How to Treat Acne

This is the second on my series on acne and its after-effects. This blog will concentrate on treatment and will require a second blog.
2500 years ago Cleopatra discovered the essentials of skin care and nothing has changed since. In the 1960's a study on acne revealed that 75% of teenagers with acne could treat themselves effectively with over the counter products and nothing has changed since. Within the last decade the makers of ProActive put out a campaign for treament of acne with products bought on the internet and it was successful and nothing has changed since. In the past 5 years Obagi Corp decided to treat teenagers with acne using topical agents and it has been successful and nothing has changed since.
Yet, in the 1970's, 80's, 90's and even today many primary care doctors and dermatologists have been treating acne with oral antibiotics. The rationale for using oral tetracycline, erythromycin, amoxicillin, and others is that they decrease the bacterial and yeast population of the skin and are also anti-inflammatory. The latter is important because fatty acids in the skin derived from sebum promote inflammation as a natural response and that is what causes red pimples and large cysts. That is usually what is responsible for scarring and post inflammatory pigmentation.
But, and this is a big BUT, the primary problem in acne of teen-agers is disordered keratinization, a term which describes the abnormal shedding of skin cells which cause them to be sticky and to fill up pores. This plugging of pores then leads to black heads and white heads and eventually to the breakdown of sebum, skin oils, into fatty acids.
If we correct the disordered keratinization and the plugging of the pores, then for most kids the acne will cease to exist. How we do this will be the subject of my next blog.

Your Do's and Don'ts For Acne Care

Acne is still the most common complaint among teen-aged and young adult patients in our practice. Acne patients are troubled by their obvious appearance changes and the subsequent reduction in self esteem. Making matters worse, acne leaves changes in skin color and even scars which vary in size and type. The next few blogs will concentrate on how to treat acne, how to treat post inflammatory hyperpigmentation, and how to treat acne scarring.
I am torn by speaking about what not to do and what to do. The obvious first don't is don't pick at your face. Picking leads to wounds which heal with scars and pigment. The second don't is still don't pick. And if it needs clarification don't even touch your face.
The next don't is don't worry about what you eat. I used to have patients bring me chocolate so I could put it in the waiting room for patints (and me) to eat. That way they would be convinced chocolate does not cause acne. And if I was wrong maybe I would get more patients so it was a win-win situation. Actually, no food has ever been shown to cause acne and this data goes back more than 50 yeras.
Since oil production clearly is related to acne, remember that sweating makes oil flow more and it needs to be addressed during exercise. When exercising, wear a wet (not dripping) terry-cloth headband so the sweat from your head and hair and from your forehead will be absorbed and not run down your face. If you have trouble breaking out on chest and back apply calamine( not caladryl ) lotion to your skin. It will absorb sweat and not become "gummy" and irritate the skin. Wash (shower) 20 minutes after exercise because it takes that long for your body heat to reduce and your sweating to stop. Shower temperature should be moderate and not hot. We don't want to prolong the sweat cycle.
What you do and don't do can have a visible effect on your complexion.