Acne

washing face

For teenagers acne is the worst four letter word. I remember looking horrified into the mirror before going to school, or worse a party, noticing a pimple on the chin or nose. Trying to make it go away ended mostly with a doublesized, glazing red one instead.

Acne is caused by inflammation of the oil glands in the skin and at the base of strands of hair. In the teenage years, hormones stimulate the growth of body hair, and the oil glands secrete more oil (sebum).

The skin pores become clogged with shedding cells and bacteria called Propionibacterium acnes (P. acnes ) growing in the clogged pores. When the body works to destroy the bacteria, the resulting inflammation forms whiteheads and blackheads in these areas. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Nearly 17 million people in the United States have acne, making it the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring, permanent scarring, which can be upsetting for people who suffer from the disorder.

The symptoms of acne are:

  • blackheads
  • whiteheads
  • pimples, some filled with puss

Other troublesome acne lesions can develop, including the following:

  • Papules—inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
  • Pustules (pimples) — inflamed, pus-filled lesions that can be red at the base
  • Nodules—large, painful, solid lesions that are lodged deep within the skin
  • Cysts—deep, inflamed, pus-filled lesions that can cause pain and scarring

These skin eruptions may be painful. In severe cases, cysts (fluid-filled bumps larger than pimples) may develop under the skin.

What causes my acne?

Although cleaning the skin is a first step in controlling acne, a dirty skin is not the cause of acne. This is one of many myths blamed for originating acne. Also foods like chocolate, pig meat or French fries are not a cause of acne. You might notice a flare up but the relation is different as it might be a mild allergy to an ingredient or it might be the stress your body gets from a unbalanced diet. Fruits and vegetables are the main components to a healthy diet and thus create a balance in your body and as such will have a positive effect on acne. Other important stress factors can be school (nothing new here) and lack of sleep. Stick to a regular 8 hour sleep a night rhythm and sleep away your acne (or keep it under control).

Sexual frustration is also not a cause of acne, although it seems to be a popular myth.

The main cause is hereditary, if it is in the genes of your mom and dad you already have a 80% chance of getting it as well. Nothing you can change about that but at least: It ain’t your fault !

Because the actual process is hormonal (testosterone) related, boys will have a worse outbreak in their teens than girls. Adult women have relatively more problems in their post teens, related with their menstrual cycle or due to the use of hormonal birthcontrol.

How to treat acne.

First of all you should review the soaps and lotions you are using as well as make-up you might use. Oily makeup will probably aggravate your condition by blocking up the pores more. In a pharmacy or cosmetic center you might get advice which ones not to use. Harsh soaps have usually a negative effect on your skin because they tend to wash away your natural fatty acids who work as your skin’s disinfectant which might cause easier growth of bacteria, contrary to the effect you are expecting!

Use “Non-soap” soaps, preferably with a acidy pH i.e. like sebamed, sanex or dove.

Several products may be used to help prevent pimples or blackheads. Treatment usually begins with putting products containing benzoyl peroxide on the areas of skin with acne. Benzoylperoxide will enter the pore and kill the bacteria inside. It also opens up the pore. The strength is not very important, however starting with the lower 5% will give less irritation to the skin. Pharmacies will have a gel for sale that is economic and can be used either as a wash or left on the skin overnight. If benzoyl peroxide alone is not effective, your doctor may prescribe antibiotics to be taken by mouth or a antibiotic lotion to put on your skin. You may also need to use a skin cream or gel containing tretinoin (Retin-A, Locacid). Tretinoin is a vitamin a derivative that peels off the old skin while stimulating growth of new cells. Their action might cause a worsening of your condition at first making your skin red and irritated. The best way is to start these creams carefully like every other day before using them daily.

They should be applied at night because they are unstable to sunlight. Other modern “peeling” creams are the those that contain alpha hydroxy acids. They are found in most anti-wrinkle creams.

An oral vitamin A derivative called isotretinoin (RoAccutane) is available for severe acne. However, isotretinoin must be used very carefully because it causes birth defects in babies born to mothers who become pregnant while they are taking the drug or who have taken it several months before becoming pregnant. Sometimes a dermatologist might even use corticosteroids to prevent scarring.

Women can also take certain birthcontrol pills that will counteract the effect of testosterone and therefore dimishing acne.

How long will the effects last?

New whiteheads usually stop appearing after 4 to 6 weeks of treatment, but usually you will need to continue the treatment at least 6 to 8 weeks. Controlling treatment might be needed until you “grow over it”.If you are taking antibiotics, at some point your doctor will ask you to stop taking them to see if they are still necessary.

Many factors may make acne worsen temporarily. Thus, even if you are receiving the proper treatment, results may vary over time. Try to discover and change, when possible, the factors in your environment or lifestyle that make the acne worse.

How can I take care of myself?

Follow the full treatment prescribed by your doctor.

In addition you can:

  • Wash your face two times a day with a gentle soap.
  • Wash your hands more frequently and avoid putting your fingers and hands to your face unnecessarily. Don’t squeeze, pick, scratch, or rub your skin. Scars may form if you squeeze pimples, however a beautician may expell blackheads with a special tool to avoid any contamination.
  • Don’t rest your face on your hands while you read, study, or watch TV.
  • Watch out wearing backpacks or headbands for a long time, the pressure on your skin can cause pimples to form, pressing weights while lying on your shoulders may have the same effect.
  • Avoid working in hot kitchens where greasy foods are cooked.
  • Avoid getting sunburned.
  • Avoid extreme stress if possible. Practice stress reduction strategies such as exercise, meditation, and counseling if stress is extreme.
  • Get physical exercise regularly.

Skin Problems and What They Look Like

Herpes Zoster

Do you have skin problems?

Is your skin itching, breaking out, covered in a rash, or playing host to strange spots? Skin inflammation, changes in texture or color, and spots may be the result of infection, a chronic skin condition, or contact with an allergen or irritant. While having reported earlier on these topics you can easier recognize the common adult skin problems with this picture library from WebMd.

Shingles (herpes zoster)
Shingles starts with burning, tingling, or very sensitive skin. A rash of raised dots develops into painful blisters that last about two weeks. Shingles often occurs on the trunk and buttocks, but can appear anywhere. Most people recover, but pain, numbness, and itching linger for many — and may last for months, years, or the rest of their lives. Treatment with antiviral drugs like aciclovir  may reduce symptoms if taken at start of symptoms. Steroids and antidepressants are sometimes used to control pain.

Hives (urticaria)
Hives, a common allergic reaction that looks like welts, are often itchy, stinging, or burning. They may appear anywhere and last minutes or days. Severe hives can cause difficult breathing (get immediate medical attention if this occurs). Medications, foods, or food additives, temperature extremes, and infections like strep throat can cause hives. Removing the trigger often resolves the hives in days or weeks. Antihistamines can provide quick relief preferably taken orally. Steroids applied locally or prescribed orally may be indicated as well.

Psoriasis
A non-contagious rash of thick red plaques covered with silvery scales, psoriasis usually affects the scalp, elbows, knees, and lower back. The rash can heal and recur throughout life. The cause of psoriasis is unknown, but skin inflammation may be triggering new skin cells to develop too quickly. Treatments include steroid or retinoid creams, light therapy, and medications.

 

Eczema
Eczema describes several non-contagious conditions where skin is inflamed, red, dry, and itchy. Stress, irritants (like soaps), allergens, and climate can trigger flare-ups though they are not eczema’s cause, which is unknown. In adults, eczema often occurs on the elbows and hands, and in “bending” areas, such as inside the elbows. Treatments include cortisone creams, pills, shots, antibiotics, antihistamines, or phototherapy.

 

Rosacea
Also called Acne rosacea is often beginning as a tendency to flush easily, rosacea causes redness on the nose, chin, cheeks, forehead, even in the eyes. The redness may intensify over time, taking on a ruddy appearance. If left untreated, bumps and pus-filled pimples can develop, with the nose and oil glands becoming bulbous. Rosacea treatment includes medications (antibiotic cream), as well as surgery to remove blood vessels or correct nose disfigurement.

The bulbous nose is often associated with alcoholism, yet there is no direct relation since Rosacea can occur at the latter stages of life without alcohol involved.

Rash from Poisonous Plants
Contact with sap from poison ivy and its relatives of which we have a few on St. Maarten causes a rash in most people. It begins with redness and swelling at the contact site, then becomes intensely itchy. Blistering appears within hours or a few days. The typical rash is arranged as a red line on an exposed area, caused by the plant dragging across the skin. The rash usually lasts up to two weeks.

These rashes in the begin stages are sometimes mistakenly diagnosed as Hives (Urticaria) until the blisters appear.

Not everyone has such an extensive reaction to Poison Ivy and sometimes a mere itch with a light redness lasting a couple of hours is all some people experience.

Razor Bumps
Razor bumps are tiny, irritated bumps that develop after shaving. The sharp edge of closely shaven hair can curl back and grow into the skin, causing irritation and pimples, and even scarring. To minimize razor bumps, take a hot shower before shaving, shave in the direction of hair growth, and don’t stretch the skin while shaving. Use a single blade. Rinse with cold water, then apply moisturizer.

Don’t use electrical shavers since they have the tendency to pull the hairs for a closer shave.

Skin tags
A skin tag is a small flap of flesh-colored or slightly darker tissue that hangs off the skin by a connecting stalk. Usually found on the neck, chest, back, armpits, under the breasts, or in the groin area, skin tags are not dangerous and usually don’t cause pain unless they become irritated by clothing or nearby skin rubbing against them. A doctor can remove a skin tag by cutting, freezing, or burning it off.

Removal of skin tags is only a temporary solution and under most circumstances will return.

Acne
At the heart of acne lies the pimple — a plug of fat, skin, and keratin. When open, the plug is called a blackhead, closed, a whitehead. Often seen on the face, chest, and back, acne is caused by many things, including hormones. To help control it, keep oily areas clean and don’t squeeze pimples (it may cause infection and scars). Only three medications are proven effective for acne treatment: benzoyl peroxide, retinoids, and antibiotics.

 

Athlete’s Foot
A fungal infection that can cause peeling, redness, itching, burning, and sometimes blisters and sores, athlete’s foot is mildly contagious, passed by direct contact or by walking barefoot in areas such as locker rooms, or near pools. The fungi then grow in shoes, especially tight ones without air circulation. It’s usually treated with topical antifungal creams and lotions or oral medications for more severe cases.

 

 

Moles
Usually brown or black, moles can be anywhere on the body, alone or in groups, and generally appear before age 20. Some moles (not all) change slowly over the years, becoming raised, developing hair, and/or changing color. While most are non-cancerous, some moles have a higher risk of becoming cancerous. Have a dermatologist evaluate moles that change, have irregular borders, unusual or uneven color, bleed, or itch.

 

Age or liver spots (lentigines)
These pesky brown spots are not really caused by aging, though they do multiply as you age. They’re the result of sun exposure, which is why they tend to appear on areas that get a lot of sun, such as the face, hands, and chest. Bleaching creams, acid peels, and light-based treatments may lessen their appearance.

To rule out serious skin conditions such as melanoma, see a dermatologist for proper identification.

Melasma (Pregnancy Mask)
Melasma (or chloasma) is characterized by tan or brown patches on the cheeks, nose, forehead, and chin. Although usually called the “pregnancy mask,” but it can also happen when other factors raise the estrogen level like taking birthcontrol pills. Melasma may go away after pregnancy but, if it persists, can be treated with prescription creams and over-the-counter products. Skin of color is even more sensitive for uneven pigmentation sometimes due to irritants in facial cosmetics.

Use a sunscreen at all times if you have melasma, as sunlight worsens the condition.

Cold sores (fever blisters)
Small, painful, fluid-filled blisters on the mouth or nose, cold sores are caused by the herpes simplex virus. Lasting about seven to 10 days, cold sores are contagious until completely crusted over.

Triggers can include fever, too much sun, stress, or menstruation. Antiviral pills or creams can be used as treatment, but call your doctor if sores contain pus, you have a fever greater than 100.5°, or if your eyes become irritated.

Warts
Caused by contact with the contagious human papillomavirus, warts can spread from person to person or via contact with something used by a person with the virus. You can prevent spreading warts by not picking them, covering them with bandages, and keeping them dry. In most cases, warts are harmless, painless, and go away on their own. If they persist, treatments include freezing, surgery, lasers, and chemicals.