Acne is a skin condition that develops when your hair follicles become plugged with oil and dead skin cells. It usually causes whiteheads, blackheads or pimples, and often appears on the face, chest, forehead, upper back and shoulders. Acne is most common among teenagers, though it affects people of all ages.
Effective treatments are readily available, but acne can be persistent. The pimples and bumps clear slowly, and when one begins to go away, new ones seem to crop up.
Depending on its severity, acne can lead to emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems.
Acne signs and symptoms differ depending on the severity of your condition:
Blackheads (open plugged pores)
Whiteheads (closed plugged pores)
Small red, tender bumps (papules)
Large, solid, painful lumps beneath the surface of the skin (nodules)
Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)
Pimples (pustules), which are papules with pus at their tips
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When to see a doctor
If self-care treatments don’t clear your acne, contact your primary care doctor. He or she can prescribe effective medications. If acne persists or is severe, you may want to seek medical attention from a dermatologist (doctor who specializes in the skin).
For some women, acne can persist for decades, with flares common a week before menstruation. This kind of acne tends to clear up without treatment in women who use contraceptives.
In older adults, about onset of severe acne may signal an underlying disease requiring medical attention.
The Food and Drug Administration (FDA) warns that some common nonprescription acne lotions, cleansers and other skin products can cause a serious reaction. This type of reaction is quite uncommon, so don’t mistake it with the redness, irritation or itchiness where you’ve applied medications or products.
Seek emergency medical attention if after using a skin product you experience:
Tightness of the throat
Swelling of the eyes, lips, face or tongue
There are four main factors that cause acne:
Excess oil production
Hair follicles clogged by oil and dead skin cells
Excess activity of a type of hormone (androgens)
Acne often appears on your face, forehead, chest, upper back and shoulders because these parts of skin have the most oil (sebaceous) glands. Hair follicles are associated to oil glands.
The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is clogged with bacteria and oil, which turns brown when it’s exposed to the air.
Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce cystlike lumps beneath your skin surface. Other pores in your skin, which are the openings of the sweat glands, aren’t normally involved in acne.
Factors that may worsen acne
These factors can cause or aggravate acne:
Hormones: Androgens are hormones that rise in boys and girls during puberty and enlarge the sebaceous glands and make more sebum. Hormonal changes connected to pregnancy and the use of oral contraceptives also can affect sebum production. And poor amounts of androgens circulate in the blood of women and can worsen acne.
Certain medications: These medications include drugs containing testosterone corticosteroids, or lithium.
Diet: Studies shows that certain dietary factors, such as skim milk and carbohydrate-rich foods including bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small analysis of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further research is needed to know why this happens and whether people with acne would benefit from following specific dietary restrictions.
Stress: Stress can worsen acne.
How acne develops
These factors have little effect on acne:
Greasy foods: Eating greasy food has little to no effect on acne. Though working in a greasy environment, such as a kitchen with fry vats, does because the oil can stick to the skin and block the hair follicles. This further irritates the skin or increase acne.
Hygiene: Acne isn’t caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can worsen acne.
Cosmetics: Cosmetics don’t really worsen acne, particularly if you use oil-free makeup that doesn’t clog pores (noncomedogenics) and remove makeup regularly. Non-oily cosmetics don’t interrupt with the effectiveness of acne drugs.
Risk factors for acne may include:
Age: People of all ages can get acne, but it’s most common in teenagers.
Hormonal changes: Hormonal changes are common in teenagers, women and girls, and people using some medications, such as those containing androgens, corticosteroids, or lithium.
Family history: Genetics also plays a role in acne. If both parents had acne, you’re likely to get it, too.
Greasy or oily substances: You may get acne where your skin comes into contact with oily lotions and creams or with grease in a work place, such as a kitchen with fry vats.
Friction or pressure on your skin: This can be caused by items including telephones, cellphones, tight collars, helmets, and backpacks.
Stress: Stress doesn’t cause acne, but if you have acne already, it may worsen it.
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