What is Acne
Acne is a skin problem that causes pimples. Acne occurs when the pores in the skin get blocked. The pores may become infected with bacteria, or they may become red, sore, and swollen.
Acne is a common skin problem, especially for teenagers. Acne usually goes away over time.
What are the causes?
Each pore contains an oil gland. Oil glands make an oily substance that is called sebum. Acne happens when these glands get plugged with sebum, dead skin cells, and dirt. Then, the bacteria that are normally found in the oil glands multiply and cause inflammation.
Acne is commonly triggered by changes in your hormones. These hormonal changes can cause the oil glands to get bigger and to make more sebum. Factors that can make acne worse include:
- Hormone changes during:
- Adolescence.
- Women’s menstrual cycles.
- Pregnancy.
- Oil-based cosmetics and hair products.
- Harshly scrubbing the skin.
- Strong soaps.
- Stress.
- Hormone problems that are due to certain diseases.
- Long or oily hair rubbing against the skin.
- Certain medicines.
- Pressure from headbands, backpacks, or shoulder pads.
- Exposure to certain oils and chemicals.
What increases the risk?
This condition is more likely to develop in:
- Teenagers.
- People who have a family history of acne.
What are the signs or symptoms?
Acne often occurs on the face, neck, chest, and upper back. Symptoms include:
- Small, red bumps (pimplesor papules).
- Whiteheads.
- Blackheads.
- Small, pus-filled pimples (pustules).
- Big, red pimples or pustules that feel tender.
More severe acne can cause:
- An infected area that contains a collection of pus (abscess).
- Hard, painful, fluid-filled sacs (cysts).
- Scars.
How is this diagnosed?
This condition is diagnosed with a medical history and physical exam. Blood tests may also be done.
How is this treated?
Treatment for this condition can vary depending on the severity of your acne. Treatment may include:
- Creams and lotions that prevent oil glands from clogging.
- Creams and lotions that treat or prevent infections and inflammation.
- Antibiotic medicines that are applied to the skin or taken as a pill.
- Pills that decrease sebum production.
- Birth control pills.
- Light or laser treatments.
- Surgery.
- Injections of medicine into the affected areas.
- Chemicals that cause peeling of the skin.
Your health care provider will also recommend the best way to take care of your skin. Good skin care is the most important part of treatment.
Follow these instructions at home:
Skin care
Take care of your skin as told by your health care provider. You may be told to do these things:
- Wash
your skin gently at least two times each day, as well as:
- After you exercise.
- Before you go to bed.
- Use mild soap.
- Apply a water-based skin moisturizer after you wash your skin.
- Use a sunscreen or sunblock with SPF 30 or greater. This is especially important if you are using acne medicines.
- Choose cosmetics that will not plug your oil glands (are noncomedogenic).
Medicines
- Take over-the-counter and prescription medicines only as told by your health care provider.
- If you were prescribed an antibiotic medicine, apply or take it as told by your health care provider. Do notstop taking the antibiotic even if your condition improves.
General instructions
- Keep your hair clean and off of your face. If you have oily hair, shampoo your hair regularly or daily.
- Avoid leaning your chin or forehead against your hands.
- Avoid wearing tight headbands or hats.
- Avoid picking or squeezing your pimples. That can make your acne worse and cause scarring.
- Keep all follow-up visits as told by your health care provider. This is important.
- Shave gently and only when necessary.
- Keep a food journal to figure out if any foods are linked with your acne.
Contact a health care provider if:
- Your acne is not better after eight weeks.
- Your acne gets worse.
- You have a large area of skin that is red or tender.
- You think that you are having side effects from any acne medicine.
Isotretinoin
What is isotretinoin?
Isotretinoin is a medicine used to treat very bad acne. It is usually used for cystic acne that did not get better after treatment with other medicines. It is important for you to take isotretinoin the right way. You should also know about the side effects of isotretinoin. Talk to your doctor if you have any questions about this medicine or if you have side effects when you take it.
Before taking isotretinoin, tell your doctor if you or anyone in your family has diabetes, asthma, liver disease, heart disease, or depression. You should also tell your doctor if you are allergic to any medicines, especially parabens (chemicals used in cosmetics, moisturizers and isotretinoin). Be sure to tell your doctor if you are taking any other medicines, even over-the-counter medicines.
How should I use and store isotretinoin?
Isotretinoin has been prescribed just for you. Don’t share it with other people and keep it away from children. You should take isotretinoin with food. You don’t have to keep the medicine in the refrigerator, but keep it out of sunlight. Don’t keep it in a place that is very warm.
You may not give blood while you are taking this medicine or for at least 1 month after you stop taking it. You should also not have cosmetic procedures done to smooth your skin (such as waxing) while you are taking isotretinoin and for at least 6 months after you stop.
Isotretinoin is like vitamin A, so while you are taking isotretinoin, you should not take vitamin A pills or multivitamins that contain vitamin A. You also should not take any antibiotics without talking to your doctor first.
What should I expect during treatment?
The dosage of isotretinoin is different for each person. During your treatment, your doctor may change your dosage. Be sure to take isotretinoin just the way your doctor tells you. If you miss one dose, don’t take extra the next time. You will probably take isotretinoin for 15 to 20 weeks.
Your acne may get worse when you first start using isotretinoin. This usually just lasts for a little while. If this happens to you, your doctor may have you use other medicines along with the isotretinoin in this stage.
Your doctor needs to check on you often. Be sure you keep all of your appointments with your doctor. He or she may check your cholesterol levels and your liver.
Does isotretinoin have any side effects?
During treatment, you may have some of the following side effects. These side effects usually go away when you stop taking isotretinoin:
- Dry skin and lips–your doctor can suggest lotions or creams to use
- Fragile (easily injured) skin, itching or rash
- Increased sensitivity to the sun (easily sunburned)
- Peeling skin on your palms and soles
- Thinning hair
- Dry, red eyes–you may find that you can’t wear your contact lenses during treatment
- Nosebleeds
- Bleeding gums
- Pain in your muscles
- Vision problems such as decreased night vision
A few people have even more serious side effects. If these problems aren’t treated, they could last even after you stop taking isotretinoin. If you have any of the side effects listed below, stop taking isotretinoin and check with your doctor right away:
- Headaches, nausea, vomiting, or blurred vision
- Depression or changes in your mood, such as feelings of sadness or irritability
- Unusual tiredness or lack of appetite
- Severe stomach pain, diarrhea, or bleeding from your rectum
- Very dry eyes
- A yellow color in your skin or eyes, and dark yellow urine
What should I expect after treatment?
Your skin might keep getting better even after you stop taking isotretinoin. Most of the side effects go away in a few days or weeks after you stop taking isotretinoin. If your side effects last for more than a few weeks after you stop taking this medicine, talk to your doctor.
Your acne may not get better the first time you use isotretinoin for 15 to 20 weeks. If you need to take isotretinoin again, you can start taking it 8 to 10 weeks after your first treatment is over. Do not give blood for at least 1 month after you stop taking isotretinoin.
Are there special concerns for girls and women?
You must not take isotretinoin if you are pregnant or if there is any chance you might get pregnant while taking this medicine!
Isotretinoin causes severe birth defects, including malformation of the head and face, mental retardation, and severe internal defects of the brain, heart, glands and nervous system. It can also cause miscarriage, premature birth, or death of the fetus.
In order to prevent pregnancy, you must use 2 forms of birth control at the same time for at least 1 month before you start taking isotretinoin and during the entire time you are taking this medicine. Keep using 2 forms of birth control for 1 month after you stop taking isotretinoin.
Your doctor will make sure you are not pregnant before you start taking isotretinoin. He or she will check again every month while you are taking it. You will be asked to read and sign a consent form to show that you understand the dangers of birth defects and agree to use 2 forms of birth control. If your period is late, stop taking isotretinoin and call your doctor right away.
