Acne is a disorder of the skin’s oil glands that results in blocked pores and outbreaks of lesions called pimples. Nearly 17 million people in the United States suffer from this condition. Although acne is not a serious health problem, severe acne can lead to disfiguring permanent scarring. Approximately 85 percent of adolescents and young adults between the ages of 12 and 24 develop the disorder. People of all races can have acne, but it is more common among Caucasians.

Several factors can contribute to the cause of acne or make it worse. Changing hormone levels in girls and women may induce a flare-up in their acne two to seven days before their menstrual period starts. Also, hormone changes related to pregnancy or starting or stopping birth control pills can also cause acne.

Cosmetics can cause acne, as can drugs like lithium and barbiturates. Even helmets and backpacks, which create friction by leaning or rubbing on the skin, can influence acne formation. Squeezing or picking at blemishes and hard scrubbing of the skin can make the condition worse.

Acne is divided into types, and treatment is based on the specific type of acne:

• Mild acne. Improvement is seen with topical Vitamin A, topical antibiotics and benzoyl peroxide gels.
• Moderate acne. Oral antibiotics are added to the above regime. Inflammatory acne may need a combination of several therapies.
• Severe acne. In addition to the topical treatments outlined above, systemic treatment with Accutane is indicated for cystic acne that is refractory to treatments.

Skin care for patients with acne includes:
Gentle cleansing or scrubbing will not improve acne; in fact, it can make it worse. It is generally recommended to use a mild cleanser in the morning and at bedtime. Skin should also be washed after heavy exercise. Rough scrubs or pads should not be used.
Avoid handling of the skin. If you squeeze, pinch, or pick at blemishes the risk of developing scars increases.

Shaving should be done with a sharp blade and with the grain.

Avoid sunburn. The sun can seriously damage the skin and many of the medications used to treat acne make you more prone to sunburn.

Cosmetics need to be oil free, meaning without lanolin and myristate. Hairstyling products that come in contact with the skin along the hairline can cause acne lesions. To avoid this problem, wipe your skin with an astringent afterwards. Products that are labeled as non-comedogenic should be used, but in some people even these products may cause acne.

In the future, we may see the development of new topical antibiotics to replace some of those in current use. As with many types of bacterial infections, we are finding over time the bacteria that causes acne are becoming resistant to treatments with certain antibiotics. A different type or stronger antibiotic is needed to kill disease-causing bacteria once they become resistant to the existing antibiotics.

More information can be found on the following web site: American Academy of Dermatology. www.aad.org.