FAQs

• What is acne?
• Why do I get acne?
• What causes acne?
• Who’s at risk?
• How can I get rid of acne myself?
• When should I go to the doctor?
• What should I expect at the doctor’s office?
• When will my acne go away?
• What if the treatment doesn’t work?

 

 

What is acne?

Acne is also known as zits, pimples, and blemishes. Acne most often affects the face, upper back, chest, upper arms and neck. Acne can also cause scarring and discoloration of the skin. No matter the name or location, acne can be emotionally distressing and very persistent if appropriate treatment is not followed.

There are several types of acne:

1. Open comedo - also known as a blackhead. These are formed when the hair follicle becomes clogged with the skin’s natural secreted oil, keratin (a protein in the skin), and melanin (pigment in skin that makes the blackhead a dark color)

2. Closed comedo - also known as a whitehead. These are formed similarly to blackheads but remained covered with skin. These often look like skin-colored bumps.

3. Inflammatory acne - these are known as papules, pustules or nodules depending on their size. The nodules are the largest(greater then 5mm) and most difficult to treat. These are the type of blemishes that are red and painful to the touch.

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Why do I get acne?

1. Overproduction of the skin’s natural oil (sebum) - Unfortunately some people just produce more sebum than others. Many factors interact to affect your sebum production such as genetics and androgen levels. During adolescent years, it is common for the skin to produce more sebum than in years previous or after.

2. Overproduction of keratin - keratin is a protein in the skin. When there is too much keratin, dead skin cells stick together and form clogs in the follicle.

3. Bacteria - one of the better known bacteria strands is propionibacterium acnes. This bacteria is normally on the skin, however, bacteria can thrive in the follicle given the appropriate growing conditions. Consequently, the body’s immune system reacts to the bacterial overgrowth and the follicle becomes inflamed.

4. Inflammation - Inflammation is when your immune system attempts to defend the body. In this situation, your body is trying to defend against bacteria. When bacteria begins to thrive in the follicle, feeding off the skin’s natural oil(sebum), the body responds with inflammation to fight the bacteria. The degree of inflammation affects both the severity and prevalence of acne. This is what causes blemishes to get red and tender to the touch.

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What causes acne?

1. Diet - Conflicting and controversial evidence exists as of now. This is definitely an area that needs further study. Some studies have linked milk consumption to acne, while there are no studies that link chocolate to acne.

2. Stress - Some studies have found a link between stress and acne severity, however, more research is needed.

3. Hormones - Specifically androgens are hormones in the body that determine the production of the skin’s natural oil(sebum). Often times hormones are blamed as the main cause of acne, especially in adolescents and pregnant women, however androgens are always present in the body and are just one factor to consider as a cause of acne. Most acne sufferers actually have completely normal levels of androgens.

4. External products or habitsa.
Soaps, face washes, towels, detergents and other methods to clean the face may remove the layer of the skin’s natural oil at that moment but do not affect how much the oil the skin produces. Too much scrubbing or harsh chemicals on the skin can actually worsen acne by disturbing the skin and increasing the inflammation.

b. Materials that cover the skin can worsen or cause acne. Clothing such as sports bras or turtlenecks may trap in moisture, sweat and oil.

c. Products such as oily hair products, oil-based makeup or overly moisturizing lotions can introduce dirt or oil to the skin. Also any product that is old and possibly been
contaminated with bacteria can contribute to bacterial overgrowth.

d. Picking at the skin can also worsen acne by causing damage to the skin and introducing more bacteria. This should be avoided as much as possible.

5. Medications/Supplements - Vitamin B2, B6, B12, glucocorticoids, androgens, lithium, azathioprine, isoniazid, bromides, phenytoin, and many others could possibly cause druginduced acne. You should check with a doctor if any medications or supplements you are on could possibly cause acne.

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Who’s at risk?

Despite acne advertisements portraying only adolescents, acne can affect adults far into middle age. People with overactive androgen production are at greater risk for more severe and prevalent acne. Fortunately, acne is not a fatal condition, however, it is emotionally distressing and can leave life-long scars on the skin.

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How can I get rid of acne myself?

For all types of acne, you should follow a regular schedule of washing your face and other affected areas twice a day with a gentle cleanser and your hands. Very hot water, harsh chemicals or the use of rough materials may worsen your acne.
If a regular cleanser does not seem to be working, you can also try over the counter cleansers that include ingredients like tea tree oil, sulfur, benzoyl peroxide, salicylic acid, or alpha hydroxy acids. Research has shown that using a combination of this non-prescription strength acne treatments is more effective than one on its own. If you have moderate to severe acne, these athome solutions may not be sufficient, however, they may help if you have mild acne.

If you are unsatisfied with your results, you should call a doctor.

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When should I go to the doctor?

You should go to the doctor if you are concerned with your acne. If you are feeling other
symptoms, there may be a chance you have an underlying health condition. In this case, you should seek medical attention. There are many health conditions like hyperandrogenism or polycystic ovary syndrome that would require further medical treatment for your overall health and well-being.

There are also many other skin conditions that are similar in appearance to acne but are very different. For example, rosacea, folliculitis, and adnexal tumors are all conditions that share some characteristics with acne, but require different treatment. If you have any questions about your acne it is best to see a doctor. The doctor may help you find the true cause of your acne as well as come up with appropriate solutions.

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What should I expect at the doctor’s office?

First, the doctor will perform a physical exam of your skin to confirm that your condition is acne. If it is, the doctor will then determine the clinical type and severity of acne and your skin type. You should expect questions concerning your medical history, drugs and supplements you may be on, and your past attempts to clear the acne. From this information, the doctor can recommend a variety of over the counter or prescription treatments. If you prefer a prescription treatment, there are many possible options. After a discussion with your doctor about what will work best for you, if appropriate the doctor can prescribe one of the following medications: oral or topical antibiotics, birth control pills, topical retinoids, isotretinoin, and prescription grade versions of the products mentioned above(i.e. salicylic acid, benzoyl peroxide). It is important to note that while taking some of these medications, it is unsafe to become pregnant. If you are able or planning to become pregnant, you should discuss this with your doctor to decide on the best treatment plan.

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When will my acne go away?

You should expect to see changes in a minimum of two to three months from the beginning of treatment.

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What if the treatment doesn’t work?

In severe cases, or if you would prefer, our doctors can refer you to a Board-certified
dermatologist for further advice.

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To schedule an appointment call Walk In clinic NYC at 212 696 5900 or visit us at our  conveniently located office in Midtown Manhattan at 274 Madison Ave(between 39-40 streets) Suite #304, New York, NY 10016.