Acne is an extremely common condition, affecting 17 million people in the U.S. It generally begins in puberty when male sex hormones, or androgens, increase in both girls and boys. Acne can damage self-esteem and even cause depression in affected individuals. 

 

People with acne should wash with a mild cleanser once or twice a day, shampoo oily hair daily and keep hair off the face. They should not pick at or squeeze pimples, touch the face or wear heavy cosmetics. Over-the-counter medications containing benzoyl peroxide, resorcinol, sulfur or salicylic acid may improve acne by drying skin oils, killing bacteria or causing the skin to peel slightly.

Contact a physician if over-the-counter medicines are not effective after several months, cysts are present, acne worsens or scars develop. Acne is not a serious health concern in itself, and its mild and moderate forms usually respond to treatment by a general practitioner. Severe cases of acne warrant a referral to a dermatologist. The physician will ask questions concerning skin care, diet, medications and past treatment. He or she will examine the areas of the skin affected by acne for inflammation and scarring.

Treatment will most likely include topical or systemic medications. Topical medications include creams, lotions or solutions of benzoyl peroxide, retinoids and antibiotics. Systemic medications are taken orally and include the commonly prescribed antibiotics doxycycline, minocycline and tetracycline. Antibiotics are generally effective; however, one type of bacterium implicated in severe acne, Propionibacterium acnes, is reportedly becoming resistant to them. 

Severe cystic acne may warrant prescription of isotretinoin, or Accutane, to prevent scarring. Isotretinoin effectively clears acne in 90 percent of patients; however, major undesirable side effects warrant discussion with the physician. Pregnant women should not take isotretinoin because it causes serious birth defects.

When skin has already been scarred by acne, there are procedures to help lessen their appearance. Chemical peels that cause the skin to blister and then peel off are useful to reduce minor scarring. More severe cases of scarring may require dermabrasion or microdermabrasion, procedures in which a rotating brush removes layers of skin. Laser resurfacing is also used to remove the top layers of skin to reduce the appearance of scars. 

Acne usually responds to a physician's treatment in six to eight weeks. Though acne generally goes away after the teen years, it may last well into middle age, appearing during times of stress and hormonal fluctuation. The psychological and social impact of acne can be substantial, especially in the teen years, so it is important to take this condition seriously.