Acne and Acne Treatments

Many people may think of acne as “having an occasional pimple” or “something teenagers deal with,” but the condition is actually far more complex. To understand the problem, it can be helpful to first take a look at what causes acne breakouts.

Our skin is covered with follicles, which are tiny pockets that each hold a single hair. The only parts of the skin without follicles are the palms, the soles of the feet, and the lips. While follicles on the scalp and in various body areas can grow thick and long hair, many follicles create only fine, thin vellus hairs, which are known as “peach fuzz.”

Our skin is also constantly shedding, with new cells being created in deeper layers, then slowly working their way up to the surface,where they eventually flake away. Unfortunately, when dead cells mix with natural oils on the surface, they can stop up follicles by blocking the opening, which is known as a pore.

The reason teenagers are associated with acne is because puberty is a time when the skin begins making more sebum. As hormone levels fluctuate, the skin can become especially oily, which can lead to more clogged follicles. Acne is also more common in pregnant women and women going through menopause, who have fluctuating hormones of their own, leading to hormonal pimples. Babies can also have acne, and newborn pimples are possible, but these should clear up on their own.

- Blackheads and Whiteheads

If a follicle blockage is exposed to the air, it oxidizes and turns dark, creating a small spot known as a blackhead. If it remains closed off from the air, it stays a light color, creating a whitehead.

These blackheads and whiteheads—medically called “open or closed comedones”—are generally not raised at all, but appear as spots in otherwise clear skin. They commonly develop on the nose, but can form just about anywhere on the body, including the chest and back.

- Papules and Pustules
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Sometimes, bacteria that live on the skin and eat the oil—known as sebum—can become trapped in the follicle. The plugged pore serves to create ideal conditions for the bacteria to thrive, grow, and multiply,prompting the body to send cells to fight the unwelcome guests.

Dead bacteria, dead white blood cells, and other debris will soon accumulate, filling the follicle and causing a bulge at the surface, where the pore is stopped up. Unlike blackheads and whiteheads, which are non-inflammatory lesions, these bacteria-fueled bumps are inflamed. If the pore remains closed, the lesion is known as a papule, which can be skin-colored or red. An eventual open pore at the top of the follicle can expose the light-colored pus inside, creating a pustule.

- A Note on “Popping”
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While you may be tempted to squeeze or “pop” anything from blackheads to pustules, it is important to leave acne alone. Scratching, picking at, or squeezing a lesion can make the inflammation worse, lead to infections, and spread the problem, resulting in a larger breakout, more frequent breakouts, and more severe results. As lesions grow, they can extend into deeper layers of skin, where they cause lasting damage that appears as a noticeable scar.

The occasional pimple can be left to resolve on its own, but widespread lesions and severe break outs should be managed with help from a skin-focused professional.

- Cysts and Nodules
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Large lesions that form as swelling numbers of bacteria and dead cells rupture the walls of a follicle are known as cysts and nodules. Afar cry from blackheads, these sub-surface lumps can be uncomfortable—and even painful. Nodules are solid, since the material inside has hardened and created a firm mass. A cyst is typically filled with fluid, though the pus can also congeal into a semi-solid state. Acne cysts may make the area feel tender or sensitive, and are considered the most severe form of the skin condition.

At Carroll Dermatology, the right acne treatment depends on the patient. What may work well for a teenager dealing with persistent breakouts may not be the same approach recommended for a pregnant woman in her 30s.

First and foremost, the Carroll Dermatology team encourages prevention in the fight against acne. A daily skincare regimen that involves gently cleansing the face goes a long way toward removing pore-clogging oil sand dead cells. There’s no need to scrub too hard or use harsh ingredients. A simple scrub in the morning and again at night is generally enough. Be sure to remove all makeup and other products before going to bed.

Patients who do have acne outbreaks have many medical dermatology options,including oral or topical antibiotics, hormone treatments, and a prescription oral medication known as spironolactone, which alters hormone levels in the body to adjust oil production and more.

Topical retinoids can help manage oil production and bacteria levels, and red or blue light treatments can also target bacteria and soother inflammation.

Two cosmetic dermatology treatments in particular—chemical peels and facials—are especially good at removing the dead skin cells and debris that cause problems, opening pores fora long-lasting clearer appearance.

Patients dealing with comedones—those whiteheads and blackheads—can have professional extractions at Carroll Dermatology. No matter the treatment, our goal is to improve the look and feel of your skin so you can be more confident in your look.

For patients whose acne has already led to scarring, there are pimple scar treatments and more available. Certain injectable dermal fillers can be used to temporarily “raise” divots for a smoother look, chemical peels can help to create a more even surface, and laser resurfacing can minimize defects and scar tissue.

No matter your specific skin concern, call Carroll Dermatology to set up a consultation. Our experienced team is ready to help.