Acne

Acne is a common problem affecting many people. It is common during puberty and in adolescence, but can occur throughout a person's life. It is caused by plugs in glands and affects the face, trunk, and buttocks. You can see blackheads (open comedones), whiteheads (closed comedones), pustules, nodules, and cysts. Hormones or other causes lead to increased keratin production, which blocks sebum secretion, leading to these lesions. This creates an environment suitable for the growth of the bacteria P. acnes, which leads to inflammation. Other causes of acne include emotional stress, excessive pressure on the skin, certain medications, and various topical products. Contrary to popular opinion, foods such as chocolate have not been proven to be associated with acne. But you can avoid such foods if you feel it helps.

There are a number of treatments for acne depending on the severity. These include topical products such as benzoyl peroxide and topical antibiotics such as clindamycin or erythromycin. Some products contain combinations of these. Products containing acids such as glycolic acid and salicylic acid help with exfoliation. Retinoids such as Retin-A (tretinoin), Differin (adapalene), and Tazorac (tazarotene) can provide significant improvement, but may also cause irritation. For this reason these are often started on a three to four time per week regimen and gradually increased to daily use. They should not be used during pregnancy or when females are breast feeding. Oral antibiotics such as doxycycline, minocycline, and tetracycline can be added for moderate acne. Use of sunscreen is imperative because these medications cause sensitivity to the sun. Oral contraceptive medications may improve acne for females who have more problems during their menstrual period. Accutane (isotretinion) is an oral medication used for severe acne when other medical treatments do not work. This has become less popular for a number of reasons including side effects such as dryness and the possibility of birth defects as well as requirements for regular blood tests. Procedural treatments for acne include manual extraction, chemical peels, and laser therapy.

This is a patient who saw improvement after four weeks of the Obagi Clenziderm system, which includes 2 % salicylic acid and 5 % benzoyl peroxide.