Acne Please Not Again – Not Now!

By Tareq Abedin, MD

Ashburn Sterling Internal Medicine & Pediatrics

. http://www.myhealthcare.org/

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Acne Please Not Again – Not Now!

Is this what you think whenever a new blemish appears? Is acne something you constantly struggle with? Are you now an adult and think, “I never had outbreaks like this as a teenager why am I breaking out now?”

Acne is very common during adolescence and not uncommon during adulthood. Acne is caused by bacteria that flourish when hair follicles on the face, neck, chest and shoulders become clogged by dead skin cells, sebum, and keratin.

Sebum is a naturally occurring oily substance produced by cells in the skin at the root of the hair follicle. The purpose of sebum is to moisturize, lubricate, and protect the skin and hair.

Keratin is a structural component of skin, hair and nails. Increased amounts of keratin and sebum cause the pores to be plugged and what we see are comedones commonly called whiteheads, blackheads or zits.

While the science is not 100% clear, it is known that male hormones, such as testosterone (yes, girls produce some testosterone), have a strong role in stimulating sebum production. Acne usually starts about the same time there is a large increase in production of hormones at the start of puberty and males have more problems with teenage acne than females do.

However, in the adult years, women are much more prone to acne than men, particularly during the days just prior to the menstrual cycle. The most likely explanation is that the hormone levels continue to fluctuate a great deal throughout the menstrual cycle.

For teenage girls and adult women with acne, the use of oral contraceptives (birth control pills) can make a significant difference in controlling acne outbreaks. Oral contraceptives contain both estrogen and synthetic progesterone. The estrogen component of the pill helps to control acne. Most birth control pills will help control acne, not just those with the FDA indication for acne treatment.

Adult women who have completed their family may be more effectively treated with the addition of another medication called spironolactone. Spironolactone blocks the receptors for testosterone, so it cannot have its effect on skin and hair growth. This is particularly useful for women who start having excess hair production in areas such as the chin, upper lip, chest and upper arms. The sooner the excess hair growth is treated, the more effective the medication will be.

There are many more treatment options for acne. For a more thorough discussion or for guidance on treating acne, make an appointment with your health care provider.