Acne

Acne is the most common skin problem that young people have. Almost everyone will develop acne to some degree, but some people have more pimples than others. Acne is not a skin problem that is treated quickly and then never comes back again. It requires time, patience, and consistent use of any medications you are given.

What Causes Acne?

The exact cause of acne is unknown. It is usually the result of several factors combined:

• Heredity may have a lot to do with whether or not you have acne.
• The increase in hormones during puberty seems to be a major factor. These hormones can cause oil glands to become more active.
• Acne is not caused by eating fried foods or chocolate.

What Is a Pimple?

Picture 1 - Pores inside your skin.

A pimple starts when a pore (an opening in the skin) gets plugged up. The pore has a tiny hair in it and oil glands at its base (Picture 1). During adolescence the skin cells lining the pores are shed quickly. The cells and oil stick together to form sebum, which plugs the pore. If the pore is open, the result is a blackhead. If the pore is closed, a whitehead is formed.

The whitehead is the beginning of a pimple. It forms when the sebum escapes from the pore wall and gets under the skin. The body tries to clean out the sebum and brings in the white blood cells to do the work. The result is a pimple. When the sebum gets deeper under the skin, a cyst can form. A cyst is a deep and uncomfortable swelling of the skin.

Unless they are squeezed, blackheads do not usually cause pimples. Blackheads are not black from dirt, but from certain skin pigments (coloring) in the cells of the pores.

What Makes Acne Worse?

• If you scrub with an abrasive soap, pick at your skin or rub it too much, the walls of the pores may break and cause more pimples. Squeezing or popping blackheads and whiteheads usually causes more problems, including scarring. Too much washing (more than 2 or 3 times a day), astringents or alcohol can make your skin too dry and cause the oil glands to work harder.
• Usually, foods like chocolate, sweets, colas, and fried foods do not make acne worse. If one food does seem to make your acne worse, do not eat it for a few weeks to see if that helps.
• Some types of makeup, sun block and moisturizing lotions may block pores. Only use products that are “oil-free” or “non-comedogenic”.
• Do not use greasy products like Vaseline, cocoa butter, baby oil, or baby lotion on your skin.

Treatment for Acne

There are many different medicines used to treat acne.

Medicated creams or gels that are put on the skin are used often. The doctor will tell you when to apply the medication. Generally a thin layer of the medicine is spread to all areas where the acne can be. For many patients the medications can be used for areas of acne on the back and chest as well as the face. Sometimes the medicines can make your skin red and dry, especially at first.

How to Use the Lotions or Gels

• First, wash your skin with your hands using the soap recommended by your doctor.
• Rinse with water. Dry your face gently with a clean towel.
• Apply a thin film of medicine and rub it in gently.
• Keep the medicine away from your eyes and the corners of your mouth.

It often takes 1 to 2 months before you can see real improvement in your acne. At first your skin may actually seem worse. Be patient. Don't give up!

The doctor may also prescribe an antibiotic for you to take by mouth. Be sure to read the special instructions and warnings on the medicine's label. Let your doctor know if you are taking any other medicines including birth control pills, antihistamines, asthma medicines and vitamins. Also, let your doctor know if you may be pregnant or are planning a pregnancy.

Other Tips and Advice

Picture 2 - Wash your face gently 2 times a day.

• Try to be positive and not get discouraged. With proper treatment you can get your acne under control. Be patient. It doesn't happen overnight.
• Pay special attention to hygiene. Wash your face gently 2 times a day with a mild soap or a wash that is recommended by your doctor (Picture 2). Do not use soaps that contain creams or perfumes. Do not use cleansing grains or abrasive pads.
• Shampoo your hair regularly (3 to 5 times a week). Style it away from your face and forehead. Do not use a lot of mousse, gel or hairsprays near your hairline.
• Never squeeze pimples. Squeezing may produce scar tissue.
• Follow your doctor's instructions carefully.
• It is important to keep your follow-up appointments. There are many medications available and your medicines may need to be adjusted or changed if you are not seeing improvement.
• Tell your doctor if your skin becomes very dry or irritated or if the medicine doesn’t seem to be helping.

If you have any questions, be sure to ask your doctor or nurse, or call your doctor’s office.

Acne (PDF)

HH-I-48 11/85, Revised 9/11 Copyright 1985-2011, Nationwide Children's Hospital