Acne

Alternative Names

Treatment

Take the following self-care steps to lessen the effects of acne:

• Clean your skin gently with a mild, non-drying soap (such as Dove, Neutrogena, or Basics). Remove all dirt or make-up. Wash once or twice a day, including after exercising. However, avoid excessive or repeated skin washing.
• Shampoo your hair daily, especially if it's oily. Comb or pull your hair back to keep the hair out of your face. Avoid tight headbands.
• Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to scarring and skin infections.
• Avoid touching your face with your hands or fingers.
• Avoid greasy cosmetics or creams. Look for water-based or "non-comedogenic" formulas. Take make-up off at night.

If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These creams and lotions are applied directly to the skin. They may contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid. They work by killing bacteria, drying up the oil, and causing your skin to peel.

If the pimples are still a problem, a dermatologist can prescribe stronger medications and discuss other options with you.

Prescription medicines include:

• Oral antibiotics (taken by mouth) such as minocycline, doxycycline, and tetracycline
• Topical antibiotics (applied to the skin) such as clindamycin or erythromycin
• Retinoic acid cream or gel (Retin-A) and isotretinoin pills (Accutane) -- pregnant women and sexually active adolescent females should NOT take Accutane, as it causes severe birth defects; Women taking Accutane should use two forms of birth control before starting the drug
• Prescription formulas of benzoyl peroxide, sulfur, resorcinol, salicylic acid

Birth control pills can sometimes help clear up acne. (In some cases, though, they may make it worse.)

Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion, or removal or drainage of cysts.

A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays is not recommended because it increases the risk of skin cancer.

Outlook (Prognosis)

Acne usually subsides after adolescence, but may last into middle age. The condition generally responds well to treatment after a few weeks, but may flare up from time to time. Scarring may occur if severe acne is not treated. Some people, especially teenagers, can become significantly depressed if acne is not treated.

Possible Complications

Possible complications include:

• Changes in skin color
• Cysts
• Damage to self-esteem, confidence, personality, and social life
• Permanent facial scars
• Side effects of Accutane (including very dry skin and mucous membranes, high triglyceride levels, liver damage, and birth defects in an unborn baby; call your doctor right away if you become pregnant while taking this drug)
• Side effects of other medications

When to Contact a Medical Professional

• Self-care measures and over-the-counter medicine have not helped after several months
• Your acne is severe (for example, you have lots of redness around the pimples or you have cysts) or getting worse
• You develop scars as your acne clears up

Call your pediatrician if your baby has acne that does not clear up on its own within 3 months.

References

Habif TP. Acne, Rosacea, and Related Disorders. In: Clinical Dermatology. 4th ed.Mosby, Inc; 2004: 162-194.

Yan AC. Current concepts in acne management. Adolesc Med Clin. Oct 2006; 17(3): 613-37; abstract x-xi.