Acne
(Pimples)

Skin Problems Slideshow

Medical Author (Revision): Alan Rockoff, MD
Medical Editor (Revision): Melissa Conrad Stöppler, MD

• What is acne?
• What causes acne?
• What other skin conditions can mimic acne?
• When should you start to treat acne?
• What can you do about acne on your own?
• What are other things you can do for acne?
• What is a good basic skin regimen for people with acne?
• What can the doctor do for acne?
• How would you sum up current day treatment of acne?
• Pictures of Skin Problems - Slideshow
• Related acne articles:
  Acne - on eMedicineHealth

What is acne?

Acne is not just a problem for teenagers, it can affect people from ages 10 through 40. It is not unusual for women, in particular, to develop acne in their mid-to-late 20's, even if they have not had breakouts in years (or ever). Acne can appear as any of the following;

• congested pores,
• whiteheads,
• blackheads,
• pimples,
• pustules, or
• cysts (deep pimples).

These blemishes occur wherever there are many oil (sebaceous) glands, mainly on the face, chest, and back.

You can do a lot to treat your acne using products available at a drugstore or cosmetic counter, that do not require a prescription. However, for tougher cases of acne, you should consult a physician.

What causes acne?

No one factor causes acne. Acne happens when oil (sebaceous) glands come to life around puberty stimulated by male hormones from the adrenal glands of both boys and girls. Oil is a natural substance which lubricates and protects the skin, and under certain circumstances, cells that are close to the surface block the openings of sebaceous glands and cause a buildup of oil underneath. This oil stimulates bacteria, (which live in everyone's skin and generally cause no problems), to multiply and cause surrounding tissues to become inflamed.

If the inflammation is right near the surface, you get a pustule; if it's deeper, a papule (pimple); deeper still and it's a cyst. If the oil breaks though to the surface, the result is a "whitehead." If the oil becomes oxidized (that is, acted on by oxygen in the air), the oil changes from white to black, and the result is a "blackhead."

Some factors that don't usually cause acne, at least by themselves are:

• Heredity: With the exception of very severe acne, most people do not have the problem exactly as their parents did. Almost everyone has some acne at some point in their life.
• Food: All over the world, parents tell teens to avoid pizza, chocolate, greasy and fried foods, and junk food. While these foods may not be good for overall health, they don't cause acne or make it worse.
• Dirt: Some individuals have more "oily" skin than others (as mentioned above, "Blackheads" are oxidized oil, not dirt). Sweat does not cause acne, therefore, it is not necessary to shower instantly after exercise for fear that sweat will clog pores. On the other hand, excessive washing can dry and irritate the skin.
• Stress: Some people get so upset by their pimples that they pick at them and make them last longer. Stress, however, does not play much of a direct role in causing acne.
• Hormones: Some women break out cyclically, but most women (and men) don't. Some oral contraceptive pills may help relieve acne, but unless a woman has abnormal menstrual periods and excessive hair growth, it's unlikely that hormones play much of a role in causing acne.
• Cosmetics: Most cosmetic and skin care products are not pore-clogging (“comedogenic.”) Of the many available brands, those which are listed as “water-based” or “oil-free” are generally a better choice.

In occasional patients, contributing factors may be:

• Pressure: In some patients, pressure from helmets, chinstraps, collars, and the like can aggravate acne.
• Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone or the steroids bodybuilders or athletes take.) Most cases of acne, however, are not drug-related.
• Occupations: In some jobs, exposure to industrial products like cutting oils may produce acne.

Acne (Pimples) - Length Symptoms Lasted

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