Acne is one of the most common skin conditions we see in both teenagers and adults. The condition can start early in the pre-teen years (as young as age 8) and persist through adolescence into early adulthood. Both women and men can suffer from this inflammatory skin disease into their 20s, 30s, and 40s. Some women get adult-onset acne, also called hormonal acne, which first appears in adulthood and can persist through menopause. The type and severity we see can vary depending on the age of the patient, family history of severe acne, and types of products people use on their skin. Dr. Naomi Brooks strives to provide an accurate assessment about specific types of acne in Boise-area patients, while also providing education about the best skin care regimens tailored to their skin profile.
Acne is a medical term that encompasses breakouts of pimples, blackheads, and whiteheads. The lesions occur most commonly on the face, neck, chest, back, and shoulders.
The earliest stage of an acne lesion is a clogged pore that becomes a bump on the skin, or a comedo. If there is a block preventing a clogged pore from being exposed to the air, it forms a whitish appearance (i.e. develops into a whitehead). If the clog in the pore is exposed to air, this build-up becomes darker (i.e. develops into a blackhead). Blackheads and whiteheads are the least severe lesions, and are much simpler to treat.
These blackheads and whiteheads can become worse and turn into small, reddish bumps known as papules or pimples.
People with more severe teenage or hormonal acne can also develop nodules and cysts underneath the skin. At this stage, the inflammation is much deeper in the skin, and the lesions can be painful. Nodules and cysts can lead to scarring. Patients can also get red or brownish discolored spots that are residual after a lesion heals. These post-inflammatory spots are not scars, but can persist for six to 12 months before gradually resolving.
There are other skin conditions that can look like acne, so it is important for a dermatologist to carefully examine a patient's skin and make an accurate diagnosis. If a patient has been diagnosed with acne, it will be graded, with grade 1 being mild and grade 4 being severe.
Acne occurs due to a combination of four factors in the skin: oil glands, overgrowth of normal bacteria on the skin known as p. acnes, skin cells that become plugged in the pores, and the body's natural inflammatory response to these conditions.
Hormones can trigger oil glands (sebaceous glands) to produce more oil. That is why acne is more common during puberty and in adult women. Although the hormone levels may be normal, some people have skin receptors that are very sensitive to these hormones. Stress does not cause acne, but may also play a role in hormones, which can exacerbate the condition. Pregnancy, certain medications, and medical conditions can also trigger flares.
There are a lot of inaccurate myths and improper skin care tips that can be confusing for people trying to control their acne. Excessive washing or scrubbing, harsh skin products such as exfoliants and astringents, or using the wrong products on the skin will actually make the condition worse, as can picking or "popping" pimples. Excess sun exposure and tanning can aggravate acne treatments and cause more residual skin pigmentation marks. Dirt or lack of cleansing, chocolate, and greasy foods are not associated with the condition. Although no specific foods have been definitively linked to causation, a healthy diet that is low-fat, low-glycemic, and high in vegetables may decrease inflammation in the skin and keep skin healthy. Good hydration with water is also helpful.
A common (and incorrect) piece of advice often provided to those suffering from the condition is to let it "run its course." But dermatologists know that this strategy often does not work.
All forms of acne can cause distress due to appearance, discomfort, and painful lesions, and if it goes untreated, can result in long-term pigmentation and scarring. Studies have shown that the condition can decrease self-esteem and cause depression, even in people with mild or moderate forms.
When targeted early on, harsh and potentially long-term effects can be prevented. Acne responds best to a combined treatment regimen that targets the different pathways in the formation of lesions, along with a good skin care education and long-term maintenance program to prevent future flare ups. Even after the skin clears, continual treatment may be recommended to prevent new breakouts.
Patients come to Boise Dermatology to treat a variety of medical skin conditions, such as skin cancer, eczema, psoriasis, and rashes. Dr. Brooks provides individualized care for every patient to maximize their treatment results while prioritizing their health and comfort.