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					                                                                     Frequently Asked questions




                              Acne
                                                                                   who specializes in treating skin prob-
                                                                                   lems) about how you can help prevent
                                                                                   acne and if treatment would help you.

                              Q: What is acne?                                  Q: What are the different types of
                              A: Acne is a disorder that causes outbreaks          acne lesions?
                                  of skin lesions commonly called pim-          A: • Comedo (whiteheads or black-
                                  ples. It is caused by the skin’s oil glands         heads) or papules. The comedo
                                  making too much sebum, an oily sub-                 is the basic acne lesion, which is a
                                  stance, which leads to plugged pores. It            plugged pore. If the plugged pore
http://www.womenshealth.gov       also can be caused by the rapid produc-             stays under the skin, it’s called a
         1-800-994-9662           tion of a bacteria P. acnes.                        closed comedo and forms a white
  TDD: 1-888-220-5446             Acne lesions occur mostly on the                    bump or whitehead. Blackheads are
                                  face, neck, back, chest, and shoulders.             comedos that open up and appear
                                  It is the most common skin disease.                 blackish on the surface of the skin.
                                  Although acne is not a serious health               This black color is not due to dirt,
                                  threat, severe acne can lead to disfigur-           but because the air reacts with the
                                  ing and permanent scarring.                         excess oil.
                                                                                   • Pustules or pimples. Pustules or
                              Q: How does acne affect women?                         pimples are acne lesions that contain
                              A: Most young women and men will have                  pus and are red at the base.
                                  at least a few pimples over the course of        • Nodules. These are more serious
                                  their lives. But acne seems to affect men          acne lesions. They lodge deeper in
                                  and women in different ways. Young                 the skin, are painful, and can cause
                                  men are more likely to have a more                 scarring.
                                  serious form of acne. Acne in young
                                                                                   • Cysts. Like nodules, these lesions
                                  women tends to be more random and
                                                                                     are deep within in the skin, are pain-
                                  linked to hormone changes, such as the
                                                                                     ful, and are filled with pus, and can
                                  menstrual cycle.
                                                                                     cause scarring.
                                  As women get older, acne often gets
                                  better. But some women have acne for
                                  many years. Some women even get               Q: What triggers acne in women?
                                  acne for the first time at age 30 or 40.      A: Many things can trigger acne in
                                  For many women, acne can be an                   women:
                                  upsetting illness. Women may have                • Hormone changes during puberty.
                                  feelings of depression, poor body image,           During puberty, girls have an
                                  or low self-esteem. But you don’t have             increase in male sex hormones called
                                  to wait to outgrow acne or to let it run           androgens. This increase causes the
                                  its course. Today, almost every case of            glands to get larger and make more
                                  acne can be resolved. Acne also can,               sebum.
                                  sometimes, be prevented. Talk with               • Hormone changes as an adult. The
                                  your doctor or dermatologist (a doctor             menstrual cycle is one of the most
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                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                    Frequently Asked questions



                                     common acne triggers. Acne lesions        Q: Can eating chocolate or greasy
                                     tend to form a few days before the           foods cause acne?
                                     cycle begins and go away after the        A: While many women feel that eating
                                     cycle is completed. Other hor-                chocolate or greasy foods causes acne,
                                     mone changes, such as pregnancy               experts have not found a link between
                                     and menopause, improve acne in                the diet and acne. Foods seem to have
                                     some women. But some women                    little effect on acne in most people.
                                     have worse acne during these times.           But, it’s important to eat a healthy diet
                                     Stopping use of birth control pills           for good health.
                                     can play a role as well.
http://www.womenshealth.gov       • Medicines. Certain medicines, such         Q: How is mild acne treated?
         1-800-994-9662             as those used to treat epilepsy and        A: There are many treatments for mild
                                    types of depression.                           acne. Mild acne can consist of white-
  TDD: 1-888-220-5446
                                  • Make-up.                                       heads, blackheads and small pustules.
                                  • Pressure or friction on the skin.              At home, you can wash your face twice
                                    Friction caused by bike helmets or             per day with warm water and a gentle
                                    backpacks can make acne worse.                 cleanser or soap. Your doctor may sug-
                                                                                   gest you also try an over-the-counter
                                  • Family history. If other people in             lotion or cream. These medicines may
                                    your family have acne, there is a              make your skin dry if you use them too
                                    greater chance you will have it.               much. Be sure to follow the directions.
                                                                                   If these medicines don’t work, your
                              Q: Does poor hygiene cause acne?                     doctor may prescribe a cream or lotion
                              A: It is a myth that women get acne                  with benzoyl peroxide, resorcinol, sali-
                                  because they don’t wash enough. Too              cylic acid, or sulfur.
                                  much washing or scrubbing the skin               • Benzoyl peroxide works to reduce
                                  harshly can make acne worse. And                   oil made by the glands.
                                  washing away surface oils doesn’t do
                                                                                   • Resorcinol, salicylic acid, and sulfur
                                  much to prevent or cure acne, because
                                                                                     help breakdown whiteheads and
                                  it forms under the skin. The best way
                                                                                     blackheads.
                                  to clean the face is to gently wash it
                                  twice a day with a mild soap or cleanser.        If your acne does not get better after six
                                  Be careful to remove make-up without             to eight weeks, talk with your doctor
                                  harsh scrubbing.                                 about changing your treatment.


                              Q: Can stress cause acne?                        Q: Can more serious forms of acne
                              A: Stress does not cause acne. But, acne            be treated?
                                  may be a side effect of some medicines       A: Yes. Work with your doctor to find the
                                  used to treat stress or depression. And          best treatment for you.
                                  in some cases, the social and emotional          Moderate to moderately severe
                                  impact of acne lesions causes stress. Talk       acne. This type of acne consists of sev-
                                  with your doctor if you have concerns.           eral whiteheads, blackheads, papules
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                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                 Frequently Asked questions



                              the face and/or other parts of the body.         of this drug may include dry eyes, itch-
                              It can be treated with antibiotic lotions        ing, mood changes, and changes in the
                              or gels, as well as retinoic acid. Retinoic      blood and liver. You and your derma-
                              acid is an altered form of vitamin A. It         tologist can decide whether this medi-
                              helps prevent whiteheads and black-              cine is right for you based on the pros
                              heads. Your doctor may also prescribe            and cons. Use any prescribed medicine
                              an antibiotic pill, such as erythromycin.        exactly as you are advised. Taking more
                              If you take birth control pills to prevent       medicine than you are supposed to take
                              pregnancy, antibiotics can affect how            may make acne or your general health
                              well they work. Be sure to use a second          worse. Ask your doctor what to do if
http://www.womenshealth.gov
                              method of birth control with the pill,           you miss a dose.
                              such as a condom. Retinoic acid and              Some large cysts do not respond to
         1-800-994-9662
                              antibiotic pills can make the skin sensi-        medication and may need to be drained
  TDD: 1-888-220-5446         tive to the sun. So, wear sunscreen and          or removed. Your dermatologist is
                              stay in the shade while using them.              the only person who should drain or
                              Severe acne. Severe acne consists of             remove these. You should never try to
                              deep cysts, redness, swelling, extreme           drain or remove your acne by squeezing
                              damage to the skin and scarring. You             or picking. This can lead to infection,
                              should see a dermatologist to care for           worsen your acne, and cause scarring.
                              this type of acne. Scarring can be pre-          Overall, if you don’t see a change in
                              vented with appropriate treatments.              your skin in six to eight weeks, talk with
                              Your dermatologist can prescribe oral            your doctor about your treatment plan.
                              antibiotics and oral contraceptives.
                              Large inf lamed cysts can be treated
                              with an injection of a drug that lessens      Q: Can birth control pills help treat
                              the redness, swelling, and irritation, and       acne?
                              promotes healing.                             A: For women who break out mainly
                              Your dermatologist may prescribe                 around their menstrual cycle, some
                              Accutane®, if other treatments have              birth control pills can help. Research
                              not worked. This is a strong medicine            shows that these pills can clear acne
                              that can help prevent scarring and treat         by slowing down overactive oil glands
                              active disease. But, Accutane also can           in the skin. Sometimes, birth con-
                              cause birth defects. It is important that        trol pills are used along with a drug
                              you are not pregnant and do not plan             called spironolactone to treat acne in
                              to get pregnant while taking this medi-          adult females. This medication low-
                              cine. You must use two methods of                ers levels of the hormone androgen
                              birth control at the same time. This is          in the body. Androgen stimulates the
                              done for one month before treatment              skin’s oil glands. Side effects of this
                              begins, during treatment, and for a full         drug include irregular menstruation,
                              month after stopping the drug. Talk              breast tenderness, headache and fatigue.
                              with your dermatologist about when it’s          Spironolactone is not appropriate thera-
                              safe to get pregnant. Other side effects         py for all patients.


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                                   U.S. Department of Health and Human Services, Office on Women’s Health
                                                                     Frequently Asked questions



                              Q: When is surgery used for acne                     • Wash your hair on a regular basis. If
                                 scarring?                                           your hair is oily, you may want to
                              A: If you have scarring, your dermatolo-               wash it more often.
                                  gist may suggest surgery to help heal            • Do not squeeze or pick at acne
                                  acne lesions and remove scarring. A                lesions. This can cause acne scars.
                                  laser can reshape scar tissue and reduce
                                                                                   • Avoid getting sunburned. Many
                                  redness. Dermabrasion is a type of
                                                                                     medicines used to treat acne can
                                  surgery that can remove surface scars
                                                                                     make you more prone to sunburn.
                                  and reduce the depth of deep scars.
                                                                                     Many people think that the sun
                                  Another option is to transfer fat from
                                                                                     helps acne, because the redness from
http://www.womenshealth.gov       one part of the body to the face. In
                                                                                     sunburn may make acne lesions less
         1-800-994-9662
                                  some cases, a single treatment can help
                                                                                     visible. But, too much sun can also
                                  scarring. But for lasting results, several
  TDD: 1-888-220-5446                                                                increase your risk of skin cancer and
                                  are often needed. There are also topi-
                                                                                     early aging of the skin. When you’re
                                  cal treatments for acne scarring.
                                                                                     going to be outside, use sunscreen of
                                  Photodynamic therapy is a new acne                 at least SPF 15. Also, try to stay in
                                  treatment. It begins with light micro-             the shade as much as you can.
                                  dermabrasion. This is used to remove
                                  dead skin cells on the face’s surface.           • Choose make-up and hair care prod-
                                  Then, an acid is put on the skin for               ucts that are “non-comedogenic” or
                                  30 to 60 minutes. After this period,               “non-acnegenic.” These products
                                  the acid is taken off. Lastly, the skin is         have been made in a way that they
                                  treated with a laser. This treatment is            don’t cause acne. You may also want
                                  still being researched, but seems to give          to use products that are oil-free.
                                  positive long-term results.                      • Avoid things that rub the skin as
                                                                                     much as you can, such as backpacks
                              Q: How can I help prevent acne                         and sports equipment.
                                 and acne scars?                                   • Talk with your doctor about what
                              A: You can help prevent acne flare-ups and             treatment methods can help your
                                  scars by taking good care of your skin:            acne. Take your medicines as pre-
                                                                                     scribed. Be sure to tell your doctor
                                  • Clean your skin gently with a mild
                                                                                     if you think medicines you take for
                                    soap or cleanser twice a day once
                                                                                     other health problems make your
                                    in the morning and once at night.
                                                                                     acne worse.
                                    You should also gently clean the
                                    skin after heavy exercise. Avoid
                                    strong soaps and rough scrub pads.         Q: Is rosacea the same as acne?
                                    Harsh scrubbing of the skin may            A: Rosacea (ro-ZAY-she-ah) is a common
                                    make acne worse. Wash your entire              skin problem often called “adult acne.”
                                    face from under the jaw to the hair-           Faired skinned and menopausal women
                                    line and rinse thoroughly. Remove              are more likely to have rosacea. Rosacea
                                    make-up gently with a mild soap                also seems to run in families. It causes
                                    and water. Ask your doctor before              redness in the center parts of the face
                                    using an astringent.                           and pimples. Blood vessels under the
                   page 




                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                 Frequently Asked questions



                                skin of the face may enlarge and show            may be painful.
                                through the skin as small red lines. The         You can help keep rosacea under con-
                                skin may be swollen and feel warm.               trol by keeping a record of things that
                                Women with rosacea don’t have the                cause it to f lare up. Try to avoid or
                                same lesions as seen with common                 limit these triggers as much as you
                                acne. They may have f lushing of the             can. Antibiotic lotions or gels can also
                                face, when they are hot, drink alco-             help. Sometimes, you may need to take
                                hol or hot drinks, or eat spicy foods.           antibiotic pills. Your dermatologist
                                This f lushing causes the face to appear         may treat you with laser surgery. If you
                                red. In the most severe form, this red-          think you have rosacea, talk with your
http://www.womenshealth.gov     ness does not go away. The eyes may              doctor about these treatments. n
         1-800-994-9662         become swollen and nodules in the skin
  TDD: 1-888-220-5446

                              For more information
                              For more information on acne, call womenshealth.gov at 1-800-994-9662 or contact the
                              following organizations:

                              National Institute of Arthritis and            American Osteopathic College of
                              Musculoskeletal and Skin Diseases              Dermatology
                              Information Clearinghouse, NIAMS,              Phone: (800) 449-2623
                              NIH, HHS                                       Internet: http://www.aocd.org/index.html
                              Phone: (301) 495-4484, (301) 565-2966
                              TTY, (877) 226-4267                            DermWeb
                              Internet: http://www.niams.nih.gov/            Phone: (604) 875-4747
                                                                             Internet: http://www.dermatology.org/
                              American Academy of Dermatology
                              Phone: (847) 330-0230, (202) 842-3555,         Clear Up Skin Care
                              (866) 503-SKIN (7546)                          Phone: (818) 508-5135
                              Internet: http://www.aad.org/                  Internet: http://clearupskincare.org/index.
                                                                             html
                              American Society for Dermatologic
                              Surgery
                              Phone: (800) 441-2737, (847) 956-0900
                              Internet: http://www.asds-net.org/


                                  Reviewed by:
                                  Diane Berson, MD
                                  Weill Medical College of Cornell University

                                  All material contained in this FAQ is free of copyright restrictions, and may be copied,
                                  reproduced, or duplicated without permission of the Office on Women's Health in the
                                  Department of Health and Human Services. Citation of the source is appreciated.
                   page 
                                  Content last updated July 16, 2009.



                                     U.S. Department of Health and Human Services, Office on Women’s Health

				
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