Wednesday, July 6, 2011
Causes, incidence, and risk factors to pimples
Acne occurs when tiny holes on the surface of the skin, called pores, become clogged.
Acne is most common in teenagers, but it can happen at any age, even in an infant. Three out of four teenagers have some acne. Hormonal changes probably cause increased oil in the skin. However, people in their 30s and 40s may also have acne.
Acne tends to run in families and can be triggered by:
- Each pore is an opening to a follicle, which contains a hair and an oil gland. These oil glands help lubricate the skin and help remove old skin cells.
- When glands produce too much oil, the pores can become blocked. Dirt, debris, bacteria, and inflammatory cells build up. The blockage is called a plug or comedone.
- The top of the plug may be white (whitehead) or dark (blackhead).
- If the plug breaks open, the material inside causes swelling and red bumps to form.
- If the inflammation is deep in your skin, the pimples may enlarge to form firm, painful cysts.
Acne is most common in teenagers, but it can happen at any age, even in an infant. Three out of four teenagers have some acne. Hormonal changes probably cause increased oil in the skin. However, people in their 30s and 40s may also have acne.
Acne tends to run in families and can be triggered by:
- Hormonal changes related to menstrual periods, pregnancy, birth control pills, or stress
- Greasy or oily cosmetic and hair products
- Certain drugs (such as steroids, testosterone, estrogen, and phenytoin)
- High levels of humidity and sweating
Symptoms
- Blackheads
- Crusting of skin bumps
- Cysts
- Papules (small red bumps)
- Pustules
- Redness around the skin eruptions
- Scarring of the skin
- Whiteheads
Signs and tests
Treatment
Steps you can take to help your acne:
- Clean your skin gently with a mild, nondrying soap (such as Dove, Neutrogena, Cetaphil, CeraVe, or Basics). Remove all dirt or make-up. Wash once or twice a day, including after exercising. However, avoid scrubbing or repeated skin washing.
- Shampoo your hair daily, especially if it is oily. Comb or pull your hair back to keep the hair out of your face.
- Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to skin infections and scarring.
- Avoid wearing tight headbands, baseball caps, and other hats
- Avoid touching your face with your hands or fingers.
- Avoid greasy cosmetics or creams. Take off make-up at night. Look for water-based or "noncomedogenic" formulas. Noncomedogenic products have been tested and proven not to clog pores and cause acne.
- They may contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid.
- They work by killing bacteria, drying up skin oils, or causing the top layer of your skin to peel.
- They may cause redness or peeling of the skin.
PRESCRIPTION MEDICINES
If pimples are still a problem, a health care provider can prescribe stronger medications and discuss other options with you.
Antibiotics may help some people with acne:
- Oral antibiotics (taken by mouth) such as tetracycline, doxycycline, minocycline, erythromycin, trimethoprim, and amoxicillin
- Topical antibiotics (applied to the skin) such as clindamycin, erythromycin, or dapsone
- Retinoic acid cream or gel (tretinoin, Retin-A)
- Prescription formulas of benzoyl peroxide, sulfur, resorcinol, or salicylic acid
- Topical azelaic acid
- A pill called spironolactone may help
- Birth control pills may help in some cases, though they may make acne worse
- A laser procedure called photodynamic therapy
- Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion, or removal, drainage, or injection of cysts with cortisone
Pregnant women should NOT take Accutane, because it causes severe birth defects. Women taking Accutane must use two forms of birth control before starting the drug and enroll in the iPledge program. Your doctor will follow you on this drug and you will have regular blood tests.
Expectations (prognosis)
Scarring may occur if severe acne is not treated. Some people, especially teenagers, can become very depressed if acne is not treated.
Calling your health care provider
- Self-care measures and over-the-counter medicine have not helped after several months
- Your acne is severe (for example, you have a lot of redness around the pimples or you have cysts)
- Your acne is getting worse
- You develop scars as your acne clears up
References
- Acne, rosacea, and related disorders. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 7.
- Review Date: 10/30/2010.Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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