March 22, 2019


Acne is a medical condition that affects 40 to 50 million Americans, making it the most common skin disorder for teenagers and adults. About 85 percent of people will have acne at some point in their lives, and by mid-teens, 40 percent of people will have acne or acne scarring.

What Causes Acne?

  • First, excess sebum production (oily secretions of sebaceous glands)
  • Second, plugging of hair follicles (or pores)
  • Third, bacteria known as P. acnes

Do Hormones Influence Acne?

  • Yes, outbreaks are seen in times of hormonal changes
  • Neonatal period
  • Adolescence
  • Around menses for women

What Things Can Make Acne Worse - Diet? Stress? Sweating?

  • Stress can worsen the condition – it increases sebum production, which clogs hair follicles.
  • Sweating can cause an outbreak similar to acne caused by a yeast called pityrosporum folliculitis. This is a normal yeast that starts to overgrow in hair follicles.
  • Diet can affect the condition. High glycemic diets (sugar, carbohydrates) and dairy products can make outbreaks worse.

What About Over-the-Counter Treatments - Do These Work?

  • The active ingredient in many over-the-counter treatments is benzoyl peroxide, which kills P. acnes bacteria. For mild cases, benzoyl peroxide alone may be effective. For more severe cases, benzoyl peroxide can be combined with prescription treatments such as retinoid cream (retin-A) and/or topical antibiotics.
  • Another good over-the-counter treatment to use is a salicylic acid cleanser or cream. This helps unclog pores.

What Are the Side Effects With Treatment?

  • Many of the topical treatments can cause dryness and irritation. The goal is to kill the bacteria and decrease sebum, but if this is overdone then you get dryness and irritation. Often you need to start treatments slowly, 2-3 times a week and increase slowly.
  • Those who require courses of oral antibiotics may experience stomach upset. Fortunately, we have new slow-release formulations that allow us to use lower doses with less stomach irritation.

Are There Any Ways to Prevent Acne?

  • Wash your face daily with a mild cleanser. Rough scrubs or harsh cleansers can make outbreaks worse by causing more inflammation.
  • Use oil-free non-comedogenic makeup and skin products. These are formulated so they will not clog pores.
  • Eat a low carbohydrate diet. A diet high in sugar and carbohydrates causes spikes in blood glucose that can worsen symptoms.