Pimples, zits and blackheads can be disgusting nuisances. Facial acne is a common problem that causes distress for those who suffer from it. This age-old dermatologic woe has many causes and a variety of treatments from pimple-popping to antibiotic pills.
There are two varieties of acne, non-inflammatory and inflammatory, according to University Assistant Dermatology Prof. Julie Padgett?.
"Non-inflammatory acne is also called comedonal acne, meaning it consists primarily of plugged follicles without redness or pustule formation. Comedones can be closed, white in color, or open, black in color," Padgett said.
Open comedones, commonly called blackheads, are black because of the contents of the comedone, such as oil, and because exposure to air oxidizes skin cells, according to Padgett.
While blackheads and whiteheads fall into the category of non-inflammatory acne, the terms "zits" and "pimples" describe acne vulgaris, a type of inflammatory acne. Padgett divided these blemishes in two categories, papules and pustules.
"A papule is a raised, red bump, and a pustule is a raised bump with a small area of pus visible in the middle," she said.
Growing up with acne
Third-year College Sarah Drummond has dealt with facial acne and the myriad of problems associated with acne for eight years. When Drummond first began to develop facial acne in seventh grade, she experienced middle school taunting about her skin condition. The problem continued to vex Drummond, lowering her self-esteem as she entered high school.
"When I was in high school, just knowing that I had acne made me feel gross," she said. "It made me feel ugly."
In hopes of eliminating her acne and improving her self-image, Drummond said she began seeing a dermatologist. She said her dermatologist prescribed her a new medication every year from when she was 12 until she entered college.
"Any time a new acne product came out he was like, 'Oh Sarah, you should try this,'" she said.
Attacking acne with
medication
Drummond said she tried several different acne medications including acne creams such as Differin, Tazorac, Sulfacetamide Sodium Topical Suspension and BenzaClin.
According to their product labels, these creams include active ingredients such as benzyl peroxide, clindamycin, tazarotene and sulfur, which treat acne differently.
While benzyl peroxide reduces inflammation and dries the skin's excess oil, clindamycin fights acne-causing bacteria according to BenzaClins's product insert. Tazarotene has anti-hyperproliferative and anti-inflammatory effects, according to Tazorac's prescription information.
Sulfur is often an ingredient in masks and drying lotions, according to Kore Russell, an aesthetician and owner of Oasis Skin Spa.
"Sulfur helps de-scale and increase cell turnover rate ... [and] get rid of acne quickly," Russell said, adding that sulfur can also cause skin to flake.
Along with using prescribed acne creams, Drummond used an oral antibiotic, which she said caused her to burn easily in the sun. Despite using a number of treatments, the prescription medications did not eliminate Drummond's acne.
"Right when I started a new medication, after the first couple weeks my face would start to look better," she said. "Then after about a month it would go back to how it was before ... It was really frustrating because nothing that the dermatologist gave me ever worked for the long term."
Skin care for acne sufferers
Drummond's frustration with finding an appropriate treatment for acne is common.
"There's no actual cure for acne," Russell said. "People just have to find the right product or system that works for them."
For non-inflammatory acne sufferers going to spas, Russell suggested a deep cleansing facial with a deep exfoliation to help control acne breakouts and reduce blackheads.
For people with persistent acne or acne vulgaris, she suggested facials with less manipulation that have acids to help peel the skin. The acids most commonly found in facials and other acne products are alpha and beta hydroxyl acids. Russell said these acids are anti-bacterial and help break down some of the proteins that can aggravate acne. Russell said products with these acids are the most effective in treating acne.
One type of beta hydroxyl Russell described is salicylic acid. She said this acid unclogs pores, reduces sebum blockages and helps eliminate dead skin cells. Russell said salicylic acid is found in many acne washes, serums and treatments.
Benzyl peroxide is also used in acne treatments, and it "can be effective for some and can bleach out the skin and be irritating for others," Russell said.
Acne scars
Not only can benzyl peroxide as well as alpha and beta hydroxyls treat acne, they also act as a lightening agent for acne scars, according to Russell.
Other treatments for eliminating acne scars are cogic acid, which decreases the formation of pigment; arbutin, which prevents the formation of melanin; and soy, which inhibits melanin cells, Russell said.
One of the most common reasons for acne scars is popping pimples, Russell noted.
Drummond said she used to pop pimples obsessively and, as a result, developed small acne scars.
Pimple popping
Though popping pimples may have caused Drummond's minor acne scars, the method of pimple popping can influence the likelihood of scarring.
Russell said if one washes his or her face and hands, uses a sterilized needle to prick the tip of a pimple and then applies pressure to the sides of a pimple, these measures can prevent a pimple from becoming infected and causing future breakouts. She noted, however, that scarring from popping a pimple is always possible.
Preventing breakouts
To avoid the need for pimple-popping procedures, one can try to prevent having bad breakouts.
"There is not a way to prevent acne in general but there are ways to prevent bad breakouts," Russell said, noting the best method of addressing acne is on a skin-care level. Daily face washing is the first step to preventing breakouts.
"The golden rule is to use a good cleanser and not soap," Russell said. In addition, one should avoid trying to strip the skin, which Russell said people often do because they think they have over-productive oil glands. Russell recommended always using a clean sponge or washcloth to prevent spreading bacteria on the face.
Russell also recommended exfoliating the skin on a regular basis as well as using oil-free or lightweight moisturizers to keep the skin hydrated.
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