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ACNE WHAT CAUSES ACNE? The sebaceous glands of the skin secrete an oily material called sebum. These glands start functioning at puberty. During teen years, hormones cause these glands to make a lot of sebum (oil) making the face shiny. Dead skin cells normally flake away from skin and follicles constantly, but with increased sebum, the dead skin cells get sticky. They plug up the follicle instead of flaking away. This starts a blackhead or whitehead (comedone). The blackhead or whitehead is filled with dead skin and sebum, which bacteria like to eat, so they move into the plugged follicle. They cause inflammation leading to swelling and possible rupture of the follicle. This leads to a "pimple", pustule, or even a painful cyst. WHAT MAKES ACNE WORSE? Severe or prolonged emotional stress may aggravate acne. This is why acne often flares before tests, a move, or any other big change. In women, fluctuation of hormones during her cycle can cause an acne flare the week before menses. Cosmetic products that are oil based or for dry skin may worsen acne. Look for products that are "Non-comedogenic" (means will not block pores) or oil free (ex: Neutrogena's Skin Clearing make-up or Clinique's Pore Minimizer makeup). Look for the same qualities in a moisturizer. However, it is always better to prevent dryness rather than to use a moisturizer at all. To prevent dryness, follow directions under "washing" and avoid excessive use of topical medication. WILL VIGOROUS WASHING HELP MY ACNE? No, vigorous washing or using gritty scrubs will irritate the skin and can even cause a rupture of the follicle, leading to a pimple. The blackheads/whiteheads are too deep to be scrubbed away. You should wash you face gently (with hands or a baby washcloth) two or three times a day. Use mild cleansers such as Purpose, Basis, or Neutrogena. Only use an astringent or toner if you have difficulty removing heavy makeup or have very oily skin, otherwise they are too drying and have no effect on improving your acne. DO CHOCOLATE OR FATTY FOODS WORSEN ACNE? Not necessarily. These once forbidden foods have little effect on acne. Rarely, some people do report sensitivity to chocolate. If you notice this, avoid the suspicious food. Otherwise, a well balanced diet is recommended. New evidence suggests a diet high in sugar and carbohydrates may worsen acne. SHOULD THE PIMPLES BE SQUEEZED OR PICKED? NO, definitely not. They should be left alone. Your physician will decide what to do. In some cases, they may be drained or injected with a steroid solution. Digging and squeezing with fingernails often results in scarring, In fact, more damage can be done to the skin by picking and squeezing than by the acne itself. WHO GETS ACNE? Newborns get acne because of hormones from their mother. The next group is "tweens" and teens, which coincides with puberty. After the teen years, men and women differ. In men, acne usually ends during the late teens-early twenties. But women can get an adult form of acne starting in their twenties and thirties, sometimes persisting into their forties. This acne is more cyclical and the lesions are more painful, deeper, around the chin/jaw line and more difficult to treat then teen acne. Also, if there is a family history of acne, it increases your chances of acne. IS THERE ANYTHING GOOD FOR ACNE? Mild sunshine helps decrease the number of bacteria on the skin (blue light in particular). But excessive sun tanning or burning can worsen acne by blocking the oil glands with swollen, peeling skin. Also, some acne medications can make your skin more sensitive to the sun, causing it to burn more easily. We recommend using a SPF 15 for normal daily use and a SPF 30 for extended outside use. Coppertone oil free sunscreen for faces, Clinique City Block, Ocean Potion, and Neutrogena sunscreen are great non-acne causing sunscreens. HOW LONG DOES IT TAKE FOR THE TREATMENT TO WORK? Acne treatment prevents new acne lesions from forming. Lesions that are already present can take 8 weeks to clear. More severe acne improves with treatment over months (4 to 6). Be patient. East Valley Dermatology Center, 1100 S. Dobson Rd, Suite 223, Chandler, AZ 85286, (480) 821-8888