Acne

Acne is a common chronic inflammatory skin disease that affects about 85% of Americans at some time during their lives. It is the source of discomfort, embarrassment, and disfigurement due to hyperpigmentation and acne scarring. Acne affects adolescent males and females and persists into adulthood in about 25% of women and 12% of men. Acne impacts quality of life. The psychological effects include anxiety, depression, and low self-esteem.

Acne typically affects the face but can present on the back, upper shoulders, neck, and chest. Acne scarring can become a lifelong remnant of acne. It develops in the hair follicles and pores and can create inflammatory and noninflammatory lesions (whiteheads and black heads). Acute and longer-term treatments are necessary to reduce and prevent new outbreaks.

Types of acne

• Comedones – whiteheads and blackheads – clogged follicles
• Raised solid lesions called papules
• Pus-filled lesions called pustules
• Deeper lesions characterized by an enclosed hair follicle with trapped dead skin cells are called cysts or cystic acne
• Infected cysts called nodules are infection deep in the skin

What causes acne?

The exact cause is unknown but results from a combination of factors including excessive oil production, pores that become clogged with dead skin cells, and bacteria that infect the hair follicles in the pores and cause inflammation.

Excessive production of sebum, the oily secretions produced by sebaceous (oil) glands is caused by increased production of hormones during adolescence. In adult women fluctuating hormones due to various types of birth control, menstruation, pregnancy, and menopause cause increased oil production from the enlarged sebaceous glands. Topical and oral treatments to reduce inflammation, decrease bacterial infection, and prevent blocked pores help to gain and maintain control.

What are the risk factors?

In addition to increased production of sex hormones, family history, age, BMI, and skin type are risk factors. Diet and skin care products can occlude the pores or irritate the skin causing additional oil production; and the side effects of some medications, such as steroids, B vitamins, work out supplements, and anticonvulsants, contribute to development of acne.

How is acne diagnosed?

Acne is typically diagnosed by clinical evaluation. Dr. Sotiriou will review your medical history, signs and symptoms and where indicated search for any potential underlying conditions that could be causing or contributing to acne.

What are the available acne treatments?

Treatment depends on the severity of the acne. The goal is to prevent the inflammatory process by keeping pores open, reducing oil production, reducing acne causing bacteria, and reducing inflammation. Thus, each treatment option addresses each of the multiple risk factors.

Treatments include:

• Non-irritating skin care products including gentle face wash products to cleanse and using a moisturizer that doesn’t clog pores (non-comedogenic).
• Exfoliation to prevent the buildup of dead skin cells in the pores. Chemical peels to remove dead skin cells and unclog pores
• Topical products that contain azelaic acid or benzoyl peroxide help to inhibit bacterial infection.
• Topical retinoids for patients with oily skin to promote cell turnover and prevent pore clogging with dead skin cells.
• Oral birth control pills to regulate hormones or modification of current birth control methods in coordination with your OB/GYN.
• Oral spironolactone to minimize hormonally driven chronic acne in women
• Oral antibiotics
• Topical tretinoin combined with oral antibiotics
• Oral isotretinoin/Accutane for severe cystic acne
• Light treatments such as Photodynamic Therapy
• Laser treatments

When you or a loved one suffers with acne, contact Dr. Michael Sotiriou at Salt Lake Dermatology & Aesthetics to schedule a consultation to learn about your treatment options to treat and prevent acne and acne scarring.