Acne

What is Acne and Why do I Have it?

 Acne is a skin condition caused by hair follicles becoming clogged with your body’s oils and dead skin cells. These plugged pores can become infected, leading to larger, redder pimples, eventually forming “whiteheads” and sometimes “blackheads” when the pores open up and expose the oils to the air. Acne is not the result of poor hygiene; it is caused by a combination of hormonal changes, the presence of certain bacteria living on the skin, and genetics. Though stress does not cause acne, it can make it worse. There is not a clear link between certain foods and acne. The elimination of certain foods is unlikely to improve acne, but a balanced healthy diet is always recommended!
 
How Will My ProviderTreat My Acne?

There are many treatments available for acne including topical ones which are applied to the skin, and medications that are taken by mouth. Typically, care plans start with the mildest treatments which are then increased only as needed, in order to avoid irritating side effects.
 
Acne treatments are aimed at preventing the formation new acne by removing oil and bacteria from the skin’s surface, and at reducing inflammation. It is important to give any treatment adequate time to work. It can take between 6-12 weeks to see a response to treatment. During this time consistency and patience are very important. You need to do your skin care every day—not just when it looks bad! Please let us know if you are having side effects that are making it difficult for you to tolerate your treatment.
 
Topical Treatments for Acne
In most cases of mild acne your provider will recommend that you start with topical treatments.

  • Facial washes - Wash with a gentle face wash such as Cetaphil, CeraVe, or Neutrogena twice each day.
  • Benzoyl Peroxide Products - When gentle washing isn’t enough, your provider may recommend a benzoyl peroxide wash with 5-10% benzoyl peroxide or topical benzoyl peroxide cream for spot treatment.  Options for face wash include: Oxy, Panoxyl. and Neutrogena Rapid Clear.  Spot treatments such as Clean and Clear Persa Gel, Neutrogena On-The-Spot,  or Up & Up benzoyl peroxide gel can be used for targeted treatment after gentle cleansing with a non benzoyl peroxide wash. The main side effect of benzoyl peroxide is dry skin. We recommend the use of an oil free face lotion after application. Be aware that benzoyl peroxide can bleach towels, pillow cases, clothing and hair!
  • Topical Retinoids - Topical retinoids such as Differin or Retin-A work to unplug the clogged pores and may be recommended if you do not see improvement with the use of benzoyl peroxide. Retinoid creams should not be used as spot treatment, they need to be applied to the whole face. Sunlight can inactivate retinoids, so they should be applied before bed. The most common side effects include dryness, burning, scaling. This side effect may be managed by reducing the frequency of application to every other night or even every third night, and then increasing the use as tolerated. While Differin is available counter, most of the other retinoids require a prescription
  • Topical Antibiotics - Topical antibiotics are another option to decrease inflammation and reduce bacteria on the skin. Often these antibiotics are combined with benzoyl peroxide (such as Benzaclin or Duac) for improved efficacy. These products can be drying, and the use of benzoyl peroxide may bleach clothing, towels, sheets or hair. These products always require a prescription.
 
Oral Acne Medications
For moderate acne, or acne that has not improved with the use of topical treatments, oral medications such as antibiotics, oral hormones, or Accutane may be recommended.
  • Oral Antibiotics - Oral antibiotics such as doxycycline and minocycline can be used to fight bacteria and reduce inflammation. If your provider prescribes one of these medications, you should still continue all topical treatments. These medications can cause irritation of the esophagus and stomach, so should be taken with lots of water or food and at least 1 hour before you lie down. They also make you more sensitive to the sun, so it is very important to apply sunscreen when spending time outside. If you experience any of the following rare but more serious side effects please call us right away: persistent headaches, blurry vision, severe heart burn or stomach pain, darkening of the gums or scars, rash, yellowing of the skin, joint paints, or flu-like symptoms.
  • Hormonal Treatment: The Birth Control Pill - The birth control pill has many uses, and can be useful in treating moderate to severe acne in adolescent females. If you and your provider decide to use the birth control pill to treat your acne they will give you a second handout with additional information.
  • Accutane - Accutane, also known as Isotretinoin, is a powerful medication used to treat severe acne, usually after all other treatments fail or have excessive side effects. It is prescribed by a dermatologist and requires close monitoring and routine lab work.
 
General Tips
  • Patience and consistency will pay off when it comes to treating acne. It is important to give any treatment 6-12 weeks to work, and to do your skin care every day!
  • Even if your doctor prescribes an oral medication, it is still important to continue topical treatments also.
  • Don’t stop using your acne medication if your skin improves – prevention is important!
  • Acne medications can make your skin more sensitive to the sun. Make sure to use sunscreen to protect your skin when you are outside.
Return to Parent Handouts

Is Your Child Sick?®