What are the different types of acne?
Acne can be categorized by its severity:
- Mild acne describes a few scattered comedones (whiteheads or blackheads) with minimal inflammation (no pustules).
- Moderate acne describes a denser collection of comedones as well as red, inflamed, pus-filled lesions (pustules).
- Severe acne, also called nodular or cystic acne, describes widespread and deep lesions that are painful, inflamed, and red. This form of acne is likely to lead to scarring if left untreated.
Who gets acne?
Anyone can get acne. Acne in teenagers is very common because the surging hormone levels (androgens) associated with puberty create more active sebaceous glands. Acne in adults is also common, particularly among women. Acne is more likely to afflict people whose parents had acne. What factors make acne worse? Acne lesions can come and go. These factors can cause acne to flare:
- Changing hormone levels in women 2 to 7 days before their menstrual period, during pregnancy, or when starting or stopping birth control pills
- Oil from skin products (moisturizers or cosmetics) or grease in the workplace (example: a kitchen with fry vats)
- Pressure from sports helmets or equipment, backpacks, tight collars, or tight uniforms
- Environmental irritants, such as pollution and humidity
- Squeezing or picking at blemishes
- Hard scrubbing of the skin
What acne treatments are available?
Almost all cases of acne can be effectively treated. The goal of acne treatment is to heal existing lesions, stop new lesions from forming, and prevent acne scars. Acne treatments control one or more of the underlying causes of acne.
Topical retinoids, such as Differin, Epiduo, Retin A Micro, Tazorac, or tretinoin, may help unclog sebaceous glands and keep pores open. Antibiotics, such as doxycycline and minocycline (Solodyn), may be used to fight the P. acnes bacteria. Accutane or hormonal agents, such as birth control pills, may be used to reduce sebum (oil) production. Your doctor will prescribe acne medications based on the following factors:
- Severity of your acne. Mild acne may respond well to a topical retinoid alone. Moderate acne may respond better to a combination of topical retinoid with an antibiotic or other medication. Severe acne with scarring may need treatment with isotretinoin, the active ingredient of Accutane (Amnesteem, Sotret).
- Results of previous treatments. Medications may be added in a step-wise fashion, only if previous treatments are found to be ineffective.
- Degree of scarring. More aggressive therapies may be started earlier if acne scars already started developing.
- Gender. Some treatments are available only for females, such as birth control pills.
Non-prescription acne medications may provide sufficient results for some people with mild acne. However, most people with moderate acne and all with severe acne will need to use prescription acne medications for effective treatment. Whatever your treatment plan, it is important that you give it enough time to work. This may mean waiting 6 to 8 weeks to see results. While the older acne lesions are healing, the medication is hard at work keeping new lesions from forming. Staying on your medication is the most important step to getting acne under control.