Who hasn’t had a blemish or two and often at the most inopportune time? Acne is most common in teens and young adults, but people of any age can have breakouts. “People can still have acne in their 60s and 70s,” says Dr. Alan Westheim, dermatologist at St. Luke’s Medical Associates of Monroe County in East Stroudsburg.
“We don’t fully understand what causes acne,” Westheim says. But it has nothing to do with dirty skin or eating greasy foods, he says. These are widely held misconceptions about acne, he says.
Genetics is believed to play a role in how easily your pores clog, Westheim says. Thanks, mom and dad!
Your skin can breakout when its pores become blocked with oil, dead skin or bacteria. Acne most commonly appears on your face, forehead, chest, upper back and shoulders. It affects these areas most because that’s where you have the most oil (sebaceous) glands, Westheim says.
People with acne, especially if it’s moderate to severe, should seek treatment for two important reasons, Westheim says. One is that people can become self-conscious with acne and may become anxious or depressed. Another reason is that left untreated, severe acne can leave scars that could be permanent, Westheim says.
Good news: The earlier you start treatment, the less likely you are to have emotional distress or scarring, Westheim says. More good news: very effective treatments are available for acne, he says.
Acne treatments aren’t one-size-fits-all, but working with your doctor, you should be able to find an effective treatment for you, Westheim says. Some treatments are available over-the-counter and some stronger medications require a prescription from a physician.
Topicals, antibiotics, hormones, light therapy
Your doctor may suggest starting with topical medications, Westheim says. Retinoid and retinoid-like topicals, which are derived from vitamin A, are available as creams, gels and lotions. They prevent pores from getting plugged.
Your doctor also may suggest topical antibiotics to be used with retinoids. If you have moderate to severe acne, you may be given oral antibiotics as well. However, oral antibiotics should be used for the shortest time possible to avoid resistance, Westheim says. “We try to limit them to three to six months.”
Some women may be given hormones, which includes birth control pills, to help treat acne, Westheim says. If oral antibiotics aren’t helping, women and teenage girls also may be given the drug spironolactone, which works by blocking the effect of androgens (“male” hormones present in men and women) on the sebaceous glands, he says.
Other treatments include laser and light therapy. This therapy, that reaches deep into the skin, targets the bacteria that causes acne, Westheim says. A drawback to light therapy is that it is not long-lasting and can be very expensive, he says.
In resistant cystic acne, a medication called isotretinoin may induce a remission that may last a lifetime, Westheim says. “However, because of potential birth defects use of this medication is restricted and must be monitored carefully in woman.”
Your doctor also might suggest chemical peels and microdermabrasion to improve scarring.
“There is no cure for acne,” Westheim says. “It is often cyclical. It waxes and wanes. You have to stay on your treatment long term. If you only do treatment when it bothers you, it will never really improve.”