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Acne leaves blemishes on our faces, blots our self-confidence and ruins a good photo opportunity. Everyone hates those stubborn pimples which are often annoying, painful and can leave physical and emotional scars. In the United States alone, eight out of ten people will experience some form of acne between the ages of eleven to thirty.
In the summertime, especially, our skin becomes more exposed to dirt, free radicals and humidity from spending more time outdoors which increases our chances of buildup, and thus, acne on our skin.
We sat down with Ashley Wu, a board-certified Nurse Practitioner at The Dermatology Specialists, to get the inside scoop on the different kinds of acne, how you can help prevent it from happening in the first place, and how to heal frustrating acne scars.
Acne occurs when hair follicles and pores are compacted with oil (also called sebum), dead skin cells and bacteria which inflame and irritate the skin. While acne is most common in teenagers, adults can still get it well into their 30s and at any other age.
Not all acne is the same — there are actually six different types of acne that can wreak havoc upon your face, chest, back and shoulders.
Here’s how to spot the six different types of acne:
Finding a cure for your acne may require some trial and error to identify the correct treatments. In part, that’s because the reason for your acne may be an excess of oil, bacterial infections, clogged pores, among other reasons.
“There is no one-size-fits-all treatment when it comes to acne as everyone’s type and severity are different. Some people get clear skin from just topical treatments while others require oral treatments in addition to topical treatments,” Wu explains.
Most types of acne can worsen as a result of hormonal changes like excessive androgen production; for women, that means acne flare-ups could be caused by menstruation or pregnancy. Other factors include stress, poor diet or even medication. That being said, getting rid of acne may require different treatments for different acne and skin types.
Wu says, “Whiteheads and blackheads are considered non-inflammatory acne and typically respond to retinoid and benzoyl peroxide topical creams. Papules, pustules, cysts, and nodules are considered inflammatory acne and typically respond to topical antibiotics and benzoyl peroxide and often may need oral or injection treatment. Cysts and nodules can be more difficult to get rid of than other types.”
Ingredients like Vitamin A, aloe vera, tea tree oil and witch hazel are popular for home remedies.
However, these remedies have limited testing standards, so we usually recommend other forms of treatment.
One of the first approaches to treat acne usually includes over-the-counter products that include benzoyl peroxide or salicylic acid, which decrease excess oil and bacteria and hasten the turnover of skin cells. These acne medications work great whether you’re battling widespread facial acne or just looking to treat a particular spot. Azelaic acid also helps combat various forms of acne. However, be careful of overusing these products because they may be drying and irritating to the skin.
Amongst available topical medications, retinoids and retinoid-like drugs contain stronger amounts of medication that clear pores. Wu explains that you can apply a thin coat of over-the-counter retinoids like adapalene to the whole face for best results. For sensitive skin, start application every two to three nights until the skin tolerates the treatment.
If topical medications don’t work (both over-the-counter and prescription), then oral medications can be a good alternative.
“If consistent topical treatment for 3 months yields no improvement, patients are often placed on oral treatments. With short-term oral antibiotics, topical treatments can be used in conjunction. But with Accutane, no topical treatments should be used in conjunction because severe irritation can occur,” says Wu.
The tetracycline group of antibiotics that include minocycline and doxycycline are used to treat various types of acne by slowing down bacteria growth while reducing swelling and redness. For women, treatments like birth control or Spironolactone may be prescribed to help regulate hormones that can cause acne. Accutane is considered one of the most effective ways to treat severe acne, and it’s also used for chronic acne that doesn’t respond to other forms of treatment.
Talk to your dermatologist who can prescribe these medications and help you weigh the benefits and any side effects.
First and foremost, wash and cleanse your skin twice each day, especially because dirt and bacteria build up throughout the day and while we sleep. You can help prevent whiteheads through simple exfoliation and washing, but it’s important to avoid harsh scrubbing as it irritates the skin further.
Here are some other tips to keep your skin clear:
Wu advises that the absolute best way to treat acne scarring is through prevention. If there’s no new acne that appears, then you’re not going to get new acne scars. Therefore, your first focus should always be to get your acne under control and to avoid popping pimples.
If you do have acne scars, they don’t have to be permanent. There are two categories of acne scars: superficial, temporary marks and deeper, more severe permanent scarring like pockmarking. Each type requires different treatments.
Superficial, temporary scars may fade naturally over time, but dermatologists can minimize their appearance more quickly through the use of chemical peels, topical retinoids, azelaic acid, and hydrocodone.
On the other hand, deeper acne scars often require the help of a dermatologist who can provide laser treatments and minor skin surgeries. Fillers, for instance, add volume to some deep atrophic scars while laser resurfacing may work on various types of both atrophic and hypertrophic acne scars.
“Over-the-counter treatments may improve acne scarring slowly over one to two years with consistent use and sun protection. However, you should see a dermatologist to determine the type of scarring you have and determine the best way to get the quickest results,” says Wu.
Acne can be a complicated struggle for many people, especially in their adolescence. The Dermatology Specialists’ supportive team of expert dermatologists and staff members can find the right solution to help you control acne throughout each stage of treatment, no matter the severity, your age or skin type.
Ashley Wu FNP-BC is a board-certified Family Nurse Practitioner specializing in dermatology. She completed her Master of Science in Nursing at Columbia University, and holds Bachelor of Science degrees in Psychology and Nursing from Rutgers University and Villanova University, respectively. Ashley is fluent in Mandarin Chinese, having lived in Taiwan for 9 years.