Patient Education
Successful management of acne is dependent on a successful partnership between the health care team and the patient. Non-adherence is one of the biggest causes of treatment failure. Clear guidelines regarding treatment, possible adverse effects, and realistic expectations of treatment outcomes should be given to the patient to achieve the best possible outcome. Ongoing patient education, follow-up, encouragement, and maintaining a positive approach are vital. Because acne can be so devastating for many, early intervention with a proactive treatment plan may well prevent some of the long-term physical and psychosocial consequences.
Myths and Facts
An integral component of the prevention and treatment of acne is discussion of the facts and expulsion of the myths.
MYTH: Any acne medication works immediately.
FACT: It can take at least eight weeks of a prescribed treatment regimen for the patient to see any improvement. Acne may even get worse before it gets better.
MYTH: Acne is a result of poor hygiene.
FACT: As a result of this myth, people tend to overwash their skin, often scrubbing hard with abrasive cleansers. Cleaning the skin too often may aggravate acne and cause flare-ups. Wash face twice per day with a mild soap; pat dry, and use appropriate acne treatment. Acne is not caused by dirt or surface oil.
MYTH: Washing many times a day will diminish acne.
FACT: Under normal circumstances, wash no more than two times a day with mild soap and lukewarm, not very hot or very cold, water.
MYTH: Washing with abrasive soaps, cleansing granules, astringents, vigorous scrubbing, or a buff puff will clear up acne on the face.
FACT: Using your fingertips or a soft wash cloth is best.
MYTH: Picking your acne will make it go away.
FACT: This may cause scarring. Do not pick at acne lesions.
MYTH: Once acne has cleared up, it will be gone forever.
FACT: There is no cure for acne. If acne medication is discontinued, acne will probably flare.
MYTH: Stress causes acne.
FACT: Stress alone does not cause acne but may exacerbate psychological reaction to the acne. Acne is caused by overactive oil glands stimulated by androgens mixing with dead skin cells. This is particularly true during the teenage years when androgen production is at its highest.
MYTH: Eating chocolate and sugar will cause acne.
FACT: There is no evidence to support this. Certain foods may make some patients' acne worse and obviously should be avoided. No specific food has been proven to worsen acne. No diet has been shown to be beneficial.
MYTH: Teenagers are the only ones affected by acne.
FACT: Acne affects adults as well as children. The body produces androgens throughout life. The circumstances around adult acne may be a little different than in teens, particularly in women. Women between 18 and 40 years may have breakouts that occur most frequently when they are premenstrual.
Evidence supporting this recommendation is of class: R
Home Care Recommendations
- Topical medications should be applied to dry skin.
- Try to avoid abrasive soaps, cleansing granules, astringents, and vigorous scrubbing.
- Under normal circumstances, wash no more than two times a day with your fingertips or a soft wash cloth.
- Patients who are treated with acne medications often develop dry skin. Use fragrance-free, non-comedogenic, oil-free moisturizers. These moisturizers will not clog pores and therefore should not cause black- or whiteheads.
- For patients who choose to use makeup to cover their acne lesions, a water-based, non-comedogenic makeup should be used. Avoid oil-based cosmetics. Use makeup sparingly.
- Do not cover acne with bandages or tight fitting clothing.
- If a topical retinoid or photosensitizing antibiotics are prescribed, recommend staying out of the sun as much as possible and stress the use of sunscreens.
Evidence supporting this recommendation is of class: R