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Acne (acne vulgaris)AAcne (acne vulgaris)Acne (acne vulgaris)EnglishDermatologyPre-teen (9-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2015-01-14T05:00:00ZMiriam Weinstein, MD, FRCPC8.0000000000000059.00000000000001487.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover the different types and causes of acne and how they can be treated.</p><p>Acne, clinically known as acne vulgaris, is the most common skin disease. It affects 85% of teenagers, some as young as 12, and often continues into adulthood. It is also called "pimples," "zits" or "blemishes."</p><h2>Key points</h2><ul><li>Acne vulgaris is the most common skin disease in teenagers.</li><li>Acne occurs deep within the skin, and severity and outcomes vary from person to person.</li><li>Acne causes comedones (whiteheads and blackheads), papules, pustules or even nodules.</li><li>Picking, squeezing and popping can lead to scarring.</li><li>Acne is manageable with the appropriate treatment. Ask your doctor or your dermatologist about your options.<br></li></ul><h2>What causes acne?</h2> <figure> <span class="asset-image-title">Anatomy of the skin</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_skin_anatomy_EN.jpg" alt="" /> <figcaption class="asset-image-caption">Acne occurs when the sebaceous glands produce more oil, clogging different parts of skin tissue.</figcaption> </figure> <p>The skin is formed by many layers of tissue, containing hair, glands, muscles, sensory receptors and blood vessels. During puberty, a group of hormones are released called androgens. Androgens allow the sebaceous glands in the skin to produce an oily substance called sebum. Acne is in part caused by this increase in sebum that naturally occurs during puberty.</p><p>Normal amounts of sebum keep skin and hair from drying out. However, excess oil can mix with dead skin cells and clog hair follicles (the tiny tunnels that lead to the root of the hair) and pores (the opening in the skin where the hair passes through).</p><p>A common type of bacteria that lives on the skin, known as <em>Propionibacterium acnes</em>, sometimes contributes to acne by causing inflammation. The acne signals white blood cells to the area, which damage the tissue and cause an inflammatory response. This causes swelling and infection.</p><p>Acne leads to persistent redness and inflammation, especially on the face, scalp, back and chest, where the most sebum is produced.</p><p>Acne varies from mild to severe, depending on what kind of blemishes appear. The different types of acne include:<br></p><ul><li>comedones</li><li>papules</li><li>pustules</li><li>nodules</li></ul><p>Comedones are pores that are blocked with oil and dead skin cells. They can be open ("blackheads") or closed by the skin ("whiteheads").</p><p>A blackhead is generally level with the skin surface and cannot be removed by normal washing of the face.</p> <figure class="asset-c-80"> <span class="asset-image-title">Open comedo (blackhead)</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_blackhead_EN.png" alt="" /> <figcaption class="asset-image-caption">The pore of a blackhead is open. When the sebum comes into contact with the air, oxygen exposure causes it to appear black.</figcaption> </figure> <p>A whitehead is slightly raised from the skin, but there is no inflammation.</p> <figure class="asset-c-80"> <span class="asset-image-title">Closed comedo (whitehead)</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_whitehead_EN.png" alt="" /> <figcaption class="asset-image-caption">A whitehead is formed when pores are blocked with sebum and dead skin cells. The pore in a whitehead is not open at the top.</figcaption> </figure> <p>Papules are red, small, hard bumps that are slightly raised on the skin. In clusters, they can feel like sandpaper to the touch. White blood cells enter the follicle, causing inflammation.</p> <figure class="asset-c-80"> <span class="asset-image-title">Papule</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_papule_EN.png" alt="" /> <figcaption class="asset-image-caption">Papules are red, painful bumps caused by inflammation of the hair follicles.</figcaption> </figure> <p>When the white blood cells in a papule make it to the surface of the skin, a pustule is formed. Pustules appear as red, inflamed circles with a central, raised bump that is yellowish or white. The bump is filled with pus. Pus is the result of inflammation and contains white blood cells, dead skin cells and bacteria.</p> <figure class="asset-c-80"> <span class="asset-image-title">Pustule</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_pustule_EN.png" alt="" /> <figcaption class="asset-image-caption">Pustules form a few days after the white blood cells in a papule make it to the surface of the skin. Pustules are typically called "pimples" or "zits".</figcaption> </figure> <p>When a papule or pustule expands, it can cause more severe inflammation in the surrounding skin. This can lead to nodules, which are deep, red, round bumps that can have a diameter of 6 to 20 mm. They are sometimes referred to as cysts.</p><p>Nodules are formed by irritated, inflamed hair follicles that have ruptured deep under the skin. They can be throbbing and painful, even without touching.</p> <figure class="asset-c-80"> <span class="asset-image-title">Nodule</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_nodule_EN.png" alt="" /> <figcaption class="asset-image-caption">Nodules are often large, inflamed, red, swollen and painful to the touch.</figcaption> </figure><h2>Psychological impact of acne</h2> <p>Acne can have a profound impact on a person's quality of life, particularly for teenagers. Reactions can range from minimal distress to more significant depression, anxiety and, less commonly, thoughts of suicide or self-harm. For these reasons, treating acne matters.</p> <h2>Treatment of acne</h2> <p>Treatment depends on the severity and type of acne. An effective treatment will help reduce future breakouts and improve the skin's appearance. Keep in mind that up to six weeks of treatment might be necessary to start noticing results.</p> <p>In most cases, your doctor or dermatologist will prescribe topical treatments (applied directly on the skin). Sometimes the doctor may prescribe an oral treatment (taken by mouth).</p> <h3>Cleansing skin</h3> <p>Acne is a process deep within the skin. Washing your face regularly helps remove dead skin cells and excess oil, but does not play a significant role in the prevention or management of acne.</p> <p>If you have acne, avoid scrubbing your face when washing, because this may worsen inflammation and irritation. Instead, gently wash your face with warm water. You may also use a mild cleansing product if you want.</p> <h3>Topical retinoids</h3> <p>Topical retinoids unplug comedones and improve the process of shedding the old cells. They may also help reduce any inflammation.</p> <p>Some side effects may occur when using a topical retinoid. These include mild irritation, redness (erythema), dryness, peeling and sensitivity to sun. If you are pregnant, or thinking about having a baby, talk to your doctor or dermatologist before using a topical retinoid, as they should not be used during pregnancy.</p> <p>Avoid skin damage, such as waxing or exfoliation (e.g., facials) when taking retinoids.</p> <p>Common topical retinoids are available in cream and gel form. There are benefits to both creams and gels, depending on the severity of acne and the sensitivity of your skin. Retinoids are also available in many strengths and formulations. Therefore, there is no one better option; your doctor will recommend a retinoid most appropriate for you.</p> <h3>Topical antimicrobials</h3> <p>Topical antimicrobials are used to kill bacteria that contribute to inflammation. They also help fight inflammation directly. One option is benzoyl peroxide, which is available over the counter. When benzoyl peroxide touches the skin, oxygen is created. <em>P. acnes</em> cannot survive in the presence of oxygen.</p> <p>Use caution when applying benzoyl peroxide because it is a potent bleaching agent that can damage fabrics. The pharmacist can answer any questions you might have.</p> <h3>Oral antibiotics</h3> <p>An oral antibiotic (taken by mouth) is sometimes used to treat more significant acne, especially in cases where the acne has spread to the back and chest. Such as topical treatments, oral antibiotics reduce inflammation.</p> <p>Antibiotics can also stop <em>P. acnes</em> from multiplying. However, the use of antibiotics should be limited because bacteria can develop a resistance to them.</p> <h3>Combined treatment</h3> <p>A combined treatment can be an effective means of treating acne. In this case, a topical retinoid and an antimicrobial cream or gel can be used together. Sometimes they are combined into one product, while other times they are used separately. For example, a topical antimicrobial may be applied in the morning and a topical retinoid may be used at night.</p> <p>Oral medications are also used in combination with a topical treatment. Most people taking a pill benefit from a topical cream or gel.</p> <p>Your doctor or dermatologist will advise you on how and when to use a combined treatment for acne.</p> <h3>Oral isotretinoin</h3> <p>Isotretinoin (known as Accutane in North America; Clarus and Epuris in Canada; and Roaccutane in Europe) is a chemical compound related to vitamin A. In most cases, isotretinoin is used to treat severe nodular and scarring acne because:</p> <ul> <li>it reduces sebum secretion</li> <li>it prevents the formation of comedones</li> <li>it acts as an anti-inflammatory</li> <li>it stops <em>P. acnes</em> from generating in hair follicles and sebaceous glands</li> </ul> <p>However, this type of acne treatment must be closely monitored because isotretinoin has a number of side effects. More common side effects include dry skin, lips, nose and eyes. All side effects will begin to disappear when treatment stops.</p> <p>However, there are more severe side effects. For example, isotretinoin can interfere with the development of a fetus. If you are pregnant or thinking about having a baby, talk to your doctor or dermatologist about the side effects of isotretinoin. There are also concerns about depression, inflammatory bowel disease and impact on liver.</p> <h3>Hormonal therapy</h3> <p>Treating acne with female hormones is an effective treatment option for some female patients. This means taking an oral contraceptive (the birth control pill). This type of treatment limits sebum secretion by reducing androgen levels. Other topical and oral treatments can be used along with oral hormonal therapy.</p> <p>Treating acne using hormones is not for everybody. For more information, talk to your doctor or dermatologist.</p>
Acné (acné vulgaire)AAcné (acné vulgaire)Acne (acne vulgaris)FrenchDermatologyPre-teen (9-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2015-01-14T05:00:00ZMiriam Weinstein, MD, FRCPC8.0000000000000059.00000000000001487.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Renseignez-vous au sujet des différents types et causes de l'acné et comment ils peuvent être traités.</p><p>​​L’acné, dont le nom scientifique est l’acné vulgaire, est la maladie de la peau la plus répandue. Elle survient chez 85 % des adolescents, parfois dès l’âge de 12 ans, et persiste souvent à l’âge adulte. On parle aussi de « boutons » pour désigner l’acné.<br></p><h2>À retenir</h2><ul><li>L’acné vulgaire est la maladie de la peau la plus répandue chez les adolescents.</li><li>L’acné est une atteinte profonde de la peau, et sa gravité ainsi que l’efficacité du traitement varient d’une personne à l’autre.</li><li>L’acné entraîne la formation de comédons (points blancs et points noirs), de papules, de pustules ou même de nodules.</li><li>Le fait de tripoter, de pincer et de crever les boutons peut laisser des cicatrices.</li><li>L’acné peut être contenue à l’aide de traitements appropriés. Demandez à votre médecin ou à votre dermatologue quels traitements sont indiqués pour vous.<br></li></ul><h2>Quelles sont les causes de l’acné?</h2> <figure> <span class="asset-image-title">Anatomie de la peau</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_skin_anatomy_FR.jpg" alt="" /><figcaption class="asset-image-caption">Les papules sont des bosses rouges douloureuses causées par l’inflammation des follicules pileux.</figcaption> </figure> <p>La peau est formée de nombreuses couches de tissus renfermant des poils, des glandes, des muscles, des récepteurs sensoriels et des vaisseaux sanguins. Durant la puberté, des hormones d’un groupe appelé androgène sont libérées. Les hormones androgènes permettent aux glandes sébacées de la peau de sécréter une substance huileuse portant le nom de sébum. L’acné est en partie causée par cette surproduction de sébum qui survient naturellement durant l’adolescence.</p><p>La sécrétion de quantités normales de sébum empêche le dessèchement de la peau et des poils. Cependant lorsqu’elle est excessive, cette huile peut se mélanger aux cellules cutanées mortes et obstruer les follicules pileux (minuscules canaux où les poils prennent naissance) et les pores (orifices cutanés d’où sortent les poils).</p><p>Une bactérie courante vivant dans la peau appelée <em>Propionibacterium acnes</em> peut parfois favoriser la formation d’acné en provoquant une inflammation. L’acné signale aux globules blancs de se diriger vers la zone touchée. Cela y endommage le tissu et y provoque une réaction inflammatoire, une enflure et une infection.</p><p>L’acné entraîne une rougeur et une inflammation persistantes, particulièrement sur le visage, le cuir chevelu, le dos et la poitrine, où la quantité de sébum est la plus abondante.</p><p>L’acné varie de légère à grave selon le type de boutons qui se forment. Les différents types d’acné sont:</p><ul><li>les comédons,</li><li>les papules,</li><li>les pustules,</li><li>les nodules.</li></ul><p>Les comédons sont des pores obstrués par le sébum et des cellules cutanées mortes. Ils peuvent être ouverts (« points noirs ») ou recouverts de peau (« points blancs »).</p><p>Comme les points noirs ne sont généralement pas proéminents, ils ne peuvent pas être éliminés en se lavant normalement le visage.</p> <figure class="asset-c-80"> <span class="asset-image-title">Comédon ouvert (point noir)</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_blackhead_FR.png" alt="" /><figcaption class="asset-image-caption">Le pore où se loge le point noir est ouvert. Quand le sébum vient en contact avec l’air, l’exposition à l’oxygène lui donne un aspect noirâtre.</figcaption> </figure> <p>Un point blanc est légèrement surélevé, mais il n’entraîne aucune réaction inflammatoire.</p> <figure class="asset-c-80"> <span class="asset-image-title">Comédon fermé (point blanc)</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_whitehead_FR.png" alt="" /><figcaption class="asset-image-caption">Les points blancs se forment quand les pores sont obstrués par le sébum et des cellules cutanées mortes. Le sommet du pore d’un point blanc n’est pas ouvert.</figcaption> </figure> <p>Les papules sont de petites bosses dures de couleur rouge. Lorsqu’elles se présentent en grappes, elles peuvent être rugueuses comme du papier sablé au toucher. Des globules blancs pénètrent dans le follicule, ce qui entraîne une inflammation.</p> <figure class="asset-c-80"> <span class="asset-image-title">Papule</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_papule_FR.png" alt="" /><figcaption class="asset-image-caption">Les papules sont des bosses rouges douloureuses causées par l’inflammation des follicules pileux.</figcaption> </figure> <p>Les globules blancs dans les papules qui émergent à la surface de la peau se présentent sous forme de pustules. Les pustules sont des lésions circulaires rouges, dont le centre surélevé est jaunâtre ou blanc. Elles sont remplies de pus, lequel se forme sous l’effet de l’inflammation et contient des globules blancs, des cellules cutanées mortes et des bactéries.</p> <figure class="asset-c-80"> <span class="asset-image-title">Pustule</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_pustule_FR.png" alt="" /><figcaption class="asset-image-caption">Les pustules sont ce qu'on appelle communément les boutons. Elles se forment quelques jours après que les globules blancs dans les papules apparaissent à la surface de la peau.</figcaption> </figure> <p>En grossissant, les papules ou pustules peuvent aggraver l’inflammation de la peau environnante. Elles peuvent alors se transformer en nodules qui sont des bosses rouges profondes et rondes dont le diamètre peut varier de 6 à 20 mm. Ces bosses sont aussi parfois appelées kystes.</p><p>Les nodules sont causés par la rupture de follicules pileux enflammés situés dans les couches profondes de la peau. Ils peuvent élancer et être douloureux, même si on ne les touche pas.</p> <figure class="asset-c-80"> <span class="asset-image-title">Nodule</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_nodule_FR.png" alt="" /><figcaption class="asset-image-caption">Les nodules sont souvent de grandes dimensions, rouges, enflammés et douloureux au toucher.</figcaption> </figure><h2>Répercussion psychologique de l’acné</h2> <p>L’acné peut nuire fortement à la qualité de vie, particulièrement chez les adolescents. Les réactions peuvent varier d’une détresse minime à une dépression plus importante, un état d’anxiété et, bien que moins couramment, à des pensées suicidaires ou à l’automutilation. C’est pourquoi il est important de traiter l’acné.</p> <h2>Traitement de l’acné</h2> <p>Le traitement varie selon le type d’acné et sa gravité. Un traitement efficace permettra d’atténuer les éruptions futures et d’améliorer l’apparence de la peau. Il est important que vous gardiez à l’esprit que le traitement peut exiger jusqu’à six semaines avant que vous commenciez à observer des améliorations.</p> <p>Votre médecin ou votre dermatologue vous recommandera généralement des traitements topiques (produits appliqués directement sur la peau), bien qu’il puisse parfois prescrire un traitement oral (médicament pris par la bouche).</p> <h3>Nettoyage de la peau</h3> <p>L’acné est une atteinte profonde de la peau. Se laver régulièrement le visage favorise l’élimination des cellules cutanées mortes et de l’excès d’huile, mais cela n’a que peu d’effets pour ce qui est de la prévention ou de la prise en charge de l’acné.</p> <p>Si vous avez de l’acné, ne vous frottez pas le visage en vous lavant, car cela peut aggraver l’inflammation et l’irritation. Lavez-vous délicatement le visage à l’eau tiède. Vous pouvez aussi vous servir d’un nettoyant doux si vous le souhaitez.</p> <h3>Rétinoïdes topiques</h3> <p>Les rétinoïdes topiques débarrassent les pores des comédons et favorisent l’élimination des cellules mortes. Ils peuvent aussi réduire l’inflammation.</p> <p>Ces produits peuvent cependant avoir un certain nombre d’effets secondaires, dont les suivants : légère irritation, rougeur (érythème), sécheresse, desquamation (peau qui pèle) et sensibilité aux rayons du soleil. Si vous êtes enceinte ou songez à le devenir, consultez votre médecin ou votre dermatologue avant d’utiliser des rétinoïdes topiques, car ils sont contre-indiqués durant la grossesse.</p> <p>Évitez les traumatismes de la peau dus, entre autres, à l’épilation à la cire ou à l’exfoliation (par exemple, soins esthétiques du visage) pendant un traitement aux rétinoïdes.</p> <p>Les rétinoïdes topiques courants se présentent sous forme de crème et de gel. Les avantages des deux formes varient selon la gravité de l’acné et le degré de sensibilité de la peau. De nombreuses formulations et concentrations sont aussi disponibles. Par conséquent, comme aucun produit n’est d’une plus grande efficacité, votre médecin vous prescrira le rétinoïde qui vous convient le mieux.</p> <h3>Antimicrobiens topiques</h3> <p>Les antimicrobiens topiques servent à tuer les bactéries favorisant la réaction inflammatoire. Ils agissent aussi directement sur l’inflammation. L’un de ces antimicrobiens, le peroxyde de benzoyle, est offert en vente libre. Au contact de la peau, le peroxyde de benzoyle libère de l’oxygène, alors que <em>P. acnes</em> ne peut pas survivre en présence de cet élément.</p> <p>Il faut appliquer le peroxyde de benzoyle avec prudence. Puisqu’il s’agit d’un agent de blanchiment puissant, il peut endommager les tissus des vêtements. Votre pharmacien pourra répondre à toutes vos questions.</p> <h3>Antibiotiques oraux</h3> <p>Des antibiotiques oraux (pris par la bouche) sont parfois prescrits pour traiter l’acné grave, en particulier dans les cas où celle-ci s’est répandue sur le dos et la poitrine. Tout comme le permettent les traitements topiques, les antibiotiques oraux réduisent l’inflammation.</p> <p>Les antibiotiques oraux peuvent aussi faire cesser la multiplication de P. acnes. Toutefois, puisque les bactéries peuvent développer une résistance à ces médicaments, on ne doit en faire qu’un usage limité.</p> <h3>Combinaison de traitements</h3> <p>Le fait de combiner deux produits anti-acné peut être efficace. Par exemple, on peut à la fois avoir recours à un rétinoïde topique et à une crème ou un gel antimicrobien. Ces substances peuvent être réunies en un seul produit ou peuvent être utilisées séparément. On pourrait, par exemple, appliquer un antimicrobien topique le matin et un rétinoïde topique le soir.</p> <p>Les médicaments pris oralement peuvent aussi être assortis à un traitement topique.</p> <p>La plupart des gens traités aux moyens de médicaments oraux se servent également d’une crème ou d’un gel topique.</p> <p>Votre médecin ou votre dermatologue vous précisera quand et comment combiner les traitements anti-acné.</p> <h3>Isotrétinoïne orale</h3> <p>L’isotrétinoïne (connue sous le nom d’AccutaneMD en Amérique du Nord, de Clarus et d’Epuris au Canada et de RoaccutaneMD en Europe) est un composé chimique dérivé de la vitamine A. En règle générale, l’isotrétinoïne sert au traitement de l’acné nodulaire et cicatricielle grave car elle :</p> <ul><li>réduit la sécrétion de sébum,</li> <li>prévient la formation de comédons,</li> <li>agit comme un anti-inflammatoire,</li> <li>met fin à la production de <em>P. acnes</em> dans les follicules pileux et les glandes sébacées.</li></ul> <p>Toutefois, ce type de traitement doit faire l’objet d’une étroite surveillance étant donné que l'isotrétinoïne comporte un certain nombre d’effets secondaires. Parmi les plus courants, mentionnons la sécheresse de la peau, des lèvres, du nez et des yeux. Tous les effets secondaires disparaissent à la fin du traitement.</p> <p>Les effets indésirables du traitement à l'isotrétinoïne sont cependant plus marqués. Par exemple, l’isotrétinoïne peut nuire au développement du fœtus. Si vous êtes enceinte ou songez à le devenir, demandez à votre médecin ou à votre dermatologue quels sont les effets secondaires de l’isotrétinoïne. Ce traitement suscite aussi des préoccupations en ce qui concerne la dépression, la maladie intestinale inflammatoire et le foie.<br></p> <h3>Thérapie hormonale</h3> <p>Le traitement de l’acné à l’aide d’hormones féminines est efficace chez certaines femmes. Cela exige la prise d’un contraceptif oral (la pilule anticonceptionnelle). Ce traitement limite la sécrétion de sébum en réduisant la production d’hormones androgènes. On peut y combiner d’autres traitements topiques ou oraux.</p> <p>Le traitement hormonal de l’acné n’est pas recommandé pour toutes les femmes. Pour obtenir plus de renseignements à ce sujet, consultez votre médecin ou votre dermatologue.</p>

 

 

Acne (acne vulgaris)770.000000000000Acne (acne vulgaris)Acne (acne vulgaris)AEnglishDermatologyPre-teen (9-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2015-01-14T05:00:00ZMiriam Weinstein, MD, FRCPC8.0000000000000059.00000000000001487.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover the different types and causes of acne and how they can be treated.</p><p>Acne, clinically known as acne vulgaris, is the most common skin disease. It affects 85% of teenagers, some as young as 12, and often continues into adulthood. It is also called "pimples," "zits" or "blemishes."</p><h2>Key points</h2><ul><li>Acne vulgaris is the most common skin disease in teenagers.</li><li>Acne occurs deep within the skin, and severity and outcomes vary from person to person.</li><li>Acne causes comedones (whiteheads and blackheads), papules, pustules or even nodules.</li><li>Picking, squeezing and popping can lead to scarring.</li><li>Acne is manageable with the appropriate treatment. Ask your doctor or your dermatologist about your options.<br></li></ul><h2>What causes acne?</h2> <figure> <span class="asset-image-title">Anatomy of the skin</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_skin_anatomy_EN.jpg" alt="" /> <figcaption class="asset-image-caption">Acne occurs when the sebaceous glands produce more oil, clogging different parts of skin tissue.</figcaption> </figure> <p>The skin is formed by many layers of tissue, containing hair, glands, muscles, sensory receptors and blood vessels. During puberty, a group of hormones are released called androgens. Androgens allow the sebaceous glands in the skin to produce an oily substance called sebum. Acne is in part caused by this increase in sebum that naturally occurs during puberty.</p><p>Normal amounts of sebum keep skin and hair from drying out. However, excess oil can mix with dead skin cells and clog hair follicles (the tiny tunnels that lead to the root of the hair) and pores (the opening in the skin where the hair passes through).</p><p>A common type of bacteria that lives on the skin, known as <em>Propionibacterium acnes</em>, sometimes contributes to acne by causing inflammation. The acne signals white blood cells to the area, which damage the tissue and cause an inflammatory response. This causes swelling and infection.</p><p>Acne leads to persistent redness and inflammation, especially on the face, scalp, back and chest, where the most sebum is produced.</p><p>Acne varies from mild to severe, depending on what kind of blemishes appear. The different types of acne include:<br></p><ul><li>comedones</li><li>papules</li><li>pustules</li><li>nodules</li></ul><p>Comedones are pores that are blocked with oil and dead skin cells. They can be open ("blackheads") or closed by the skin ("whiteheads").</p><p>A blackhead is generally level with the skin surface and cannot be removed by normal washing of the face.</p> <figure class="asset-c-80"> <span class="asset-image-title">Open comedo (blackhead)</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_blackhead_EN.png" alt="" /> <figcaption class="asset-image-caption">The pore of a blackhead is open. When the sebum comes into contact with the air, oxygen exposure causes it to appear black.</figcaption> </figure> <p>A whitehead is slightly raised from the skin, but there is no inflammation.</p> <figure class="asset-c-80"> <span class="asset-image-title">Closed comedo (whitehead)</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_whitehead_EN.png" alt="" /> <figcaption class="asset-image-caption">A whitehead is formed when pores are blocked with sebum and dead skin cells. The pore in a whitehead is not open at the top.</figcaption> </figure> <p>Papules are red, small, hard bumps that are slightly raised on the skin. In clusters, they can feel like sandpaper to the touch. White blood cells enter the follicle, causing inflammation.</p> <figure class="asset-c-80"> <span class="asset-image-title">Papule</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_papule_EN.png" alt="" /> <figcaption class="asset-image-caption">Papules are red, painful bumps caused by inflammation of the hair follicles.</figcaption> </figure> <p>When the white blood cells in a papule make it to the surface of the skin, a pustule is formed. Pustules appear as red, inflamed circles with a central, raised bump that is yellowish or white. The bump is filled with pus. Pus is the result of inflammation and contains white blood cells, dead skin cells and bacteria.</p> <figure class="asset-c-80"> <span class="asset-image-title">Pustule</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_pustule_EN.png" alt="" /> <figcaption class="asset-image-caption">Pustules form a few days after the white blood cells in a papule make it to the surface of the skin. Pustules are typically called "pimples" or "zits".</figcaption> </figure> <p>When a papule or pustule expands, it can cause more severe inflammation in the surrounding skin. This can lead to nodules, which are deep, red, round bumps that can have a diameter of 6 to 20 mm. They are sometimes referred to as cysts.</p><p>Nodules are formed by irritated, inflamed hair follicles that have ruptured deep under the skin. They can be throbbing and painful, even without touching.</p> <figure class="asset-c-80"> <span class="asset-image-title">Nodule</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_nodule_EN.png" alt="" /> <figcaption class="asset-image-caption">Nodules are often large, inflamed, red, swollen and painful to the touch.</figcaption> </figure><h2>Psychological impact of acne</h2> <p>Acne can have a profound impact on a person's quality of life, particularly for teenagers. Reactions can range from minimal distress to more significant depression, anxiety and, less commonly, thoughts of suicide or self-harm. For these reasons, treating acne matters.</p> <h2>Treatment of acne</h2> <p>Treatment depends on the severity and type of acne. An effective treatment will help reduce future breakouts and improve the skin's appearance. Keep in mind that up to six weeks of treatment might be necessary to start noticing results.</p> <p>In most cases, your doctor or dermatologist will prescribe topical treatments (applied directly on the skin). Sometimes the doctor may prescribe an oral treatment (taken by mouth).</p> <h3>Cleansing skin</h3> <p>Acne is a process deep within the skin. Washing your face regularly helps remove dead skin cells and excess oil, but does not play a significant role in the prevention or management of acne.</p> <p>If you have acne, avoid scrubbing your face when washing, because this may worsen inflammation and irritation. Instead, gently wash your face with warm water. You may also use a mild cleansing product if you want.</p> <h3>Topical retinoids</h3> <p>Topical retinoids unplug comedones and improve the process of shedding the old cells. They may also help reduce any inflammation.</p> <p>Some side effects may occur when using a topical retinoid. These include mild irritation, redness (erythema), dryness, peeling and sensitivity to sun. If you are pregnant, or thinking about having a baby, talk to your doctor or dermatologist before using a topical retinoid, as they should not be used during pregnancy.</p> <p>Avoid skin damage, such as waxing or exfoliation (e.g., facials) when taking retinoids.</p> <p>Common topical retinoids are available in cream and gel form. There are benefits to both creams and gels, depending on the severity of acne and the sensitivity of your skin. Retinoids are also available in many strengths and formulations. Therefore, there is no one better option; your doctor will recommend a retinoid most appropriate for you.</p> <h3>Topical antimicrobials</h3> <p>Topical antimicrobials are used to kill bacteria that contribute to inflammation. They also help fight inflammation directly. One option is benzoyl peroxide, which is available over the counter. When benzoyl peroxide touches the skin, oxygen is created. <em>P. acnes</em> cannot survive in the presence of oxygen.</p> <p>Use caution when applying benzoyl peroxide because it is a potent bleaching agent that can damage fabrics. The pharmacist can answer any questions you might have.</p> <h3>Oral antibiotics</h3> <p>An oral antibiotic (taken by mouth) is sometimes used to treat more significant acne, especially in cases where the acne has spread to the back and chest. Such as topical treatments, oral antibiotics reduce inflammation.</p> <p>Antibiotics can also stop <em>P. acnes</em> from multiplying. However, the use of antibiotics should be limited because bacteria can develop a resistance to them.</p> <h3>Combined treatment</h3> <p>A combined treatment can be an effective means of treating acne. In this case, a topical retinoid and an antimicrobial cream or gel can be used together. Sometimes they are combined into one product, while other times they are used separately. For example, a topical antimicrobial may be applied in the morning and a topical retinoid may be used at night.</p> <p>Oral medications are also used in combination with a topical treatment. Most people taking a pill benefit from a topical cream or gel.</p> <p>Your doctor or dermatologist will advise you on how and when to use a combined treatment for acne.</p> <h3>Oral isotretinoin</h3> <p>Isotretinoin (known as Accutane in North America; Clarus and Epuris in Canada; and Roaccutane in Europe) is a chemical compound related to vitamin A. In most cases, isotretinoin is used to treat severe nodular and scarring acne because:</p> <ul> <li>it reduces sebum secretion</li> <li>it prevents the formation of comedones</li> <li>it acts as an anti-inflammatory</li> <li>it stops <em>P. acnes</em> from generating in hair follicles and sebaceous glands</li> </ul> <p>However, this type of acne treatment must be closely monitored because isotretinoin has a number of side effects. More common side effects include dry skin, lips, nose and eyes. All side effects will begin to disappear when treatment stops.</p> <p>However, there are more severe side effects. For example, isotretinoin can interfere with the development of a fetus. If you are pregnant or thinking about having a baby, talk to your doctor or dermatologist about the side effects of isotretinoin. There are also concerns about depression, inflammatory bowel disease and impact on liver.</p> <h3>Hormonal therapy</h3> <p>Treating acne with female hormones is an effective treatment option for some female patients. This means taking an oral contraceptive (the birth control pill). This type of treatment limits sebum secretion by reducing androgen levels. Other topical and oral treatments can be used along with oral hormonal therapy.</p> <p>Treating acne using hormones is not for everybody. For more information, talk to your doctor or dermatologist.</p><h2>Scar prevention</h2> <p>If left untreated, some acne can cause scarring. It is not always easy to predict which acne will cause scarring; it is a complex problem.</p> <p>Handle acne with care. Manipulating, squeezing and popping increases the likelihood of scarring. The best way to prevent scarring is to actively treat the acne. Treatment is not only for those who have severe acne; no matter how little or how much acne you might have, you can seek treatment for your skin.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/acne_vulgaris.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/acne_vulgaris.jpgAcne (acne vulgaris)False

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