Understanding and treating acne

Even if you sail through your teens with clear skin, acne may develop when you're an adult. Don't despair. Understand what’s going on and what you can do.

• Acne occurs when the oil (or sebaceous) glands under hair follicles, often on your face, neck, chest or back, get plugged up, inflamed or infected. Frequently, the glands simply secrete too much of a thick waxy lubricant called sebum that keeps your skin healthy.
• This blocks the pores and creates a perfect breeding ground for bacteria (especially Propionibacterium acnes). Follicles then get red and inflamed. Hormonal imbalances can play a role as well.
• Sebum increases with the overproduction of testosterone and other androgens in teenage boys, for instance, or with women’s hormonal fluctuations, such as those associated with the menstrual cycle, pregnancy and menopause.
• In mild cases of acne (referred to as acne vulgaris), whiteheads and blackheads appear, and maybe some raised red blemishes. In more severe cases (called cystic acne), pus-filled cysts and deep nodules form around the inflamed follicles, causing unsightly bumps, tenderness and often pain.

• Go to a dermatologist: Don't visit a general practitioner, especially if you need a procedure done. Skin doctors are specially trained to do such treatments.
• Choose acne products with care: Expensive medicated cleansers often don't work better than mild soap, and are not worth the extra cost.
• Try a blackhead extractor: This drugstore device may save you trips to the dermatologist. Before using the tool, soften the area with hot, wet compresses for about 10 minutes.

In addition to medical treatments, good home care is essential for dealing with acne breakouts successfully. Try to do the following.

• Wash your face gently (no more than twice a day): Use a mild soap to remove oil, dead skin cells and bacteria.
• Pay attention to your hair: Style it away from your face so scalp oils don't irritate your complexion, and avoid greasy styling products. Always pull your hair back when you sleep.
• Wear loose-fitting, clean exercise gear: Working up a sweat in tight, non-absorbent clothes or a constricting sweatband alters oil production, contributing to acne formation.
• Don't squeeze lesions. Picking at pimples will likely make the inflammation worse and increase the risk for scars and pitting.
• Avoid prolonged exposure to the sun and ultraviolet lamps: These light sources help dry up acne, but they also result in long-term skin damage and can even cause cancer.
• Use water-based makeup: Look for products labeled "non-comedogenic" or "non-acnegenic." Also, don't overdo on moisturizing, and skip cosmetics completely if your acne is severe.

• A couple of herbal products are useful for drying up acne.
• Topically applied tea tree oil is a natural alternative to benzoyl peroxide. Wipe on a 10 percent to 15 percent strength solution twice a day.
• The herb chamomile also has long been used for easing skin inflammations. Make a strong chamomile tea and wipe the cooled liquid over your face each morning. This effective daily rinse tones and cleanses your skin.

• If you're looking for a skin doctor, the Royal College of Physicians and Surgeons of Canada in Ottawa can provide referrals to derma­tologists in your area (1-800-668-3740 or www.royalcollege.ca).
• For information about acne and specifics on skin diseases, check with the experts at the Canadian Dermatology Assocation (CDA) in Ottawa (1-800-267-3376 or www.dermatology.ca).