Vinay Gupta asked:


Acne is a skin disease caused by changes in the pilosebaceous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Severe acne is inflammatory, but acne can also manifest in noninflammatory forms. Acne lesions are commonly referred to as pimples, spots, or zits.

Acne is most common during adolescence, affecting more than 85% of teenagers, and frequently continues into adulthood. For most people, acne diminishes over time and tends to disappear, or at least decrease, after one reaches his or her early twenties. There is, however, no way to predict how long it will take for it to disappear entirely, and some individuals will continue to suffer from acne decades later, into their thirties and forties and even beyond. Acne treatments work by reducing oil production, speeding up skin cell turnover, fighting bacterial infection, reducing the inflammation or doing all four. With most prescription acne treatments, you may not see results for four to eight weeks, and your skin may get worse before it gets better.

You can avoid or control most acne with good basic skin hygiene techniques:

Wash problem areas with a gentle cleanser. Try over-the-counter acne lotion to dry excess oil and promote peeling. Look for products containing benzoyl peroxide or salicylic acid as the active ingredient. Avoid irritants. You may want to avoid oily or greasy cosmetics, sunscreens, hair-styling products or acne concealers. Use products labeled “water-based” or “noncomedogenic.”

Keep your hair clean and off your face. Don’t pick or squeeze the acne. Picking or squeezing can cause infection or scarring. Your doctor or dermatologist may recommend a prescription medication you apply to your skin (topical medication) or take by mouth (oral medication). Topical treatments Acne lotions may dry up the oil kill bacteria and promote sloughing of dead skin cells. Over-the-counter lotions are generally mild and contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or lactic acid as their active ingredient. These products can be helpful for very mild acne. Antibiotics. For moderate to severe acne, prescription oral antibiotics may be needed to reduce bacteria and fight inflammation.

You may need to take these antibiotics for months, and you may need to use them in combination with topical products.Isotretinoin. For deep cysts, antibiotics may not be enough. Isotretinoin (Accutane) is a powerful medication available for scarring cystic acne or acne that doesn’t respond to other treatments. Oral contraceptives. Oral contraceptives, including a combination of norgestimate and ethinyl estradiol (Ortho-Cyclen, Ortho Tri-Cyclen), have been shown to improve acne in women.Laser and light therapy. Laser- and light-based therapies reach the deeper layers of skin without harming the skin’s surface. Laser treatment is thought to damage the oil (sebaceous) glands, causing them to produce less oil. Cosmetic procedures, Chemical peels and microdermabrasion may be helpful in controlling acne. Doctors may be able to use certain procedures to diminish scars left by acne. These include fillers, dermabrasion, intense light therapy and laser resurfacing.

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