What is acne?

Acne occurs when the pores of your skin become clogged, most often on the face, neck, back, and chest. No one knows exactly why this happens, but we do know that testosterone plays a part, as does heredity.1-5

Once a pore becomes clogged, it traps skin oil inside. Bacteria grows in this oil and can cause an inflammatory response in the skin. Acne lesions can be small and hardly noticeable, have a small white or black head, or can appear red with a white/yellow center. Sometimes a clogged pore will become so inflamed that it can lead to larger, more painful lesions called nodules or cysts, which can ultimately scar. Almost no one escapes some clogged pores and pimples, especially during adolescence--a fragile time when self-esteem and confidence is just emerging.9-10 Acne afflicts people of all ethnicities and is treated the same regardless.† 11-15

Our skin is healthiest and clearest when it is in balance. The more irritation your skin experiences, the more likely it is to break out. Conversely, the less irritation your skin experiences, the better it is able to remain clear. Sources of irritation include anything which rubs, scratches, or comes into prolonged contact with your skin, as well as anything which sends your skin out of balance such as overdryness, sunburns, shaving the face with irritating razors, and pore-clogging cosmetics. To best clear acne, try to keep your skin as untouched as possible. Acne is not caused by dirt, and washing your face, while it is fine to do up to twice per day, is going to do little to help with your acne.

Finally, popping pimples is not off limits. None of us likes to walk around with puss filled pimples. Done correctly, properly popping can actually help hasten healing. However, whatever you do, do not pick at your skin.6-8

How to treat acne

Treatment must continue until your body outgrows the disease, which the majority of people do for the most degree after adolescence.16-17 Aside from Accutane (isotretinoin), there is no other oral or topical treatment for acne which produces long lasting remission of acne symptoms.18 However, ongoing treatment can get the skin completely clear and keep it that way for years if need be.

2.5% Benzoyl Peroxide

The most effective treatment aside from Accutane (isotretinoin) is benzoyl peroxide, which has been a mainstay of acne treatment since the 1930s, and for good reason. It is the only medication which can penetrate into the skin and deliver oxygen.19 Acne bacteria cannot live in the presence of oxygen, and benzoyl peroxide kills 99.9% of them almost instantly.20 For benzoyl peroxide to completely clear acne, it must be applied as outlined in The Acne.org Regimen: generously, and in 2.5% strength. Applying in this fashion allows most people to completely suppress acne symptoms until their bout of acne naturally subsides.
The Acne.org Regimen »

Accutane (isotretinoin)

For severe, widespread, and potentially scarring acne, Accutane is an option. Isotretinoin is a systemic oral treatment which is taken for 15-20 weeks and produces long-term remission of acne symptoms in about 66% of people, but comes with a large range of side effects including severe birth defects, and must be administered in close partnership with your physician.21-22
Accutane (isotretinoin) »

Many other topical and oral treatments exist for acne, some producing moderate to good results. Home remedies, however, do not tend to deliver on their promises.

References

† Women of Asian heritage and men and women of African heritage can respond to some antibiotics differently – if you fit into any of these categories, check with your physician if you decide to take antibiotics for your acne.

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    American Family Physician. 2012: 86(8): 734-40.
  2. Bataille V, et al. ”The use of the twin model to investigate the genetics and epigenetics of skin diseases with genomic, transcriptomic and methylation data.“
    Journal of the European Academy of Dermatology and Venereology. 2012: 26(9): 1067-73.
  3. Kligman AM and Plewig G.
    Acne and Rosacea. Berlin: Springer, 2000.
  4. Chen WC and Zouboulis CC. "Hormones and the pilosebaceous unit."
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  14. Halder RM and Nootheti PK. "Ethnic Skin Disorders Overview."
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  15. Davis EC and Callender VD. "A review of acne in ethnic skin: Pathogenesis, clinical manifestations, and management strategies."
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  16. Cunliffe WJ, Goulden V and Stables GI. "Prevalence of Facial Acne in Adults."
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    The Journal of Dermatological Treatment. 2012 Jul 25.
  20. Savage L and Layton A. "Treating Acne Vulgaris: Systemic, Local and Combination Therapy: Benzoyl Peroxide."
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  21. Ganceviciene R and Zouboulis CC. "Isotretinoin: State of the art treatment for acne vulgaris."
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