James D. Briggs M.D.3300 Providence Dr #212

Anchorage, AK 99508(907) 561-4459 Phone

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Acne Teen VersionWhat is acne? Acne is a skin condition that occurs when the oil glands in your skin are clogged and become inflamed or infected. More than 90% of teenagers have some acne. With acne you will probably have:

● whiteheads, which are closed plugged oil glands ● blackheads, which are open plugged oil glands (the oil turns black when it is exposed to

air) ● red bumps, which are inflamed oil glands (the larger red bumps are quite painful).

Acne usually appears on your face, neck, and shoulders.

What causes acne? Acne is due to an overactivity and plugging of the oil glands. The main cause of acne is an increased levels of hormones during adolescence. Heredity also plays an important role. Acne is not caused by diet. A person who has acne does not have to avoid eating fried foods, chocolate, or any other food. Acne is not caused by sexual activity. It is not caused by dirt or by not washing your face often enough.

How long does it last? New whiteheads usually stop appearing after 4 to 6 weeks of treatment. You will probably need to continue the treatment for several years. Acne usually lasts until age 20 or even 25. Do not worry about scarring. It is rare for acne to leave scars, although this can happen in severe cases.

How is it treated? There is no medicine at this time that will cure acne. However, good skin care can keep acne under control and at a mild level. Basic treatment for all acne

● Wash your skin twice a day and after exercise. Use lukewarm water and wash gently. Do not scrub. The most important time to wash is bedtime. Use a mild soap such as Dove.

● Shampoo your hair daily. Pull your hair away from your face. Long hair can make acne worse by rubbing against your skin.

● Avoid picking and squeezing. Picking stops acne from healing. Squeezing causes bleeding into the skin and blotches that can last a month.

● Avoid scrubbing your skin or using abrasive soaps. Hard scrubbing of the skin is harmful because it irritates the openings of the oil glands and can cause them to be more tightly closed.

● Avoid putting any oily or greasy substances on your face. Oily and greasy substances make acne worse by blocking oil glands. If you use cosmetics, use water-based cosmetics and wash them off at bedtime. Look for make-up, cosmetics, and skin care products with the word noncomedogenic on the label. This means that it does not cause or worsen acne.

● Avoid hair tonics or hair creams (especially greasy ones). When you sweat, these substances will spread to your face and aggravate the acne.

● If you are using acne medicine, don't stop using the medicine too soon. It takes 6-8 weeks to see a good response. After the acne clears up, you will need to continue the medicine for years. If you stop it, the acne will come back.

Treatment for whiteheads (closed comedones)Whiteheads should be treated with the following:

● Benzoyl peroxide 5% or 10 % lotion or gel (Oxy-10 gel and other brands)This lotion helps to open pimples and unplug blackheads. It also kills bacteria. It is available without a prescription. Ask your pharmacist to recommend a brand. Apply the lotion once a day at bedtime. Redheads and blonds should apply it every other day for the first 2 weeks, and start with a lower strength preparation. An amount of lotion the size of a pea should be enough to cover most of your face. If your skin becomes red or peels, you are using too much of the medicine or applying it too often. Try using less of it or applying it less often. You may need to use this lotion for several years. Caution: Benzoyl peroxide bleaches clothing, carpets, etc. Apply it only at bedtime and put it on sparingly. A few people are allergic to Benzoyl peroxide. If you develop severe itching and redness, stop using it.

● Pimple opening In general, it is better not to "pop" pimples, but most teenagers do it anyway. Therefore, do it safely. Never open a pimple before it has come to a head. Wash your face and hands first. Use a sterile needle (sterilized by alcohol or a flame). Nick the surface of the yellow pimple with the tip of the needle. The pus should run out without squeezing. Wipe away the pus and wash the area with soap and water. Scarring will not result from opening small pimples, but it can result from squeezing boils or other large, red, tender bumps.

Treatment for blackheads (open comedones)Blackheads should be treated with the following:

● Benzoyl peroxide 5% or 10 % lotion or gel This lotion is also excellent for removing thickened skin that blocks the openings to oil glands. Use the lotion as described above for whiteheads.

● Blackhead extractor Blackheads that are a cosmetic problem can sometimes be removed with a blackhead extractor. This instrument costs about a dollar and is available at any drugstore. By

placing the hole in the end of the small metal spoon directly over the blackhead, you can apply uniform pressure that does not hurt normal skin. This method is much more efficient than anything you can do with your fingers. Soak your face with a warm washcloth before you try to remove blackheads. If the blackhead does not come out the first time, leave it alone.

Treatment for red bumps Large red bumps mean the infection has spread beyond the oil gland. If you have several red bumps, you probably also need an antibiotic. Antibiotics come as solutions for the skin or as pills. Examples are clindamycin (Cleocin), erythromycin, and dapsone (Aczone) gels, and doxycycline tablets. Your antibiotic is _________________________. Use it ________ times a day every day. If you still have problems with acne, talk with your healthcare provider about prescription medicines such as retinoids or hormone pills, or other possible treatments.

Topical retinoidsFor moderate or severe acne, the doctor will usually prescribe a topical retinoid such as tretinoin cream or Retin-A. This works by peeling off the top layer of the skin and preventing formation of whiteheads and blackheads. It is often used in combination with benzoyl peroxide, with the benzoyl peroxide applied in the morning and the tretinoin at bedtime. When using tretinoin, it is important to use a very small amount (just a few tiny dabs) and spread it evenly on the skin, keeping it away from the eyes, corners of the mouth, and folds of the nose. Blond and redheaded people should start by applying it every other day for the first two weeks. These medicines can cause increased sensitivity to sunburn, so it is important to use a facial sunscreen if you are going to be in a sunny place. Some dryness and peeling of the skin are normal with tretinoin. You can use a non-comedogenic facial cream to counteract this.

Treatment of pimples on the back and chestFor body acne, try using a benzoyl peroxide acne wash, available without a prescription. An example is Clean & Clear. For more severe cases, the doctor may prescribe an oral antibiotic, such as doxycycline.

When should I call my healthcare provider? Call during office hours if:

● The acne has not improved after you have treated it with benzoyl peroxide for 6 weeks. ● It looks infected (large, red, tender bumps). ● You have other concerns or questions.

Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.

Modified by James D. Briggs, MD 1/19/13. Published by RelayHealth. Last Modified: 3/22/2007. Last Reviewed: 6/18/2009. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. © 2010 RelayHealth and/or its affiliates. All Rights Reserved.