How to Get Rid of Acne
Acne is a disease of the hair follicles of the face, chest, and back that affects almost all teenagers during puberty — the only exception being members of a few primitive Neolithic tribes living in isolation. It is not affected by bacteria, although bacteria play a role in its development. It is not unusual for some women to develop acne in their mid- to late-20s.
Acne vulgaris is typical teenage acne which is characterized by three types of lesions:
- the comedo or blackhead;
- the inflammatory papule; and
- The pustule or pimple.
No one factor causes acne. Acne happens when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a “blackhead.” The plugged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and usual skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin’s surface produces a pustule; deeper inflammation results in a papule (pimple); if the inflammation is deeper still, it forms a cyst.
Folliculitis: Pimples can occur on other parts of the body, such as the abdomen, buttocks, or legs. These represent not acne but inflamed follicles. If these don’t go away on their own, doctors can prescribe oral or external antibiotics, usually not the same ones used for acne.
Rosacea: This condition is characterized by pimples but not comedones and occurs in the middle third of the face, along with redness, flushing, and superficial blood vessels. It generally affects people in their 30s and 40s and older.
Pseudofolliculitis: This is sometimes called “razor bumps” or “razor rash.” When cut too close to the skin, growing hairs twist into the skin and produce tender bumps. This is a mechanical problem, and treatment involves shaving less (growing a beard, laser hair removal). Pseudofolliculitis can, of course, happen in patients who have acne, too.
Gram-negative folliculitis: Some patients who have been treated with oral antibiotics for long periods of time develop pustules filled with bacteria that are resistant to the antibiotics that were previously used. Bacterial culture tests can identify these germs, leading the doctor to prescribe different antibiotics or other forms of treatment.
When should someone start acne treatment?
Since everyone gets acne at some time, the right time to treat it is when it becomes bothersome or when the potential for scarring develops. This can be when severe acne flares suddenly, for mild acne that just won’t go away, or even when a single pimple decides to show up the week before one’s prom or wedding.
Treatment of acne scars
For those patients whose acne has gone away but left them with permanent scarring, several options are available. These contain surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing (“fractional resurfacing”) are less invasive and heal faster than older methods, although results are less whole and the procedures may need to be repeated three or more times. These treatments can help, but they are never totally successful at eliminating acne scars.