Oct. 23, 2003
Dr. Greg Vercellotti appeared Oct. 23, 2003 on the KARE-11
Today Show to discuss Acne. Information from the program is summarized below.
Q: What can be done to minimize the effects of
acne on teenagers?
Are there ways to prevent or control acne?
Vercellotti:
Dermatologists estimate 17 million people in the United States have acne,
making it one of the most common skin diseases. The condition typically peaks
during adolescence, but about 12 percent of women and 3 percent of men will
experience acne up until age 44. While its not life threatening, it can have a
lasting impact by leaving scars.
There are multiple types of acne. The condition is caused by
pores that become clogged. The skins oil glands produce a substance called
sebum, which collects in hair follicles. That irritates the follicles, which
shed a substance called keratin. Thats when the whorled process, or small bump
associated with pimples, starts to form. Once the plug breaks through the
surface of the hair follicle, a patient can start to see whats commonly called
a blackhead.
More severe cases of acne, like acne fulminans, produces
nodular cysts that can drain and be painful. This variety tends to be more
frequently associated with scarring.
There are other varieties, too. About 20 percent of healthy
babies get neonatal acne. Babies can get infantile acne up to six months old
before it typically goes away. Sometimes teenagers and adults will get acne
mechanica, which is caused by irritation of the skin from constant rubbing.
People who wear bicycle helmets or protective padding for football often
develop pustules or blackheads on places like their hairline or on their
shoulders. Occupational exposures to certain chemicals used to treat wood or
manufacture electrical conductors can promote acne as well.
Sometimes acne can be drug-induced. Some medications that
contain or promote production of the hormone testosterone tend to aggravate
acne.
Key Points
- Adolescents
go through cognitive, social, and emotional changes along with physical
development.
- Teenagers
have a sense of being on stage before an imaginary audience, making them
feel like theyre on display before their peers. They dont realize that
other students feel the same way. Having acne can heighten that sense of embarrassment,
making them feel like everyone notices their pimples. In reality, other
adolescents are preoccupied with their own self-image and probably do not
notice.
- At
the same time, teenagers are also going through a cognitive change called
the phenomenon of normal egocentrism. The attitude its all about me or
the world revolves around me stems from this development. Even though
other kids might be going through the same changes, they have a sense that
theyre the only ones who know what its like.
- Then
there are the social changes. Teenagers begin to develop a strong sense of
peer involvement and belonging. Having acne can make some feel ostracized
because they see themselves as different from others.
- For
children with moderate to severe cases of acne, parents should gently
bring up the subject by asking them about their skin care regimen and if
theyd like to talk to a doctor. If a teenager says no, a parent can say
Thats fine, but let me know if you change your mind.
Myths
According to the American Academy of Dermatology, there are
several myths about acne. Studies have shown that acne is not caused by eating
foods like chocolate, pizza or caffeinated beverages. Stress can aggravate the
condition, but everyday stress does not induce acne. Dermatologists recommend
those with pimples or zits avoid squeezing them to make them go away; chances
are it will make the blemishes worse. Contrary to popular belief, exposure to
the sun will not help acne heal.
Immediate steps
- Avoid
getting sunburned. Exposure to ultraviolet light is harmful to skin and
will not help clear up acne.
- Choose
cosmetics carefully. Pick foundations, powders and blushes that do no
contain oil.
- Shave
carefully. Shaving can irritate skin and cause inflammation of the oil
glands.
- Wash
your face two to three times a day. Washing more frequently can dry out
skin and cause irritation.
Remedies
Acne that produces blackheads and so-called whiteheads are
relatively easy to treat with topical solutions containing benzoyl peroxide,
which helps kill Propionibactium acnes, the bacteria that causes acne. Some
over-the-counter products and prescription creams, gels, and solutions contain
this ingredient. Those containing ingredients like salicylic acid, sulfur,
resocinal can help break down blackheads and whiteheads. It can take up to
eight weeks for skins appearance to improve. Sometimes, a physician will
prescribe antibiotics to treat the condition as well.
More serious cases, such as cystic acne, require treatment
by a dermatologist. One medication is called Accutane. In 90 percent of
patients who complete a 15- to 20-week course of the drug, acne disappears.
The use of Accutane is highly regulated because it has been
associated with birth defects, and female patients are required to sign
informed consent forms before taking the medication. In some cases, Accutane
has been associated with depression and suicidal tendencies. Those who
experience symptoms should immediately contact a doctor.
For women, some types of oral contraceptives have been
proven to help clear up acne. Ortho Tricycline has been approved specifically
for the treatment of acne, but other brands have been shown to work as well.
Additional Information
American Academy of Dermatology:
http://www.skincarephysicians.com
National Institute of Arthritis and Musculoskeletal and Skin
Diseases
http://www.niams.nih.gov
The Health Talk &
You Web site provides general information on health-related topics. The information
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medical advice. Specific advice on diagnosing or treating a health care problem
should be obtained from a health care provider. Visit
University of Minnesota Physicians for a list of medical specialties at the
University of Minnesota, or call 612-672-7422.
