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Pimples
By peace | October 27, 2005
Most people get pimples at some time in their life - that’s just the way it is. Whether you’re a teenager, young adult, or even advanced in years, pimples will likely make an appearance. And if you’re like most people, you’ll reach for your over-the-counter pimple cream, dab it on your pimples and wait for them to go away. But that’s just treating the symptom after it appears, rather than preventing the outbreak of pimples in the first place.
You see, by the time a pimple appears on your skin, it has been forming under the skin for about two weeks. Using over-the-counter pimple treatments on existing pimples does little to prevent or treat new pimples forming under the skin. These pimple products mainly use salicylic acid or benzoyl peroxide to treat pimples you see, which is fine, but have little effect on what causes pimples to form in the first place.
What Causes Pimples?
A number of things contribute to the formation of pimples. The main factor is the abnormal flaking of cells inside a hair follicle, which leads to the formation of a plug. This plug can grow and even rupture the hair follicle. A ruptured hair follicle dumps its load of oil and debris into the skin, which leads to swelling, redness and pimples.
Bacteria that normally live on the skin also play a role in causing pimples. The bacteria, known as P. acnes, produce substances that cause redness and inflammation. They also make enzymes which turn the sebum from oil glands in the skin into irritants which can make the inflammation worse, resulting in the formation of pimples.
Another factor in the creation of pimples is the presence of androgens, which are male hormones found in both men and women, although their levels are higher in males. These androgens enlarge the sebaceous glands in the skin and cause them to increase their production of sebum. This increased sebum forms plugs and feed the bacteria which causes pimples to grow.
While over-the-counter treatments containing benozyl peroxide, salicylic acid, or glycolic acid may be helpful in treating occasional outbreaks of pimples or mild cases of acne, they do little to treat and prevent these underlying causes of pimples and acne.
WHEN TO SEE YOUR DOCTOR
- Over-the-counter acne medicines aren’t helping.
- Your pimples are forming scars after they heal.
What Your Symptom Is Telling You
Acne usually begins in adolescence, when hormones start to rage. Along with producing major bodily changes like the appearance of a beard or breasts, those hormones can also produce oil. With the extra, thicker oil supply, the tiny ducts leading from the oil glands to the surface of the skin can become narrowed or clogged.
Sometimes, oil gets caught at a pore’s opening, and when it hits the air, it oxidizes and turns dark, forming a blackhead. Those irritating dark spots are not from inadequate cleansing, dermatologists say. You could wash your face six times a day and still be prone to blackheads. When oil can’t escape a plugged-up pore, a small white cyst, known as a whitehead, may form. Either a blackhead or a whitehead can become infected, producing the inflammation and redness of an acne pimple.
But the raging hormones of youth aren’t the only cause of problem complexion. External oils on your skin — greasy cleansers, hair products or cosmetics, or even oils you encounter at work — may cause pimples. Stress plays a part, too. Some researchers say that chemicals released by the skin during stress can worsen inflammation.
Acne in adults is essentially the same as the plague of adolescents. Older skin tends to react a little differently, producing deeper lesions and fewer whiteheads and blackheads. Another kind of acne is unique to adults. It’s called rosacea or “the curse of the Celts”. This is a skin condition common among rosy-cheeked people of Scotch-Irish descent. These people have a tendency to flush easily, and the increased blood flow to the skin overstimulates oil glands. Over time, this condition can produce acne-like pimples.
Symptom Relief
There’s a lot you can do on your own to clear up pimples.
1. Use the right OTCs.
Over-the-counter preparations can be a big help with acne, if you know which ones to use, dermatologists say. Oxy-5, Oxy-10 and Clearasil contain benzoyl peroxide, which fights infection and promotes drying, says Ralph Coskey, M.D., a clinical professor of dermatology at Wayne State University School of Medicine in Detroit.
2. Handle with care.
Gentle cleaning is the watchword for acne. Twice a day, cleanse your skin with an antibacterial soap. Don’t use abrasive scrubs — they can make acne worse. Avoid astringents — Astringents can be irritating, causing the follicles to swell and leading to further breakouts.
3. Soak, but don’t pick.
Warm compresses can ease acne inflammation — Dip a washcloth in warm water, wring it out and apply it to the affected area for 20 minutes twice a day. Avoid the temptation to pick at the lesions, which can cause scarring.
4. Use nonclogging makeup.
Use only cosmetics labeled “noncomedogenic“, which won’t clog pores.
5. Soothe your stress.
Studies show that stress may be part of your skin problem. Removing the sources of stress from your life, along with daily relaxation techniques and exercise, will ease the stress that can aggravate acne.
6. Don’t touch.
Touching your face frequently only encourages inflammation.
Help from the Doctor
Fortunately, even the worst case of acne can be temporary. Here’s how your dermatologist can help.
1. Open the pores.
A form of vitamin A called tretinoin (Retin-A) has gotten a lot of press for its ability to reduce wrinkles. But the primary mission of Retin-A is to treat acne by peeling away the buildup of skin in clogged pores. Your doctor can prescribe Retin-A for as long as you’re troubled with acne. At first your skin may be irritated, but your doctor can adjust the dose to the concentration that’s right for you. Another side effect of Retin-A is increased sensitivity to the sun. If you’re using Retin-A, apply a nongreasy sunscreen with an SPF (sun protection factor) of 30 every time you go outdoors. Check labels. You should look for a gel-type sunscreen that contains alcohol.
2. Kill bacteria.
For persistent acne, dermatologists often prescribe benzoyl peroxide medicines to be applied to the skin. Benzoyl peroxide cuts down bacterial activity in the pores, and also produces a mild amount of peeling.
3. Ask about antibiotics.
Your doctor may also prescribe antibiotic creams or lotions to cut down on skin bacteria. The normal bacteria in your skin break oil down into fatty acids, which may cause inflammation. For more severe lesions, your doctor may prescribe oral antibiotics.
4. Peel pimples away.
Fruit acids called alpha-hydroxy acids are effective new weapons in the acne-fighting arsenal. A light chemical peel gives fairly quick control over acne. It may take two or three light peels, repeated monthly. Your dermatologist will apply a diluted solution of glycolic acid in the office. You will feel stinging and burning for about 30 minutes and experience some initial redness and swelling. If you have the peel done on a Friday, by Monday you’ll have only mild flaking, which makeup can cover.
5. Zap them with zinc.
Prescription zinc creams, sometimes mixed with an antibiotic such as erythromycin, may slow the inflammatory process and aid in healing.
6. Approach Accutane with caution.
Accutane is a powerful prescription drug for severe cystic acne that doesn’t respond to any other treatment. But Accutane can cause birth defects and must be used with extreme caution in women of child-bearing age. If you’re a woman using Accutane, your doctor will require that you use a reliable method of birth control and that you be tested regularly for pregnancy. Other side effects often associated with Accutane are extremely dry skin, nosebleeds, dry eyes, muscle aches and elevated triglycerides and cholesterol. Accutane therapy lasts for 16 to 20 weeks, and is 80 percent effective for severe acne.
January 25th, 2008 at 2:04 pm
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