Let's Clear It Up!

by Janice Moranz, M.D.

Dispelling acne myths to reveal a beautiful complexion at every age.

Severe acne can be traumatizing regardless of whether you are heading back to school at 14 years old or attending a board meeting at 40.

Some people think that pimples come from uncleanliness and others try to cure breakouts by sitting in the sun. Unfortunately, misinformation leads to failure, frustration, and possible worsening of the condition. This article dispels many common myths about the causes and treatment of acne and offers practical suggestions to reduce the frequency and severity of breakouts.

MYTH #1:Acne is caused by uncleanliness.

Graphic of the skin.Dirt does not cause acne. Acne is an inflammatory disorder. We all know the signs: blackheads, pimples, purple discoloration, and/or painful cysts in the skin. Material in the follicles gets stuck or clogged. Bacteria break down fatty acids leaving behind inflammatory substances. These processes can cause the follicle wall to break. The substances in the follicle then leak out and cause more inflammation. The cause is most commonly hormonal. When babies get acne, it's at the time when there is a rise in testosterone. The same reason explains teenage acne.

Hormones are again the cause of acne in men and women in their twenties, thirties, forties, and even fifties. Genetics can be a predictor of severe acne as well, but we all know families where parents didn't have acne, but the children do. In large studies, no foods were implicated as causing acne either. However, some people find that specific foods make acne worse. The greatest culprits include milk products, nuts, fatty foods, and chocolate.

Stress can make acne worse but usually does not cause it. The same can be said about exercise. If you are acne prone, you may notice your acne is worse when you exercise. The summer humidity can also make it worse. You can reduce your chance of a breakout by washing your face (back and chest also, if they are affected) with an acne cleanser such as benzoyl peroxide or salicylic acid immediately after exercising. Get all the dirt and sweat off. Then apply a topical acne medication

MYTH #2: You will naturally outgrow acne.

Hormones continue to ebb and flow throughout life and so do acne breakouts. Left untreated, acne can leave physical (and emotional) scars. Acne can range from mild to severe. Mild acne is manifested as blackheads and whiteheads. As acne gets more severe, red bumps called papules develop. In the most severe cases, deep, painful cysts develop under the skin.

MYTH #3: Drying the skin under the sun will cure a breakout.

While there is some semblance of truth in this wive's tale, with the advances in dermatology, it is certainly not a preferred treatment — and it can cause premature wrinkling and skin cancer. More times than not, mild acne can often be controlled with over the counter benzoyl peroxide cleansers, gels, and salicylic acid cleansers. If the acne gets more severe, your dermatologist may recommend prescription medications. These medications are aimed at the specific mechanism taking place in the skin. Retin-A, Differin, Tazorac are topical medications that work to keep the follicles unclogged. Benzoyl peroxide and antibiotics kill the bacteria that break down the fatty acids. Antibiotics also reduce the inflammation. Although antibiotics can be topical or oral, more severe acne usually requires oral antibiotics. Some people are afraid of taking antibiotics to reduce acne because they fear that overuse of an antibiotic might reduce its affect on other infections. There is no need to worry, however; there are many antibiotics that can be used.

Acne Graphic of skinIf all these treatments fail, Accutane may be appropriate. Accutane is a very strong medication with a multitude of possible side effects. It is used with great caution and with full consent of the patient and the parents, in the case of a minor. The most serious side effect is birth defects found in babies whose mothers were on Accutane during the pregnancy. Pregnancy tests are run before and during Accutane therapy. Birth control is required. More than one form of birth control is recommended.

With so many good treatments for acne, long term scarring can be avoided. Acne should be taken seriously and treated. Begin treatment with over the counter medications. However, if the acne continues or worsens, appropriate prescription and treatments can minimize the long-term effects. Don't let acne myths keep you from the complexion you deserve!

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