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Frequently Asked Questions About Acne
Acne is a very common disease. People
who have it tend to have similar kinds of questions about it and its
treatment. This section addresses some of the common questions asked
by people with acne. Please remember that your dermatologist is
always the best source of specific information about your individual
health issues, including acne.
Click on a specific question to go
directly to the answer to that question, or you can read through all
the questions.
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What causes acne?
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I wash my face several
times a day. Why do I still get acne?
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Does stress cause acne?
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I never had acne as a
teenager. Why am I now getting acne as an adult?
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What role does diet play
in acne?
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Does the sun help acne?
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What is the best way to
treat acne?
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What kind of cosmetics
can an acne patient use?
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Is it harmful to squeeze
my blemishes?
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Can anything be done
about scarring caused by acne?
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How long before I see a
visible result from using my acne medications?
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Would using my
medications more frequently than prescribed speed up the clearing
of my acne?
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My topical treatment
seems to work on the spots I treat, but I keep getting new acne
blemishes. What should I do?
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My face is clear! Can I
stop taking my medication now?
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Does it matter what
time I use my medications?
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I have trouble
remembering to take my oral medication every day. What's a good
way to remember? What should I do if I forget a dose?
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What causes acne?
The causes of acne are linked to the
changes that take place as young people mature from childhood to
adolescence (puberty). The hormones that cause physical maturation
also cause the sebaceous (oil) glands of the skin to produce more
sebum (oil). The hormones with the greatest effect on sebaceous
glands are androgens (male hormones), which are present in females
as well as males, but in higher amounts in males.
Sebaceous glands are found together with a hair shaft in a unit
called a sebaceous follicle. During puberty, the cells of the skin
that line the follicle begin to shed more rapidly. In people who
develop acne, cells shed and stick together more so than in people
who do not develop acne. When cells mix with the increased amount
of sebum being produced, they can plug the opening of the
follicle. Meanwhile, the sebaceous glands continue to produce
sebum, and the follicle swells up with sebum.
In addition, a normal skin
bacteria called P. acnes,
begins to multiply rapidly in the clogged hair follicle. In the
process, these bacteria produce irritating substances that can
cause inflammation. Sometimes, the wall of the follicle bursts,
spreading inflammation to the surrounding skin. This is the
process by which acne lesions, from blackheads to pimples to
nodules, are formed.
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I wash my face several
times a day. Why do I still get acne?
Many people still believe that acne
is caused by dirty skin. The truth is, washing alone will not
clear up or prevent acne. Washing does, however, help remove
excess surface oils and dead skin cells. Many people use all kinds
of products, including alcohol-based cleansers, and scrub
vigorously, only to irritate the skin further and worsen their
acne. Washing the skin twice a day gently with water and a mild
soap is usually all that is required. However, acne is actually
caused by a variety of biologic factors that are beyond the
control of washing. For that reason, you should use appropriate
acne treatments for the acne.
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Does stress cause acne?
Stress is commonly blamed for the
development of acne. Stress can have many physiologic effects on
the body, including changes in hormones that may theoretically
lead to acne. In some cases the stress may actually be caused by
the acne lesions, not the other way around! If the acne is being
treated effectively, stress is not likely to have much impact on
the majority of people.
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I never had acne as a
teenager. Why am I now getting acne as an adult?
Usually, acne begins at puberty and is gone by the early 20s. In
some cases, acne may persist into adulthood. Such types of acne
include severe forms that affect the body as well as the face
(which afflict males more than females) and acne associated with
the menstrual cycle in women. In other cases, acne may not present
itself until adulthood. Such acne is more likely to affect females
than males.
There are several reasons for this. As females get older, the
pattern of changes in hormones may itself change, disposing
sebaceous glands to develop acne. Ovarian cysts and pregnancy may
also cause hormonal changes that lead to acne. Some women get acne
when they discontinue birth control pills that have been keeping
acne at bay. Sometimes young women may wear cosmetics that are
comedogenic-that is, they can set up conditions that cause
comedones to form.
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What role does diet play
in acne?
Acne is not caused by food. Following
a strict diet will not, clear your skin. While some people feel
that their acne is aggravated by certain foods, particularly
chocolate, colas, peanuts, shellfish and some fatty foods, there
is no scientific evidence that suggests food causes or influences
acne. Avoid any foods which seem to worsen your acne and, for your
overall health, eat a balanced diet--but diet shouldn't really
matter if the acne is being appropriately treated.
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Does the sun help acne?
Many patients feel that sunlight
improves their acne lesions and go to great lengths to find
sources of ultraviolet light. There is no proven effect of
sunlight on acne. In addition, ultraviolet light in sunlight
increases the risk of skin cancer and early aging of the skin. It
is, therefore, not a recommended technique of acne management,
especially since there are many other proven forms of treatment
for acne. Moreover, many acne treatments increase the skin's
sensitivity to ultraviolet light, making the risk of ultraviolet
light exposure all the worse.
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What is the best way to
treat acne?
Everyone's acne must be treated
individually. If you have not gotten good results from the acne
products you have tried, consider seeing a dermatologist. Your
dermatologist will decide which treatments are best for you. For
more information about the types of acne treatments that are
available, and for basic acne treatment guidelines, please see
Acne Treatments in the main part of
AcneNet.
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What kind of cosmetics
and cleansers can an acne patient use?
Look for "noncomedogenic" cosmetics
and toiletries. These products have been formulated so that they
will not cause acne.
Some acne medications cause
irritation or pronounced dryness particularly during the early
weeks of therapy, and some cosmetics and cleansers can actually
worsen this effect. The choice of cosmetics and cleansers should
be made with your dermatologist or pharmacist.
Heavy foundation makeup should be
avoided. Most acne patients should select powder blushes and eye
shadow over cream products because they are less irritating and
noncomedogenic. Camouflaging techniques can be used effectively by
applying a green undercover cosmetic over red acne lesions to
promote color blending.
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Is it harmful to squeeze
my blemishes?
Yes. In general, acne lesions should
not be picked or squeezed by the patient. In particular,
inflammatory acne lesions should never be squeezed. Squeezing
forces infected material deeper into the skin, causing additional
inflammation and possible scarring.
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Can anything be done
about scarring caused by acne?
Scarring is best prevented by getting
rid of the acne. Dermatologists can use various methods to improve
the scarring caused by acne. The treatment must always be
individualized for the specific patient. Chemical peels may be
used in some patients, while dermabrasion or laser abrasion may
benefit others. It is important that the acne be well controlled
before any procedure is used to alleviate scarring.
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How long before I see a
visible result from using my acne medication?
The time for improvement depends upon
the product being used, but in almost all cases it is more a
matter of weeks or months instead of days. Most dermatologists
would recommend the use of a medication or combination of
medications daily for 4 to 8 weeks before they would change the
treatment. It is very important for patients to be aware of this
time frame so they do not become discouraged and
discontinue their medications. Conversely, if you see no change
whatsoever, you might want to check with your dermatologist
regarding the need to change treatments.
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Would using my
medication more frequently than prescribed speed up the clearing
of my acne?
No--always use your medication
exactly as your dermatologist instructed. Using topical
medications more often than prescribed may actually induce more
irritation of the skin, redness and follicular plugging, which can
delay clearing time. If oral medications are taken more frequently
than prescribed, they won't work any better, but there is a
greater chance of side effects.
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My topical treatment
seems to work on the spots I treat, but I keep getting new acne
blemishes. What should I do?
Topical acne medications are made to
be used on all acne-prone areas, not just individual lesions. Part
of the goal is to treat the skin before lesions can form and to
prevent formation, not just to treat existing lesions. Patients
are generally advised to treat all of the areas (forehead, cheeks,
chin and nose) that tend to break out rather than just individual
lesions.
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My face is clear! Can
I stop taking my medication now?
If your dermatologist says you can
stop, then stop--but follow your dermatologist's instructions.
Many times patients will stop their medication suddenly only to
have their acne flare up several weeks later. If you are using
multiple products, it may be advisable to discontinue one
medication at a time and judge results before discontinuing them
all at once. Ask your dermatologist before you stop using any of
your medications.
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Does it matter what time
I use my medication?
Check with your dermatologist or
pharmacist. If you were taking one dose a day of an antibiotic,
you could probably take it in the morning, at midday or in the
evening, although you should pick one time of day and stay with it
throughout your treatment. With oral medications prescribed twice
a day or three times a day, you should try your best to spread out
the doses evenly. Some antibiotics should be taken on an empty or
nearly empty stomach. For optimal results with topical treatments,
you should strictly follow your dermatologist's recommendations.
For example, if instructed to apply benzoyl peroxide in the
morning and a topical retinoid at bedtime, it is important to
follow these directions strictly. If the two were applied together
at bedtime, for example, you could decrease the efficacy of the
treatment because of chemical reactions that make them less
effective.
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I have trouble
remembering to take my oral medication every day. What's a good
way to remember? What should I do if I forget a dose?
This is a common problem. Many
patients try to associate taking their medication with a routine
daily event such as brushing teeth or applying makeup. It also
helps to keep the medication close to the area where the reminder
activity is carried out.
In most cases, if you miss a day of
your oral treatment, do not double up the next day; rather, get
back to your daily regimen as soon as possible--but there may be
different instructions for different oral medications. Ask your
dermatologist or pharmacist about what to do if you miss a dose of
your particular medication.
More FAQs
All
content solely developed by the American Academy of Dermatology |
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Once acne significantly
improves or clears, continued treatment is needed to
keep acne from re-appearing. |
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