Acne

Overview and Facts about Acne

Acne is the most common skin condition seen by dermatologists, affecting approximately 50 million Americans annually. It is characterized by blemishes on the skin, including blackheads, whiteheads, papules, pustules (commonly called pimples), cysts and nodules.

Although acne typically strikes during puberty and affects many adolescents and young adults, it can also affect adults in their 30s and 40s. Acne can appear on the face, back, chest, upper arms and buttocks.

Signs and Symptoms of Acne

Signs of acne depend on the type of blemish. Acne may appear as:

• Acne cysts, which are pus-filled and often painful lesions beneath the skin's surface
• Blackheads, which appear as dark, black dots on the skin
• Nodules, which are large, solid acne lesions that arise deep in the skin; they do not contain pus
• Papules, which are small, red bumps that do not have pus
• Pustules, which are small bumps that contain pus
• Whiteheads, which appear as round, white bumps on the skin

Causes and Risk Factors of Acne

The main cause of acne is pores clogged with bacteria, dead skin cells, excess oil or sebum. Normally, as new skin cells form, older, dead skin cells shed naturally. When these cells do not fully shed from the pores and become trapped with oil, acne forms.

Cystic acne and nodules are caused when the bacteria living on the skin get inside a clogged pore. Once there, the bacteria can multiply quickly, resulting in the pore becoming inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule forms.

Hormonal changes experienced by teens and women can trigger excess oil production leading to clogged pores and acne. Hereditary factors may also play a role.

Tests and Diagnosis of Acne

A primary care doctor can diagnose acne by simply looking at the skin. Depending on the severity of the acne — grade 1 (mild) to grade 4 (severe) — a dermatologist may be recommended. This is a specialist in skin care that can help properly control acne to avoid scarring or damage to the skin.

Treatment and Care of Acne

Mild acne can be treated with over-the-counter products containing such ingredients as benzoyl peroxide and salicylic acid.

Moderate to severe acne is treated with prescription medication topically applied to the skin. The type of topical treatment depends on the type of acne and its severity. Some topical treatments help to reduce oil, while others help kill bacteria.

Oral medication may be prescribed to treat severe, red, swollen types of acne, such as cysts and nodules.

Medications include antibiotics, which helps to kill bacteria, and oral contraception, which treats acne caused by hormonal changes in women.

In some cases, in-office procedures may also be used to treat acne, including:

• Chemical peels to treat blackheads and papules
• Drainage and extraction to remove large acne cysts that are unresponsive to medicine, which eases the pain associated with this type of acne
• Laser and other light therapies to reduce bacteria