Acne

Alternative names:

acne vulgaris; cystic acne; pimples

Treatment:

Treatment is designed to prevent formation of new lesions and aid the healing of old lesions.

Topical medications that dry up the oil and/or promote skin peeling may contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or tretinoin, or retinoic acid (Retin-A).

Antibiotics (such as tetracycline or erythromycin) may be prescribed if the skin lesions appear infected. Topical antibiotics (applied to a localized area of the skin) such as clindamycin or erythromycin are also used to control infection. Note: oral tetracycline is usually not prescribed for children until after they have all their permanent teeth, because it can permanently discolor teeth that are still forming.

Synthetic vitamin A analogues (isotretinoin, Accutane) have been shown to be of benefit in the treatment of severe acne. However, pregnant women and sexually active adolescent females should not take this medication!

Other medications may include topical or injected forms of cortisone.

Surgical intervention may include professional (chemical) skin peeling, removal of eruptions or scars (dermabrasion), or removal and/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 prolonged exposure increases the risk of skin cancer.

Home treatment may lessen the effects of acne:

• Clean the skin gently but thoroughly with soap and water, removing all dirt or make-up. Wash as often as needed to control oil, at least daily and after exercising. Use a clean washcloth every day to prevent bacterial reinfection.
• Use steam or warm, moist compresses to open clogged pores.
• Shampoo hair daily when possible. Use a dandruff shampoo if necessary.
• Comb or pull hair back to keep hair out of the face.
• Use topical astringents to remove excess oil.
• Don't squeeze, scratch, pick, or rub lesions. These activities can increase skin damage. Wash your hands before and after caring for skin lesions to reduce the chance of infection.
• Don't rest your face on your hands. This irritates the skin of the face.
• Identify and avoid anything that aggravates acne. This may include foods, lotions, make-up, and so on. Avoid greasy cosmetics or creams, which can aggravate acne.
• Acne often improves in the summer, so some foods that aggravate acne may be tolerated in the summer but not in the winter.

Expectations (prognosis):

Acne is usually chronic from puberty to adulthood, but eventually lessens. Acne generally responds well to treatment after a few weeks, but may flare up from time to time. Acne is not medically dangerous except for untreated, severe infection. Scarring may occur if severe acne is not treated.

Complications:

• cyst
• skin abscess
• permanent facial scars
• keloids
• skin pigment changes
• psychological damage to self-esteem, confidence, personality, social life
• side effects of Accutane (including liver damage and damage to the fetus)
• side effects of other medications

Calling your health care provider:

Apply home treatment and call your health care provider if there are signs of complications or if acne is severe and progressively worsening.

Call for an appointment with your health care provider if new symptoms develop, including large or painful cysts.