Coping With Acne

Acne - Coping With Acne

Only in very rare cases can acne represent a serious general health risk. But, its effects can still be severe. The unsightly blemishes, the appearance of having unhealthy skin will almost inevitably lead to mild depression or worse.

One important method for keeping that outlook under control is to make reasonable efforts to combat the condition.

Not everyone can readily afford a professional dermatologist on an ongoing basis. But even one visit can provide tons of useful advice and a prescription for acne medication. That's worth quite a lot. Even though there is a substantial amount of information available on the Internet today, it's helpful to have someone experienced who can help interpret it.

The medicine itself is important, both to treat the disease and the psychological effects. As the patient lessens the number of lesions, and lengthens the period between outbreaks, the skin will clear. At the same time, even when acne is still present, knowing that one is doing everything possible to combat the condition promotes a better attitude.

Passivity in the face of acne creates a downward spiral. The person feels bad about having a skin disease. They look in the mirror and don't want to face the day, which includes other people who will see them.

But passively accepting the situation only worsens it. It reinforces the mistaken belief that nothing can be done. It's a self-fulfilling prophecy. If nothing is done, the condition doesn't go away or at least lingers much longer, and more severely than need be. That provides false evidence that there's nothing that can be done to make it go away.

Taking action tends to create a positive spiral. Severe acne won't normally disappear in a day, even with the best treatment. But fighting it leads to greater confidence that it can be fought, especially when reality helps show it as the condition actually improves.

That attitude has another, perhaps greater, benefit. It builds up the inner resources that one can deal with the challenge. It helps create a mental outlook that focuses on achieving other values, not dwelling on one unfortunate - and usually short-lived - problem.

Over 85% of those between ages 12-24 will get acne at some time. It is usually mild and usually only lasts a couple of weeks or less, with proper treatment. Since it's so common, one needn't feel singled out. Since it occurs to nearly everyone at some point, it can be accepted as a normal, if regrettable, fact of life.

Facing that reality isn't pleasant. But a realistic attitude that understands that bad things will happen, and that good things can be created, will help encourage us. Realizing that we don't have to passively accept those bad things, but that despite our best efforts they may take time to solve, contributes to a positive outlook.
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Women and Acne

Acne - Women and Acne

When it comes to acne issues, women sometimes have a larger burden to bear. Lament it as we might, they're often judged more on looks than men. Their hormonal systems make them more prone to developing acne at certain times. Treatment options can be more expensive for them and costs harder to meet.

During the teen years, girls tend to develop acne sooner than boys. On average most girls will start to develop acne by about age 11, as contrasted with age 13 for boys. The reason isn't hard to find. Girls mature sooner. They tend to enter puberty a few months to a couple of years before boys.

During those years the human hormone system sees rapid increases in levels of a number of well known hormones, such as estrogen or testosterone. But there's a class of hormones that are less well known by name, but more relevant at this stage to acne onset: androgens.

As the name suggests, these hormones are shared by both males and females. But, as noted, the rise in females occurs sooner. Once they reach puberty, the androgen levels rise higher in males, so they tend to suffer more severe acne.

About 2/3 of all teens will develop acne, at least in mild form. But for females, the condition tends to last longer, at least cyclically. As a woman enters her 20s, her menstrual cycle tends to raise the likelihood of developing at least mild acne. Since that occurs approximately once per month, so does the acne. The week prior to the onset of flow is typically the worst for almost 62% of women.

The problem persists for women throughout the years of reproductive capacity. Over 50% of women (as opposed to only 42.5% of men) between ages 20-29 develop acne. The numbers dip radically for the years 30-39 to 35.2% and 20.1% respectively. By the time she's reached her 40s, the number has lowered to 26.3% (12% for men). For those aged 50 and older the numbers are about 15% and 7% for women vs men.

The severity follows a similar pattern. Between the third and fourth weeks of the menstrual cycle, inflammations increase about 25%. Even blackheads and whiteheads rise about 20% during this time.

Pregnancy offers some relief, but it mostly shifts the pattern. It doesn't eliminate acne entirely. During pregnancy, breakouts can occur at random. Skin changes, even for those who have never had acne, are a common occurrence when a woman is carrying.

Here again, significant hormonal changes are taking place. The largest number of cases tends to occur during the first trimester. That shouldn't be surprising, since this is the interval during which hormone levels are changing most rapidly from their usual amount and distribution. Delivering the baby will often put an end to the outbreaks, but they tend to persist longer in women who breastfeed.

Though a woman has to always be more careful about what medications she takes, normal over the counter treatments are considered safe. Some studies have suggested, however, that isotretinoin (brand name: Accutane) and tetracycline (doxycycline), treatments for severe acne, should be avoided during pregnancy. They may cause birth defects or development problems in the fetus.

When in doubt, consult a dermatologist.

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Diagnosis of Acne

Acne - Diagnosis of Acne

In very mild forms of acne, little diagnosis is required. Most people who reach their teens will readily recognize the small blackheads or white pimples surrounded by a reddened area that constitute mild acne.

But more severe forms, where nodules or cysts form, where papule or pustules have spread around the face, shoulders and chest often call for a visit to the dermatologist. These skin professionals will obtain a complete history and carefully examine the affected areas. They'll note the color, number and size of outbreaks.

The acne may consist of a field of small, white bumps called whiteheads. These will often disappear on their own. Blackheads form when the material reaches the surface, where it combines with air to form the characteristic dark color. These two are called, respectively, closed or open comedones. A good antibacterial cleanser and time may be all that's needed.

In the more severe cases, where nodules or cysts form, the patient may have other symptoms we don't commonly associate with acne, such as fever and aching joints, or even headaches and GI (gastrointestinal) distress. These indicate more serious types of acne, calling for more specialized treatments, such as prescription drugs or lasers.

When symptoms appeared, and in what order, is important. Typically, only the patient can provide that information. It's useful to keep track by keeping a log. Note what type of lesion occurred before the appearance of any pustules and when.

Along the way the dermatologist will, naturally, attempt to rule out any alternative explanations.

Certain insect bites, such as mosquito or spider bites, can temporarily resemble acne. Mosquito bite lesions, left alone, will disappear in a day or two for all but those who are allergic. Spider bites are often harmless, but some may be poisonous and lesions can spread. That calls for entirely different treatment from acne.

Rosacea is a common skin disorder that differs from acne in several respects, but still forms papules and red pustules. Keratosis pilaris produces small bumps that may resemble whiteheads. Miliaria rubra, or heat rash, produces small red bumps. All of these would call for very different treatment from acne.

Similarly, many allergies can produce skin lesions, redness and many other symptoms similar to acne. Sexually transmitted diseases are a common ailment. Sometimes they actually produce acne, but they can cause other skin problems, too. Herpes, for example, may show up as red, painful bumps on the buttocks.

Certain drugs can actually cause acne. Anabolic steroids, lithium and prednisone, are common today. Phenobarbital and tetracycline can cause acne. Dermatologists will require a complete and honest history of drug use in order to make a proper diagnosis.

Sometimes, even excess use of Vitamin B complex can cause acne. The doctor will need to know about diet, supplements and whether any over the counter medications or remedies have already been tried.

Knowing as much as possible about your own skin and the history of any outbreaks will aid proper diagnosis. That, it should go without saying, is key to any proper treatment.

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Who Gets Acne?

Acne - Who Gets Acne?

The short answer to the question 'Who gets acne?' is: nearly everyone sooner or later. But the breakdown of who and when is interesting and helpful.

Acne is a condition in which a skin pore becomes clogged as a result of excess dead skin cells and sebum, a natural skin oil, being unable to exit the follicle. That can lead to bacterial growth, rupture of the follicle wall and other circumstances that promote acne. Hormones called androgens are thought to be a major driver of the increase in sebum production.

Since it is during our teen years that hormone levels increase dramatically, it's not surprising that acne shows up most prominently during this period. Acne typically develops in girls around age 11 and 13 in boys, reflecting the average age at which the two genders start puberty.

Once it develops, the incidence and severity is greater for males. Boys produce considerably more androgen hormones than females, and so they tend to develop more (and more severe) acne. Around 40% of teen acne is severe enough to warrant treatment by a dermatologist.

But the scales tip later in life.

Young or even mature adults can get acne, women more often than men. Nearly 85% of the population of the U.S. between age 12 and 24 develop some form of acne. Males and females tend to suffer about equally during the period, but women have a higher incidence after that time.

One quarter of these people have acne on other parts of the body besides the face - most commonly the back and neck areas. 40% of acne sufferers seek medical attention because of the severity of their breakouts.

There are studies that suggest that the monthly hormonal cycle of women has an effect on the occurrence of acne. Nearly 44% of women between the ages of 20-32 experience premenstrual related acne. The odds are even higher for women aged 33 and older. This is according to one of the largest studies of the menstrual cycle's effect on acne.

But acne can occur at any age.

Babies often get small whiteheads. It may take 3-6 weeks for baby acne to disappear, which it generally does, spontaneously. Acne can appear in those over 50 and even later in life. Often it is correlated with taking certain drugs, such as lithium, corticosteroids or phenobarbital. It's not just a teen's disease and it can have many causes.

Acne affects all races, too. Though more prevalent among Caucasians, blacks, Hispanics, Asians and others all get acne from time to time. Treatments are essentially the same for everyone.

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Types of Acne

Acne - Types of Acne

Sometimes acne is nothing more than a simple pimple, a bit of trapped pus consisting of sebum, dead skin cells and white blood cells. But it can be more severe. Knowing which type you have is key to a proper diagnosis and treatment plan.

Professionals recommending a course of treatment will rank acne by Grade.

Grade I includes milder, non-inflamed types such as blackheads, whiteheads or milia. Grade II involves a larger number of these, and frequently includes papules or pustules that are mildly inflamed.

Papules are small lesions, a change or break in the skin, that is smaller than 5 mm - about the width of a thin cigarette. They're in the form of a bump that rises above the surface. A pustule, by contrast, is pus-filled - a mixture of bacteria, white blood cells and dead skin cells.

Grade III is more severe. The papules or pustules will be red, larger and more numerous. Grade IV is the most severe level, and includes nodules and cysts. The inflammation is usually wide spread and includes more than just the face.

Acne vulgaris is the common form of mild acne. Any of the Grade I forms will fall under this heading. They can usually be treated with over the counter medications.

In more severe form acne can develop into a type known as acne congoblata. The name may sound amusing, but the condition is anything but. It's characterized by heavy inflammation and deep abscesses. The result is often scarring and other forms of serious skin damage.

Inflamed nodules will form around comedones - a general term for blackheads, whiteheads and milia. They often grow until they spontaneously discharge pus. While they do, they're painful. When they do, they're unsightly. Keliod-type scars are commonly left behind.

Another type is known as acne fulminans. Here, the nodules will often ulcerate, leading to a painful and recurrent form of acne. The person afflicted may even develop a fever or aching joints. Treatment with corticosteroids or NSAIDs (non-steroidal anti-inflammatory drugs) is usually called for. But these treat symptoms, not the underlying cause.

In still more severe forms, a person may develop nodulocystic acne. Cysts form (red bumps produced by severe inflammation), but they're of an unusual type. Sometimes they become numerous and close enough together to form a larger inflamed area. When they form small tunnels under the skin, infection can spread more readily. A treatment of antibiotics is called for, and isotretinoin (brand name: Accutane) is frequently employed.

Gram-negative folliculitis occurs when the follicles - the shaft in which hairs grow and sebum flows from the sebaceous glands - become infected. Bacteria grow inside and the body responds by dispatching white blood cells to fight the infection. The result is a deep eruption that calls for special treatment.

The type of bacteria that produces it may be resistant to normal antibiotics. In fact, the condition may have resulted from treatment of other types of acne treated with antibiotics.

Proper diagnosis of these forms of acne calls for a visit to a professional. A dermatologist's care is warranted in these cases, as it may be in other forms of severe acne.

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Acne - Over the Counter Treatments

Acne - Over the Counter Treatments

Self-treatment of acne is the most common situation. Most acne is mild enough that over the counter, non-prescription medications work fine. Combined with a regimen of overall good skin care, they will do an effective job of clearing up acne in as short a time as possible.

Benzoyl Peroxide

One of the most common - and most effective - treatments possible for mild acne, benzoyl peroxide is used daily by millions. It works by helping combat the bacteria that is partly responsible for acne in the first place: Propionibacterium acnes. It also helps to remove dead skin cells from the area. If those don't move to the surface where they can be sloughed or washed off, they can accumulate, upping the odds of getting acne.

Benzoyl Peroxide has been in use for decades so the pros and cons are well known. One possible side effect is excessive drying of the skin. It can also bleach fabric, and so should be used with care when treating acne while dressed.

The risk of side effects can be minimized by using the proper amount. If a 2.5% concentration is working, don't assume that 10% is better, or will work faster. Higher dosage only increases the odds of side effects without any compensating value.

Salicylic Acid

This is the active ingredient in aspirin and part of the reason this simple compound is sometimes called a miracle drug. It has many uses and is safe and effective, used properly.

Often coming in the form of soaked pads, salicylic acid helps break down blackheads and whiteheads. It slows down the process of shedding dead skin cells inside the follicle, making build up and compaction less likely. It also helps remove them. This helps prevent bacteria build up in the sebum (skin oil) inside the pore.

It should not be combined with other treatments, unless recommended by your dermatologist. Excessive skin irritation can occur.

Resorcinol

Resorcinol is another popular OTC medication and is effective in many cases, especially when combined with other compounds such as sulfur. It functions by breaking down hardened skin, leading to more effective removal from the follicle and the area outside. That also produces lower odds of clogging, a major factor in acne formation.

It should not be used in conjunction with astringents such as alcohol.

Alcohol and Acetone

Both of these common chemicals are safe, but are generally much less effective than more modern treatments. Alcohol is a mild antibacterial and helps remove oil from the surface. Similarly, acetone is a degreasing agent and helps keep the surface clear. But the excess oil (sebum) that contributes to acne lies well under surface where it lends a growth medium for bacteria and helps clog pores. Removing surface oil is of limited benefit.

The small savings over other treatments is generally money wasted, except as part of an overall skin care regimen.


Use all over the counter medications in the manner directed on the instructions. If acne persists for more than a couple of weeks, or grows worse, see a dermatologist. He or she may recommend a stronger treatment, such as a prescription medication.

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What Is Acne?

Acne - What Is Acne?

Acne is a common skin disease that results when pores get blocked and bacteria form inside them. It comes in a variety of familiar forms and affects nearly everyone at some stage, particularly in their teen years. The inflamed, red bumps that sometimes form can be painful, and even painless white pimples are unsightly.

In the surface of the skin are pores, tiny openings called a hair follicle. Deeper inside the pore, near the base of the follicle, there are sebaceous glands that produce sebum, a natural type of oil. That oil helps keep the skin flexible and protected.

Hair continues to grow through the surface, while oil or sebum oozes out the side and is spread around the area. Skin cells grow and die and are sloughed off through washing, rubbing or spontaneously. But that process can be interrupted when the pores close and when bacteria form inside them. The result is acne.

The white pimples that sometimes form are usually a combination of dead skin cells, white blood cells and bacteria. The trapped pus often creates an inflamed, red area around it. The term 'pus' is an adaptation of 'pustule', a type of acne that results when the follicle wall bursts and the white blood cells rush into the area as part of a healing process.

When the tiny bumps or spots appear black they're called blackheads, naturally enough. They're a non-inflamed form of acne that come from the material having poked through the surface. Their dark color isn't the result of contact with dirt on the skin. It's a combination of dead skin cells and sebum that have oxidized. Oxygen in the air causes a chemical reaction that turns them black.

Often, however, the material doesn't break the skin, but simply pushes it up, forming a small, white bump called whiteheads. One form are known as 'milia'. Normally dead skin cells will get washed off or simply fall off the surface. But they can get trapped underneath the surface. This type of acne is common among infants, but can affect people at any age.

All these variations go by a general medical term called 'comedones', and whether that formation is open or closed is part of the clinical difference between them.

As the acne develops it can variously form what are called papules, nodules or cysts. A papule forms when the walls holding the hair follicle burst near the surface. They're small and don't contain pus. A nodule is a hardened lump under the skin, resulting from a break at the base of the follicle. A cyst is a larger, reddened bump. They're soft, but can be very painful.

Naturally, while it's helpful to know what acne is, the most important thing is to be able to treat it. In order to do that, it's necessary to know what type we have. We turn to that next...

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What Causes Acne?

Acne - What Causes Acne?

While there are always new questions to answer, many of the factors that tend to produce acne have been well researched.

Hormones and Sebum

It's no accident that acne tends to be associated with teens. It strikes over 85% of us during those years. It's at that stage of life when hormone levels rise sharply. Androgen levels increase in both males and females.

Among other effects, those stimulate the sebaceous glands that produce sebum, the natural oil found in hair follicles. The largest increases occur in the face, back and upper chest - right where acne tends to concentrate. The result can well be an outbreak of acne.

Increased oil or sebum isn't generally a problem if it reaches the surface. It's spread around, and often washed off with alcohol or soap and water by those who take good care of their skin. Still, blackheads may form as a result of the excess oil.

Worse, pores can close, causing them to become clogged with that excess oil. That encourages the growth of whiteheads. Also, the resulting pressure can cause follicles to rupture. The bacteria have a more 'friendly' environment in which to grow. At the same time, bacteria and the white blood cells that deal with it (normally without any problem) get trapped. The result is pus and inflammation. Acne.

Stress itself doesn't produce acne, but it can make it worse by increasing hormones. It also contributes to weakening the immune system, thus leading a less effective defense against invading bacteria. But it's not a major factor.

Drugs

Certain drugs can encourage the development of acne. Barbituates and tetracycline are known to be among the culprits. Anabolic steroids are widely recognized by professional dermatologists to be a major contributor among those who take them. Forgoing these, except for specific medical purposes, helps reduce the odds.

Heredity

Genetics plays a role, as well. How large, is still not yet quantified. The area is one of active research, and therefore the exact mechanism isn't detailed. But, statistics show that acne does tend to run in families. That may be partly due to diet or other common family circumstances. But it's more a factor of inheritance.

Diet & Skin Care

This is a much more minor cause than is commonly supposed. While certain foods are themselves greasy, that doesn't translate directly into increased oil in the skin. Of course, poor eating habits often go hand in hand with poor skin care practices. And, any food that tends to increase the production of sebum (oil) or certain hormones will have an effect.

But no study suggests that the common culprits - soft drinks, chocolate and greasy cheeseburgers, among others - play a large role in producing acne.

Poor cleansing habits play some role, because bacteria that lie near the surface sometimes remain 'unmolested'. Regular use of a good cleanser can help. Take care that the skin doesn't become excessively dry, however. That causes other problems.

Also, heavy dirt or even makeup can contribute to a problem by blocking the pore, especially if they block oil ducts. But surface dirt itself isn't responsible for acne. The dark head on blackheads is the result of exposure to air, not trapped dirt.


There's little one can do about heredity, and passing through the teen years is a normal part of life. But good skin care, quick treatment at the onset of symptoms and other controllable choices will help keep acne at bay.

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Concealing Acne

Acne - Concealing Acne

There are numerous safe and effective treatments for acne. Over the counter medications do a good job of treating mild forms. Prescription medications and advanced treatments can cure almost all acne within a few months. But in the meantime, and afterward, it can help to hide it as well as possible.

It does little good to tell people they should be less concerned about their appearance. That only adds unnecessary guilt to an already unpleasant situation. For a whole host of valid reasons individuals may be interested in optimizing their appearance. Superficial vanity or excessive concern with what others think is one thing. Wanting to look one's best as a reflection of a healthy and confident inner self is quite another.

For women, the situation is both more difficult and easier. More difficult because they tend to be judged more, and more stringently, on their looks. Easier, because they have more tools to meet the challenge. Makeup is the most obvious one.

First and foremost, look for makeup labeled 'non-comedogenic'. 'Comedones' is the general term for certain types of mild acne, including whiteheads and blackheads. Those types of makeup are specially formulated to minimize clogging pores, one of the major contributors to acne development.

Concealer is the first line of defense. The redness that often accompanies burst pimples or, in more severe cases, cysts can be well covered. Just daub it on and work it over with a disposable sponge. Avoid overdoing it. You don't want to look like someone has troweled on brown cement when the concealer dries.

Using a good foundation can help blend tones together. Here again, try not to use too much. You want to avoid looking like your face has been painted with beige latex. But an even, covering foundation for masking blemishes can do a very good job. Blending it in well so that the overall color is even is key.

Foundation helps in another way. By providing a less reflective surface than skin, it softens shadows. That lessens the contrast produced by the bumps that often occur with acne. Think of good films or photographs, where the proper lighting minimizes skin blemishes. It makes the person look as if their skin is made of silk. Foundation can help achieve a similar effect.

A light powder to finish has all those benefits. It can even out color tones and reduce shadows, reducing contrast.

Men, outside the stage or studio, typically don't wear makeup as women do. Yet, specially formulated acne covering compounds can also help them hide acne. Over the counter medications often incorporate makeup-like compounds in order to do just that. But makeup for men is also an option. It's typically much more subtle, and sometimes the effects are therefore less concealing. But many men find the results helpful.

Any acne covering product should be removed before bed. A gentle wash with a mild cleanser, followed by treatment with appropriate medications, helps combat acne. And, elimination is the best cover of all.

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Acne Scars and Their Treatment

Acne - Acne Scars and Their Treatment

The unsightly appearance of acne lesions or pimples isn't the only potential problem with the disease, unfortunately. In some cases, it's possible for acne to leave permanent scars.

Some conditions may appear to be scars that are not. Macules and other bumps can occur even after acne is treated. Redness may persist for up to a year. But these aren't true scars. They're not permanent.

True scars are a permanent change to skin tissue produced by the healing process itself, chiefly creating fibrous tissue. As white blood cells attack bacteria they can produce changes in underlying skin cells in the surrounding area. This is one way scars become permanent.

They may also not be limited to areas under the surface.

So-called icepick scars are small pinholes that form in the surface of the skin. They look as if the skin has been poked with an icepick, hence the name. They're typically too deep to be treated with simple dermabrasion or even laser resurfacing.

Boxcar scars are similar, except they tend to be flatter on the bottom, rather than narrowing to a point like icepick scars. Since they're often shallower they can sometimes be treated with resurfacing techniques.

Keloid scars are firm and grow beyond the site of the injury. They're characterized by an excess production of collagen. They often result in a shiny pink or red scar.

Prevention is the best option, of course. But when that's not possible, there are a number of standard treatments.

Dermabrasion

Dermabrasion is used to treat a wide range of skin conditions, including mild to moderate acne scarring. A local anesthetic is given and the professional uses a high speed brush to remove layers of skin. The skin then naturally regenerates, minus the scar in many cases. When it's not entirely removed, it's often less obvious.

A variation on the technique is known as microdermabrasion. Instead of a high speed brush, aluminum oxide crystals are moved rapidly through a type of vacuum hose. They carry away skin cells on their way to being collected. It's less invasive or traumatic to the skin, but the results may, therefore, be less.

Lasers

Laser treatment can be effective for some patients. Used well, they can change the contour and size of scars. CO2 lasers are often used to remove some tissue. Sometimes a single treatment is enough, but redness can persist for several weeks afterward. Lasers work in these types of treatment, essentially, by burning.

Surgery

A technique called 'punching' can be used to remove some icepick scars. The scar is excised down to subcutaneous fat and the resulting hole repaired. The repair may be done with sutures or a small skin graft.

Subcisions may be performed. These involve actually lifting the scar tissue away from unscarred skin. Results are mixed, but the technique can be effective.

Drugs

Keloids don't respond well to these mechanical techniques, since altering the skin often just provokes the formation of more keloids. Sometimes a topical retinoid is applied. In other cases steroid-type drugs are injected directly into the skin around the scar. They're difficult to treat by any means and results vary widely from person to person.

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Acne Myths Exploded

Acne - Acne Myths Exploded

There are several common beliefs about the causes and course of acne that simply don't square with scientific studies. Fortunately, it isn't necessary to understand them in depth to separate fact from fancy. Common experience can help persuade, too.

Diet

There's no direct link between eating chocolate or greasy cheeseburgers and developing acne. Soft drinks do not increase the odds. What is true is that diet plays a role in all the body's systems, and so has a minor part in whether acne is more or less likely.

For example, eating greasy foods doesn't directly translate into increased oil production from the sebaceous glands that contribute to acne. But foods that do increase the oil production would. However, excess iodized salt is the only food substance that has been shown to have any substantial effect. It only worsens existing acne. It doesn't cause it.

Hygiene

Diet and hygiene are closely linked. But that's more because people tend to have habits. People who have a non-nutritious or unhealthy diet tend to have poor hygiene habits as well. But even here the influence on the development of acne is minor at best.

The odds of acne are increased when a pore gets plugged and bacteria are trapped inside. White blood cells rush to the area to combat the bacteria. Trapped dead skin cells contribute. The result can be inflammation and the creation of pus, a component of one type of acne.

So, hygiene habits that tend to close the pores can play a role. But the effect is minimal. The dead skin cells and bacteria that get trapped, and can't make their way out of the pore to the surface, are only somewhat influenced by whether a person washes the face regularly and well. After acne occurs good skin care is particularly important, though.

A mild cleansing twice a day with soap and water, not heavy scrubbing several times per day, is best. That helps encourage healthy skin in general.

But acne is strongly influenced by excess sebum production (a natural skin oil), triggered primarily by hormones. Good hygiene is a good idea for many reasons. But it helps more in treating acne that has already occurred by providing a good surface for medications to do their work most effectively.

Harsh cleansers applied roughly don't just clear away the excess oil that plays a role in acne formation. Rather, it weakens the skin's ability to deal with it. Also, contemporary makeup formulations will rarely increase the odds of forming acne.

Stress

As a factor that weakens the immune system and influences hormones, stress might be thought to play a role in the onset of acne. But no clear correlation is found in major studies. Stress can have a small effect on acne that has already formed, but as a possible cause it ranks very low on the list.

Here again, though, people who experience excess or chronic stress tend to be in the cluster of those who have other health problems. Always a good thing to avoid. Keep in mind that stress and being challenged by ordinary life events are not the same thing. Stress occurs when someone thinks they're not up to the task of dealing with those challenges well.

Medication

Increasing the dosage of over the counter (or, worse, prescription) medications to treat acne is harmful, not helpful. At best, it wastes medication. At worst, it can actually harm the skin. Stick to the recommendations on the instructions. If over the counter medications don't clear up the condition within a couple of weeks, seek the guidance of a dermatologist for better treatments.

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Acne Problem

Acne - Acne and Skin Care

Good skin care practices play only a minor role in whether a person develops acne problem. But they are essential to treating it, and to good skin health in general.

Some believe, mistakenly, that a thorough scrubbing will help prevent acne. Actually, washing has little effect on whether acne develops or not. The effects occur mostly afterward, once acne has occurred.

Scrubbing doesn't help, in general, though. It merely roughens and often dries out the skin. Harsh treatment of skin exposes lower layers, which then have to develop a protective coating of oil and outer dermis. In the interim, the skin is exposed to airborne and contact bacteria. The skin is our first defense against pathogens of all kinds. Removing multiple layers of it doesn't promote good skin health.

Instead, a gentle washing with a mild cleanser is the answer. Be thorough. Since acne can occur on shoulders, back and chest as well as the face, take care of those areas in the shower. During mid-day and in the evening, a mild cleaning from underneath the jaw to the hairline is helpful.

While natural skin oil (sebum) plays a role in developing acne problem, removing every trace of it is not beneficial. Sebum helps keep skin flexible, which discourages microcracks from forming. These can provide a pathway for bacteria. It also keeps the skin from becoming excessively dry, which can again lead to small cracks in the outer layers.

Astringents that remove oil should be used sparingly. Over the counter acne treatments are specially formulated to achieve the right balance. They should be used according to the directions.

Shaving is always a challenge, of course. Men's faces are the hardest problem to solve. Electric razors help solve it, but even they can nick the skin, especially when it contains blemishes. There's no substitute for patient, careful movements. Use of a pre-shave softener can help, too.

Use of a manual or safety razor is possible. It plays a negligible role in developing acne. An ingrown hair and clogged pores that produce acne follow from different causes. Don't backshave against the direction of hair growth, though. Softening the beard before shaving with warm water and soap can help smooth the process.

For women, there are other helpful recommendations.

Makeup selection is easier these days. There are numerous formulations that specifically address the possibility of acne. They are designed not to clog pores. Going light on the foundation can help. Subtle cheek blush is better than slathering it on. Look for makeup labeled 'non-comedogenic'. 'Comedones' is a general term for the most common types of mild acne, including blackheads and whiteheads.

An over-the-counter antibacterial can help prevent acne problems in both sexes, but is most helpful after it has developed. But follow the directions. Over medicating can lead to clogged pores and damaged skin, exactly the conditions that tend to promote acne.

Keeping pores open in order to allow for natural oil movement and shedding dead skin cells is key to minimizing outbreaks of the problem. Proper skin care practices aid both.

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