraviolet light may be a recommended treatment.

POSSIBLE COMPLICATIONS

• Poor self-image and psychological distress.
• Permanent facial scars or pitting of skin.

PROBABLE OUTCOME--Most cases respond well to treatment and the condition tends to disappear after adolescence. Despite good treatment, acne will flare up from time to time.

How To Treat

GENERAL MEASURES--

• If your skin is oily, cleanse it as follows: Gently massage face with soap for 3 to 5 minutes. Don't massage sorest places. Cleanse skin gently--rough scrubbing spreads infection. Rinse soap off for 2 to 3 minutes. After cleansing, use an astringent, such as alcohol, to remove oil. Use a fresh washcloth each day. Bacteria can grow in damp, wet cloths.
• Shampoo hair at least twice a week. Don't let hair hang over the face--even at night. Hair spreads oil and bacteria. Use dandruff shampoo to treat or prevent dandruff. Avoid cream rinses.
• After vigorous exercise, wash sweat and oil off as soon as possible.
• Don't squeeze, scratch, pick or rub the skin; use a comedone extractor. Acne heals better without damage to the skin. If you must squeeze pimples, blackheads or whiteheads, wash your hands first. Cleanse the area with alcohol before and after squeezing.
• Don't rest your face on your hands while reading, studying or watching TV.
• Use water-based cosmetics.

MEDICATION--Your doctor may prescribe:

• Antibiotics to fight infection.
• Cortisone injections into lesions.
• Skin lotions with drying agents.
• Isotretinoin (don't use if pregnant).
• 5% or 10% benzyl peroxide may be helpful. Caution: If you are pregnant, don't take oral medications for acne.

ACTIVITY--No restrictions.

DIET--Foods don't cause acne, but some foods may make it worse. Keep a record of the foods you eat. To discover any food sensitivities, eliminate foods from your diet that you suspect make your acne worse. Then reintroduce them one at a time. If acne flares up 2 or 3 days after a food is eaten, leave it out of your diet. If not, you may eat it. Acne usually improves in the summer, so some foods that cannot be eaten in the winter may be tolerated in the summer.

Call Your Doctor If

• You have acne.
• New, unexplained symptoms develop. Drugs in treatment may produce side effects.