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Last Updated: Oct 23, 2019
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Acne (Pimples)- Myths and Facts

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Dr. Neeti KumariDermatologist • 15 Years Exp.MBBS, MD - Dermatology & Venereology
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What is acne?
Acne [pimples] is an inflammatory skin disease, which affects millions of people throughout the world. The eruptions usually occur on the face, but can also affect the arms, back and chest.

What causes acne? 
The oil producing glands in the skin are called the sebaceous glands. The hormone testosterone acts on these glands at puberty leading to increased secretion of sebum. The dead cells, bacteria and sebum form a plug at the outlet of the pilosebaceous follicle. The plug formed on the surface of the skin appears as a black dot-the ‘ blackhead’. If the plug remains just below the skin it appears as a whitish elevation-the ‘whitehead’. Sometimes, the plugged follicle bursts or becomes inflamed leading to the formation of small or large solid bumps, pus pimples [pustules] and cavities containing a sticky fluid [cysts]. 

When does acne start?
Acne usually starts with comedones at puberty i. E. Between 10 and 12 years of age, when the greasiness of the skin starts. It affects both boys and girls. Severe acne leading to scarring can occur in both sexes though commoner in men. Acne often reaches its peak between 13 and 19 years of age. Later it generally starts subsiding, though it may persist until the early or mid-twenties. Sometimes acne starts or reappears in mid-thirties when hormonal influences play a major role.

Is it hereditary?
When a person suffers from severe acne it is often found that one or both of his or her parents have had it like this; however this is not always so.

Does diet influence acne?
High caloric food can trigger or exacerbate existing acne. But here I want to put the fact that a high glycemic index diet act as single edged sword but milk and milk products act as double edged sword. So if you have serious type acne then you have to give up your love for milk. And also if if you are convinced that a particular food exacerbates acne then it might be worthwhile avoding the same. Have healthy food habits and eat a lot of fresh fruits, vegetables, salads and drink a lot of water. 

Do I have to avoid cosmetics if I have acne?
 Greasy [oil based cosmetics] block the pores on the skin and tend to bring on or increase preexisting acne. The same applies to moisturizers that are too heavy and may block the skin pores. A sudden bout of acne following facials, clean-up, bleaching ect…is common.

Can drugs cause acne? 

Pills [oral contraceptives] can sometimes aggravate acne. Steroids, inh [given for tuberculosis] and anti-epileptics like phenobarbitone can produce acne. Topical steroids applied on the face often triggers acneform eruptions after they are withdrawn.

Are there any other predisposing factors?
A shower of new lesions often occurs a few days prior to the onset of menstruation in females. Tight fitting jeans may occlude the ducts leading to acne on the buttocks and thighs. Prolonged wearing of helmets can lead to pimples on the forehead. Both acne and dandruff occur on greasy skin and can coexist.

Why should acne be treated at all?

Acne can produce pustules and cysts, which can lead to pemanent disfiguring scars if left, untreated. Acne can scar not only the skin but also the psyche. It can produce low self-esteem, self-consciousness, anxiety, depression and introvert personality. Clear skin helps tremendously in boosting the self-confidence of an individual.

What is the right treatment for acne? 
Consult your dermatologist for a proper scientific treatment. There are some general instructions to be followed by the patients: 
1) wash your face 3-4 times daily with soap and water.
2) the scalp should be cleansed 2-3 times a week preferably with shampoo.
3) avoid all greasy cosmetics on the face.
4) do not squeeze pimples. It can cause severe scarring.

There are several topical agents and oral medications available for successful treatment which your doctor will decide. You may need long courses of antibiotics for several months in severe acne. For resistant, severe recalcitrant acne your doctor may suggest a medication called isotretinoin.

But you should have a lot of patience and take medications and take medications in the correct doses prescribed and for a proper length of time. Remember that it might take several weeks for acne medication to take effect and the face to clear.

 I ignored my acne and now I have scars. Can you do something for my scars? 
It is always better to prevent scars by proper and early treatment of severe acne. Your doctor will advise you on treatment available for marks

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