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How to Deal with Acne

Updated on April 7, 2016
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Acne generally starts and ends with puberty, but for some of us, it’s a lifelong affliction. So what can you do about it? Is there really a way to make it go away?

My earliest memory of having bad acne was when I was in junior high. I was using an over-the-counter product that claimed to be invisible once it went on. This was an alternative to the “flesh tone” version that was, of course, never actually the same shade as my skin. This particular morning was a cold one, even for New Jersey. I believe it was probably below freezing. We had to wait outside the school for them to ring the bell and let us in if we got there early and, of course, we were there early. That’s when I discovered that the clear acne medication had a big drawback: when it was too cold, it turned white. My previously invisible medication was now white, and it looked like I had been rubbing my face against a clown’s. It was extremely embarrassing, and it taught me an important lesson about the claims made by all the acne products on the market – they didn’t always tell the absolute truth.

What is acne?

According to PubMed Health, there are actually three types of acne: mild, moderate, and severe. Mild acne occurs when an individual has blackheads or whiteheads, which are simply clogged skin pores. Someone with a few pimples might also be considered to have mild acne. Moderate acne occurs when someone has papules (small bumps) and pustules (filled with pus). This type of acne is bacterial and inflammatory. Severe acne occurs when someone has a lot of papules and pustules and also has nodules – the nodules will be red and painful and can sometimes cause scarring.

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What causes acne?

No, you can’t cause it by eating too much chocolate. A lot of people like to blame food for their acne, and in some cases, there can be an effect from certain foods for certain people, but, as a general rule, one particular food is not bad for everyone.

Acne is actually caused oily skin. It tends to appear during puberty because that’s when the body produces hormones, such as androgen, which causes the skin to produce more oil. Because not all teenagers get acne, and because some people get it beyond their 20s, it appears that there are other factors, including genetics and the immune system. There are studies that suggest that acne may also be related to stress and smoking, but there is no definitive proof yet.

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How long does a zit last?

It varies, unfortunately, but as a general rule, a zit should live out its little lifecycle in no more than one week. That’s one of the reasons why so many of the medications claim to improve your skin in one to two weeks – it will improve in that time, regardless of whether or not the medicine works.

How can you deal with acne?

Keep your face clean and don’t touch your face too often. We often subconsciously touch our faces or play with our hair. Doing that will help move the oil onto the skin and around on the skin, potentially causing more or bigger breakouts. If you can avoid doing that, you can slow down or stop the acne. It probably won’t be a cure, but it can make it better at least.

Try some of the medications, if you want to. Remember that you aren’t required to have clear skin. It’s up to you.

Avoid extra-stringent washes/antiseptic washes. If you over-dry your face, it won’t stop the acne. It’ll just make it more painful when those zits break through the already dry skin.

Do wash your face, but just normally. Keep it clean, but don’t worry about washing it more than the average person.

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How should you pop a zit?

Ewwww, right? But sometimes it’s necessary. It’s best to avoid actually doing the “pop.” The two best ways are to get a doctor or dermatologist to do it with a scalpel or with a shot or to use a hot, warm towel. I was lucky; one of my doctors offered to let me just come in (without an appointment), and he would fit me in between other appointments to take care of it since it was only a few seconds of work for him. The big plus was that, since he was using a seriously sharp and clean scalpel, it didn’t hurt, and it didn’t get infected. The other option was to use a new, clean towel, and put it under extremely hot water – so hot that I could barely touch it. Then I could wring it out a little and apply it to the zit. It would pop itself, mostly painlessly, and then also be clean.

Over the counter “cures”

The two most common active ingredients in over the counter medications are salicylic acid and benzoyl peroxide.

Salicylic acid is a keratolytic agent. It works because it reduces the swelling and redness by unblocking pores, which allows the pimples to shrink. It is applied topically for acne, and it often comes in different forms, including lotions, creams, ointments, and even in treated pads or wipes. Its main side effects are skin irritation and stinging where it’s applied.

Benzoyl peroxide is used to treat mild and moderate acne. It is generally applied one time a day, and it is often used in cleansing bars or liquids. The most common side effects are dryness or peeling of skin, tingling, stinging, or feelings of warmth in the areas where it’s applied.

Prescription “cures”

The two most common prescriptions are Retin-A (which is also used for aging/wrinkles) and Accutane.

Retin-A one of the brand names of Tretinoin. Tretinoin is used in the treatment of acne, but it is not considered a cure. It comes as a topical liquid, gel, or cream, and it’s normally applied at bedtime. Unfortunately, the treatment does tend to make things worse for the first week or so, but after that, it begins to improve, and within two to three weeks, the acne often is under control. Common side effects include lightening or darkening of the affected skin, increase in acne, warmth or stinging, red and scaling skin, or swelling and blistering of skin.

Accutane is a retinoid, and unlike Retin-A, it is taken in pill form instead of being a topical treatment. It’s intended for people with severe recalcitrant nodular acne. While it is normally effective, it can have severe side effects for women is they become pregnant during or after its use. These side effects include loss of pregnancy, the baby dying shortly before or after birth, or physical birth defects. In some cases, women will be required to take a pregnancy test before receiving their prescription each month. Accutane does make some birth control pills less effective. Some other common side effects include slowed healing of cuts or sores, sweating, flushing, tiredness, red and cracked lips, nosebleeds, changes in skin color, dry skin, voice changes, and cold symptoms.

Another option that often works is an antibiotic, which works by reducing the amount of bacteria on the skin. Unfortunately, many antibiotics can interact with birth control pills, making them less effective – or completely ineffective. Some antibiotics that doctors prescribe include Erthyomycin, Minocycline, and Doxycycline. Common side effects of the antibiotics include nausea and upset stomach, among others.

Psychological effects of acne

I have gone through my own effects. It was not unusual for well-meaning people to stop me and tell me what would cure my problems, or for people to tell me, “you would be so pretty if only…” I even had people telling me that fixing my acne would get me a boyfriend, which always made me laugh because I tended to have at least three or four boyfriends at any given time throughout most of high school. The potential worst moment was when, after I’d already gotten married, an old woman stopped me in the vegetable area of the grocery store and actually told me that I needed to eat tomatoes so that I could get rid of my acne and get a husband. I tried to be polite, but in the end, I told her to go away because she was rude.

But I have a strong personality and don’t shy away easily. For others, acne can be more serious. Because it tends to hit during adolescence, when peer acceptance and physical appearance are important, self esteem can definitely be affected. Teens and adults may find themselves having problem forming relationships because of fear or negative comments or a lack of self-confidence. They can also have issues with academic performance or work for the same reasons. In extreme cases, acne can result in depression.

Online support groups

If you suffer from acne and want to join an online support group for help, check these out:

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