Say Goodbye to Acne

Did you have pimples in secondary school? Do you still have pimples in adult life? This curse was supposed to disappear along with CXC and A’ Levels when we hit adulthood but according U.S. statistics there has been a 20% increase in adult acne over the last two decades.

What is Acne? Acne is one of the most common skin diseases. It is not contagious but occurs most usually in the early teens and sometimes continues into the twenties and beyond.

Almost everyone will suffer from some form of acne during their lives. Most people get acne during the teenage years when they experience massive changes in their body due to hormone production at puberty. It is usually as common in women as in men and usually occurs in the face, neck, back, chest and shoulders.

It is caused by a combination of factors:

  1. Genetics: If your parents had acne you will probably have it too.
  2. Hormones: An increase in hormone activity causes increased sebum (oil) production which leads to plugged pores.
  3. Blockages in the hair follicles and pores: Overproduction of cells in the hair follicle may lead to the pore to become blocked. Sebum (oil) which normally flows to the skin’s surface gets blocked. This mixture of oil and cells allows the bacteria that normally live on the skin to grow in the plugged follicle.
  4. Bacteria – the P. acne bacteria is the main culprit leading to blocked pores becoming inflamed and becoming acne lesions.

“There is a wide spectrum of acne sufferers from those who have just papules (small, pink bumps), which Trini’s refer to as “heats” to large cysts (deep, painful pus filled lesions) experienced by persons who have cystic acne” says Port of Spain dermatologist Dr. Marilyn Suite.

Some Common Acne Myths

Myth #1: Acne is caused by diet

Reality Check:

Prevailing wisdom in the dermatology community is that diet and acne are not related. Of course science is never a 100% reliable enterprise. But at this time, there is no evidence that chocolate, sugar, oil, milk, seafood, or any other food causes acne. Some people absolutely insist that a certain food causes acne for them, or that a specific acne diet works for them. In this case, doctors sometimes recommend that they avoid that food or follow that diet. Regarding chocolate specifically, several studies have been performed, and the answer to “does chocolate cause pimples?” is a resounding “No”.

Myth #2:  Washing your Face More Often will Clear Up Acne

Reality Check:

Facial blemishes are not caused by dirt. Contrary to what you may have seen in commercials, pores do not get blocked from the top down. Rather, an entire pore collapses from deep within the skin, starting acne formation. Frequent washing does nothing to prevent this.

Over-washing is actually irritating, and excess irritation can worsen acne. A washcloth can aggravate this situation further. Dr. Suite says “there are vagrants out there with good skin and they are certainly not over washing!”

Myth #3: Masturbation or Sex Causes Acne

Reality Check: This antiquated notion started in the early 17th century to dissuade young people from having pre-marital sex and is just plain wrong.

Myth #4: You will Grow Out of It

Reality Check: You do not always outgrow acne. Teenagers are often told that it is a part of growing up and that you will outgrow it. This is not always the case. The approach should be to treat it and prevent permanent scarring to your skin.

The Best Anti Pimple Program for You

Finding your ideal regimen, of course depends on what kind of pimples you get and how often.

If you get occasional pimples:

Consider the Pill. “Oral contraceptives help to regulate the hormonal upsurges that can cause breakouts,” says Dr. Suite.  But don’t expect overnight miracles – it can take as long as three months to see a difference in your skin.

Use skin-clearing products. If birth control pills aren’t enough or you don’t want to use them try over the counter acne products with benzoyl peroxide, salicylic acid or sulfur.

Benzoyl Peroxide: destroys the P.acne bacteria and helps to reduce oil production.

Salicylic Acid: helps breakdown whiteheads and blackheads.

Sulfur: helps with the breakdown of whiteheads and blackheads.

If you have pimples that won’t go away:

Use prescription acne fighters. Dr. Suite recommends first using a topical antibiotic and topical Retin-A (vitamin A derivative) that helps to de-clog pores each night. If the patient is not responding to topical treatments, she will then prescribe oral antibiotics.

For really severe acne, usually cystic acne, your dermatologist may recommend Roaccutane. This drug helps shrink the oil gland and results in less oil production which means less P.acne bacteria and thus less inflammation.  Dr. Suite warns that this should be reserved for severe nodulocystic acne. It should not be the first line of treatment and is considered bringing out the ‘heavy guns’.”

“Persons who have taken oral antibiotics in the proper doses for the recommend amount of time and have not responded may be good candidates for Roaccutane treatment.” She adds that “in cases of dysmorphophobia where the psychological impact of the acne outweighs the physical impact it might be a good solution to avoid further damage to the individual’s self image.”

The drug has come under fire because of suspected links to depression. It does cause severe birth defects, so avoid it if you might get pregnant. In fact, your doctor will require you to take two pregnancy tests before prescribing the medication.

Once you are using it you will need to use two very effective forms of birth control simultaneously to ensure that you do not become pregnant.

Dr. Suite notes that Roaccutane is not for the average patient, she usually prescribes the drug to approximately six patients per year.

Some Tips for Making the Best of You Skin

While you are waiting for your choice of an acne treatment to work, there are some things you can do in the short term to make life more bearable.

Make-Up Works Wonders!

Dr. Suite advises: “Just because you have acne, does not mean that you should avoid make-up.” Make up can help make you look better while you are treating your acne and help your self esteem and self image.

Keep checking weekly for our weekly column. Ask your questions here and we provide answers as the questions pop up.

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