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Acne is a disorder of the hair follicles and sebaceous glands. With acne, the sebaceous glands are clogged, which leads to pimples and cysts.
Acne is very common - nearly 17 million people in the US are affected by this condition. Acne most often begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls, causing the sebaceous glands to become more active - resulting in increased production of sebum.
The sebaceous glands produce oil (sebum) which normally travels via hair follicles to the skin surface. However, skin cells can plug the follicles, blocking the oil coming from the sebaceous glands. When follicles become plugged, skin bacteria (called Propionibacterium acnes, or P. acnes) begin to grow inside the follicles, causing inflammation. Acne progresses in the following manner:
Eventually, the plugged follicle bursts, spilling oil, skin cells, and the bacteria onto the skin surface. In turn, the skin becomes irritated and pimples or lesions begin to develop. The basic acne lesion is called a comedo.
Acne can be superficial (pimples without abscesses) or deep (when the inflamed pimples push down into the skin, causing pus-filled cysts that rupture and result in larger abscesses).
Rising hormone levels during puberty may cause acne. In addition, acne is often inherited. Other causes of acne may include the following:
Acne can be aggravated by squeezing the pimples or by scrubbing the skin too hard.
Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands, including the following:
The following are the most common signs/symptoms of acne. However, each adolescent may experience symptoms differently. Symptoms may include:
The symptoms of acne may resemble other skin conditions. Always consult your adolescent's physician for a diagnosis.
The goal of acne treatment is to minimize scarring and improve appearance. Specific treatment will be determined by your adolescent's physician based on:
The goal of acne treatment is to minimize scarring and improve appearance. Treatment for acne will include topical or systemic drug therapy. Depending upon the severity of acne, topical medications (medications applied to the skin) or systemic medications (medications taken orally) may be prescribed by your adolescent's physician. In some cases, a combination of both topical and systemic medications may be recommended.
Prescription topical medications are often prescribed to treat acne. Topical medication can be in the form of a cream, gel, lotion, or solution. Examples include:
|benzoyl peroxide||kills the bacteria (P. acnes)|
|antibiotics||helps stop or slow down the growth of P. acnes and reduces inflammation|
|tretinoin||stops the development of new acne lesions (comedones) and encourages cell turnover, unplugging pimples|
|adapalene||decreases comedo formation|
Systemic antibiotics are often prescribed to treat moderate to severe acne and include the following:
Isotretinoin (Accutane®), an oral drug, may be prescribed for adolescents with severe, cystic, or inflammatory acne to prevent extensive scarring. Isotretinoin reduces the size of the sebaceous glands that produce the skin oil, increases skin cell shedding, and affects the hair follicles, thereby reducing the development of acne lesions. Isotretinoin can clear acne in 90 percent of patients. However, the drug has major unwanted side effects, including psychiatric side effects. It is very important to discuss this prescription medication with your adolescent's physician prior to use.
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