What is Acne?

Acne is a skin condition which consists of clogged pores (blackheads and whiteheads), inflamed pimples (pustules), and deeper lumps (nodules). It occurs on the face, as well as the neck, chest, back, shoulders, and upper arms. Although most teenagers get some form of acne, adults in their 20’s, 30’s, 40’s, or even older can develop acne. Often acne clears up after several years, even without treatment. However, acne can be disfiguring and upsetting to the patient. Untreated acne can leave permanent scars; these may be treated by your dermatologist in the future. To avoid acne scarring, treating acne is important.

What causes acne?

Normally dead skin cells are shed from the surface of the skin every day. Normal skin also produces sebum, which is an important oil that keeps our skin from drying out. When sebum production is increased during certain phases of life, the excess oil can cause the dead skin cells to stick together inside the pore. Instead of being shed, the cells become trapped inside the pore.

One type of bacteria that lives on everyone’s skin is called P. acnes. Inside the pores, the bacteria have a perfect environment for multiplying very quickly, especially if there is a lot of oil in the pores. When hormones change at puberty, oil production increases in the skin. The combination of bacteria and oil in the pores is very irritating to the surrounding skin so the pore becomes inflamed (red and swollen). Sometimes the inflammation can damage the lining of the pore and then the inflammation goes deep into the skin, causing an acne cyst or nodule to appear.

What are the benefits of acne treatment?

Treatment has many benefits. If you have severe acne, which consists of deep and often painful lumps called cysts and nodules, effective acne treatment may prevent acne scars. Clearing acne usually improves a person’s self-esteem. Some patients say they feel happier and more confident.

If you want to treat acne, it is important to have realistic expectations. Misinformation about acne treatment is widespread. Here are five important facts about acne treatment that you should know:

  • It takes time to see results (at least 4 to 8 weeks).
  • “Overnight results” or an “immediate cure” is not possible.
  • Treatment may help to clear existing acne faster, but works best to prevent new breakouts.
  • To continue seeing results, you must continue treating acne even after your skin has cleared.
  • When red acne bumps go away, they often leave red or brown flat marks which will gradually go away over several months. These are not necessarily permanent scars.

When is Accutane used?

Accutane is a unique, very effective acne medication which has been available for nearly 30 years. It works by temporarily shrinking the oil (sebaceous) glands, thus “starving” the acne. Because it causes birth defects if female patients become pregnant while taking this drug, it’s use is limited to those patients who have failed other treatments or who have more severe acne. A course of treatment with Accutane (isotretinoin) is usually 4-8 months depending on dosing, response to treatment, weight of the patient and tolerance of side effects. Because Accutane shrinks the oil glands of the skin, dry lips/nose/eyes can be a problem. These common side effects are usually easy to control.

How can patients assure the best result from treatment?

Treating acne is a team effort, and following through with the recommended treatment is the most important part of this teamwork. The most common cause of treatment failure is failure to use the prescribed medication. Treatment is usually very successful and can make the patient look and feel better as well as preventing scars.