Acne Explained
Acne vulgaris is one of the most prevalent skin disorders in the United States, affecting 85% of individuals between the ages of 12 and 24. For many, acne does not resolve in adolescence. Approximately 26% of women and 12% of men continue to experience acne into adulthood. This condition can significantly impact self-esteem, and severe acne often results in scarring if left untreated.
Acne vulgaris appears in two primary forms: inflammatory and non-inflammatory. Inflammatory acne consists of papules and pustules (what are commonly called pimples), deeper nodules, and cystic lesions, all accompanied by inflammation. Non-inflammatory acne, on the other hand, includes common whiteheads and blackheads (comedones). Acne is most commonly found on the face but can also occur on the chest and back. Although it often begins during adolescence, it can commonly continue into adulthood or even begin as adult acne.
Multiple factors contribute to acne development, including clogged pores and hormonal changes. During puberty, an increase in hormones stimulates the production of more oil (sebum) in the skin. This excess oil, combined with sticky dead skin cells, clogs the pores. Normal bacteria present on the skin become trapped in these clogged pores, leading to an inflammatory response. Clogged pores without significant bacterial involvement result in whiteheads and blackheads, while greater bacterial activity leads to inflammatory lesions like pustules, papules (small bumps), cysts, and nodules (solid, hard lesions).
While these are the primary contributors to acne, other factors can exacerbate the condition. For example, a diet high in sugary, processed foods (high-glycemic index) can increase inflammation and sebum production, worsening acne. Hormonal imbalances, such as those seen in polycystic ovarian syndrome (PCOS), can also lead to increased sebum production. Therefore, acne can be a sign of underlying physiological processes.
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Increased hormones lead to higher sebum production
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Sticky dead skin cells clog the pores
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Increased bacterial flora on the skin
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Elevated levels of skin inflammation
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High-glycemic index diet
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Insulin resistance
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Hormonal imbalances, such as in PCOS
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Certain medications, including steroids and anticonvulsants
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Occlusive cosmetics or moisturizers
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Direct, prolonged pressure on the skin, such as with sports helmets
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High environmental humidity
Fortunately, a variety of effective treatments are available to manage acne. Because different factors can cause acne, a personalized approach is essential for successful treatment. A one-size-fits-all solution is rarely effective. It is important to note that acne treatments take time, often showing results over four to eight weeks.
The primary goals of acne treatment are to unclog pores, reduce acne-causing bacteria, decrease sebum production, and minimize inflammation. Preventing scarring is also a critical aspect of treatment. Combination therapy is generally the most effective approach. For example, topical retinoids can help unclog pores by promoting the shedding of dead skin cells. Chemical peels containing glycolic and salicylic acid can enhance exfoliation and reduce oil production. Topical and oral antibiotics are commonly prescribed to decrease bacterial counts and inflammation. Phototherapy can also be employed to target bacteria and inflammation.
For women with hormonally driven acne or PCOS, oral contraceptives or other hormonal treatments may be appropriate. In severe nodular or cystic acne cases or those resistant to other treatments, isotretinoin (commonly referred to as Accutane) is often an effective treatment.
As acne severity increases, so does the likelihood of scarring. It is crucial to begin treatment early to prevent scarring. However, if scarring does occur, several cosmetic treatments are available, including microneedling, chemical peels, and laser therapy.
Treatment Options
Acne is one of the most common skin conditions, affecting people of all ages. Whether you’re a teenager dealing with hormonal breakouts or an adult struggling with persistent acne, TeeHealth Dermatology offers a range of effective treatment options tailored to your skin’s needs. We aim to help you achieve clear, healthy skin through personalized care and advanced dermatologic solutions.
Acne occurs when hair follicles become clogged with oil and dead skin cells. This can lead to various forms of acne, including blackheads, whiteheads, pimples, cysts, and nodules. Hormonal changes, genetics, diet, and stress can contribute to acne development. There are different types of acne, each requiring a specific approach to treatment:
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Comedonal Acne: Characterized by blackheads and whiteheads, comedonal acne is usually the result of clogged pores.
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Inflammatory Acne: This type includes red pimples caused by bacteria and inflammation.
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Nodulocystic Acne: Cystic acne is a severe form of acne that involves deep, painful nodules and cysts beneath the skin’s surface.
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Hormonal Acne: While all acne has a hormonal component, some patients experience a more consistent hormonal pattern of flares along the jawline and chin.
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At TeeHealth dermatology, we understand that acne can significantly impact your self-esteem and quality of life. That’s why we offer a comprehensive range of treatment options to address every type of acne, from mild to severe.
Our approach to acne treatment begins with thoroughly evaluating your skin, the type of acne, its severity, and current and past treatment successes and failures. Based on this assessment, we will create a personalized treatment plan to achieve optimal results.
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Topical treatments are often the first line of defense against acne. These medications are applied directly to the skin and treat mild to moderate acne. Common topical treatments include:
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Retinoids: Retinoids, derived from vitamin A, help to unclog pores, reduce inflammation, and prevent new acne from forming. They are particularly effective for comedonal acne.
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Benzoyl Peroxide: Benzoyl peroxide kills acne-causing bacteria and reduces inflammation. It is often used in combination with other treatments.
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Salicylic Acid: Salicylic acid helps to exfoliate the skin and clear blocked pores, making it a common ingredient in over-the-counter acne treatments.
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Antibiotics: Topical antibiotics can reduce inflammation and bacterial growth on the skin, helping to treat inflammatory acne.
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For more significant or persistent cases of acne, oral medications may be prescribed.
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Oral Antibiotics: Oral antibiotics reduce the bacteria contributing to acne and decrease inflammation. They are typically used for moderate to severe acne.
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Hormonal Treatments: For women, oral contraceptives or anti-androgen medications (spironolactone) can help regulate hormone levels and reduce breakouts.
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Isotretinoin (Accutane): Isotretinoin is a powerful medication for severe cystic acne that hasn’t responded to other treatments. It works by reducing the size of the oil glands, decreasing oil production, and preventing clogged pores.
If you are struggling to manage acne and want to explore effective treatment options, schedule a consultation with board-certified dermatologist Dr. Michael Tee. Dr. Tee is widely regarded as one of the best dermatologists in Seattle.
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Dr. Michael Tee
Clinical Director & Founder
Dr. Michael Tee focuses on helping patients manage a comprehensive range of skin conditions that can significantly impact daily comfort and confidence. He works extensively with patients experiencing skin changes during pregnancy, helping them navigate the complex dermatological shifts that occur during this important time. His practice also centers on mole evaluation and management, including atypical moles that require careful monitoring and assessment. Dr. Tee regularly treats patients dealing with acne, seborrheic dermatitis, and various forms of eczema, conditions that can affect both appearance and quality of life.