Top 10 Questions on Acne

Introduction:

Acne vulgaris, which is commonly known as pimples, starts in teens. It results in a lowering of self-esteem, decreased work capacity, and some form of permanent scarring. And even small breakouts can make you feel low and less confident. The widespread prevalence of myths about acne is one of the primary reasons to give you a sense of shame, making you feel responsible for your acne.

Here are the commonly asked top ten questions about acne:

What Is Acne?

Acne is a basic disorder of the pilosebaceous unit found in the skin. The sebaceous gland with a hair follicle is known as a pilosebaceous unit. The most important lesion in acne is a comedone. Besides this, papules, pustules, and nodules are also found. In common terms, these are referred to as pimples. The locations where pimples occur include the face, chest, back, and shoulders.

What Causes Pimples?

Pimples are caused by factors like androgenic hormones, inflammation, Propionibacterium acnes, etc., acting on the pilosebaceous unit. Initially, a block develops in the glands' opening, and later, the unit ruptures into the dermis as a result of the pent-up sebum, thus aggravating the condition.

I Get Blackheads as Well. What to Do?

Most parents or even patients themselves, after having complained about acne or pimples, add that my child gets blackheads as well. Blackheads actually mean open comedones and are thus a part of the overall disorder. Comedones are distinct into two: open and closed. Open comedones turn blackish in color, probably due to exposure of sebum to air.

Pimples Do Occur in Teenage. Do We Need to Treat Them?

This is one commonly asked question by the parents. They are either well versed in the self-limiting nature of the disorder beforehand or develop this understanding in the course of the discussion. They thus conclude that treatment is not necessary. I, however, tell them that this conclusion is incorrect. Acne most commonly does start in the teenage and heralds the onset of puberty. In girls, it may start a year prior to the onset of menstruation. Acne is self-limiting as well, but treatment is definitely required as it can get aggressive and cause scarring if left to resolve by itself. The scarring may last a lifetime.

I Applied Many Creams Without Relief. Why?

The common reason for the treatment to fail to include either one of the following:

• You may be applying a topical steroid. Topical steroids are easily available over the counter in many countries and are thus used by all patients invariably before consulting a dermatologist. By virtue of their strong anti-inflammatory action, they are able to suppress acne. But once stopped, a severe rebound occurs so that you are forced to apply it again. This vicious cycle of steroid application and rebound acne sets in and can damage the skin. In case you are applying a steroid on your face, seek help from a dermatologist.

• Using an over-the-counter preparation that may not be appropriate to the severity of your condition or may have developed resistance to the treatment.

• You may be using an irrelevant drug for your pimples.

• You may be insufficiently using an otherwise effective medicine.

I have seen all four instances in my practice.

How to Apply Medicine and For How Long Should the Treatment Continue?

The duration of the treatment typically depends on the severity of the condition. Dermatologists use many classifications to grade the severity of acne. In simple terms, the condition may be divided into mild, moderate, or severe types. A combination of treatment options is usually used to ward off resistance to treatment. Most of the medicines used need close supervision by a dermatologist, and the method or manner of application depends on the drug used. Your skin may have areas with pimples and areas without pimples. The area without pimples looks normal, and patients usually do not apply the medicine in this area. However, the correct approach is to apply a thin film over both areas.

Sunscreen lotions and moisturizers are to be applied liberally. Sunscreen lotions are to be applied during the day. Ask your dermatologist for the exact technique and take this only as a general guideline.

What Are the Dietary Recommendations on Acne?

There is no specific evidence to debate that any particular diet aggravates acne. However, some studies point towards chocolates and dairy products. With the advent of bad dietary habits, it seems prudent to advise that one must eat a well-balanced diet including proteins, fats, carbohydrates, and fiber and keep processed foods like sugar, junk foods, fruit juices, etc., to a minimum. The diet you take should be decided by your age, gender, and level of activity.

My Child Worries Too Much About Her Skin. Is This Not a Small Issue After All?

Acne is associated with significant psychiatric morbidities in almost half the teenagers. It has also been known to be associated with potential impairment in functioning, including job prospects. What may seem insignificant to some may significantly affect others. Some children may need counseling as well. Stress aggravates acne, and acne aggravates stress. It is a kind of vicious cycle that needs to be broken. The take-home message is NOT to neglect the psychological aspect of any disease, and pimples are no exception.

Is Acne Associated with Any Other Diseases?

Most of the time, acne is a straightforward clinical diagnosis. However, in some cases, it may be associated with some other diseases. If you have a sudden onset of pimples, a severe disease, poor response to treatment, menstrual irregularities, deepening of the voice, excessive hair growth, hair loss, etc., your dermatologist may have to order certain lab tests to check your hormonal status or insulin resistance.

What Are the Dos and Don'ts With Acne?

Do's:

• Do a gentle cleansing twice a day.

• Apply moisturizers on a wet face.

• Apply medicines regularly.

• If under stress, seek help.

Don'ts

• Do not over scrub.

• Do not pinch or burst the pimples.

• Do not apply over-the-counter medications if you are unsure about their proper use.

Conclusion:

Acne is a significant adolescent problem, and it can negatively impact self-esteem and quality of life. But understanding the condition better and getting it treated will help improve the symptoms.