Acne is due to an over activity and plugging of the oil glands. More than 90 percent of teenagers have some acne. The main cause of acne is increased levels of hormones during adolescence. Acne is not caused by diet. A person who has acne does not have to avoid eating fried foods, chocolate, or any other food (although there may be other health reasons not to). Acne is not caused by sexual activity. It is not caused by dirt nor by not washing your face often enough. The tops of blackheads are black because of the chemical reaction of the oil plug with the air. Acne usually lasts until age 20 or even longer. It is unusual for acne to leave any scars, and people worry needlessly about this. There is no magic medicine that will cure mild or moderate acne. However, good skin care can keep acne under control and at a mild level.
Basic treatment for all acne:
- Wash your skin twice a day. The most important time to wash is bedtime. Use a mild soap such as Dove soap or Cetaphil cleanser.
- Shampoo your hair daily. Long hair can make acne worse by rubbing against your skin.
- Avoid picking. Picking stops acne from healing.
Acne Treatment and Prevention
What is an Acne Boil?
An acne boil is a localized infection deep in the skin. It is also referred to as a skin abscess. A boil usually starts as a tender area, red in color. After a period of a week or so, the area becomes hard and firm. Eventually, the center of the abscess softens and becomes filled with infection-fighting white blood cells that the body sends from the blood stream to eradicate the infection. This collection of white blood cells, bacteria, and proteins is known as pus. Finally, the pus forms a head which can be surgically opened or spontaneously drain out through the surface of the skin.
There are several different types of boils. Among these are:
Furuncle or carbuncle
Furuncle or carbuncle: This is an abscess in the skin caused by the bacterium Staphylococcus aureus. A furuncle can have one or more openings onto the skin and may be associated with a fever or chills.
Cystic acne: This is a type of abscess that is formed when oil ducts become clogged and infected. Cystic acne affects deeper skin tissue that the more superficial inflammation from common acne. Cystic acne is most common on the face and typically occurs in the teenage years.
Hidradenitis suppurativa: This is a condition in which there are multiple abscesses that form under the arm pits and often in the groin area. These areas are a result of local inflammation of the sweat glands. This form of skin infection is difficult to treat with antibiotics alone and typically requires a surgical procedure to remove the involved sweat glands in order to stop the skin inflammation.
Pilonidal cyst: This is a unique kind of abscess that occurs in the crease of the buttocks. Pilonidal cysts often begin as tiny areas of infection in the base of the area of skin from which hair grows (the hair follicle). With irritation from direct pressure over time the inflamed area enlarges to become a firm, painful, tender nodule making it difficult to sit without discomfort. These frequently form after long trips that involve prolonged sitting.
Why do Acne Boils Occur?
Acne boils can arise from many factors. Ingrown hair is a common cause. Others can form as the result of a foreign material that has become lodged in the skin. Others boils, such as those of acne, are caused by plugged sweat glands that become infected.
The skin is an essential part of our immune defense against microbes that are foreign to our body. Any break in the skin, such as a cut or scrape, can develop into an abscess and could then become infected with bacteria.
How to Treat Acne Boils
Most acne boils can be treated at home. Treatment should begin as soon as a boil is noticed otherwise it may result in skin surface complications at a later stage.
The primary treatment for most boils is heat application, usually with hot soaks or hot packs. Heat application increases the circulation to the area and allows the body to better fight off the infection by bringing antibodies and white blood cells to the site of infection.
As long as the boil is small and firm, opening the area and draining the boil is not helpful, even if the area is painful. However, once the boil becomes soft or forms a head (that is, a small pustule is noted in the boil), it can be ready to drain. Once drained, pain relief can be dramatic. Most small boils, such as those that form around hairs, drain on their own with soaking. On occasion, and especially with larger boils, the the larger boil will need to be drained by a healthcare practitioner. Frequently, these larger boils contain several pockets of pus that must be opened and drained.
Antibiotics are often used to eliminate the accompanying bacterial infection. Especially if there is an infection of the surrounding skin, the doctor often prescribes antibiotics. However, antibiotics are not needed in every situation. In fact, antibiotics have difficult penetrating the outer wall of an abscess well and often will not cure an abscess without additional surgical drainage.
What Can Be Done to Prevent Acne Boils?
There are several ways that you can take to prevent acne boils or abscesses. The regular use of an anti-bacterial face wash can help to prevent bacteria from building up on the skin. This can reduce the chance for the hair follicles to become infected and prevent the formation of boils. When the hair follicles on the back of the arms or around the thighs are continually inflamed, regular use of an abrasive brush in the shower can be used break up oil plugs and build up around hair follicles.
Pilonidal cysts can be prevented by avoiding continued direct pressure or irritation of the buttock area when a local hair follicle becomes inflamed. At that point, regular soap and hot water cleaning and drying can be helpful.
For acne and hidradenitis suppurativa (see above), antibiotics may be required on a long-term basis to prevent recurrent abscess formation. As mentioned above, surgical resection of sweat glands in the involved skin may be necessary. Other medications, such as isotretinoin (Accutane) can be used for cystic acne and has been helpful in some patients with hidradenitis suppurativa. Recurrences are common in patients with hidradenitis suppurativa.
Other Non Surgical Treatments and Products
There are several nonsurgical treatment options and products that may be appropriate for your acne boils and scars, which include topical creams, chemical peels, skin fillers and skin camouflage.
Creams can act to improve your acne and help to smooth very fine acne scarring, these help by encouraging collagen production in your skin. Chemical Peels can improve overall skin tone and lustre, but do little for scars. Skin Fillers are materials that are injected into the depressed area of the scar to elevate it to the level of the normal surrounding skin. Results are temporary, lasting 3-6 months and are effective only in rolling scars.
Conventional Treatment for Pimples
Use Benzoyl peroxide 5% lotion or gel. This lotion helps to open pimples and unplug blackheads. It also kills bacteria. It is available without a prescription. Ask your pharmacist to recommend a OTC brand products contain the same basic ingredients, but have not proven better even though they’re more expensive. Apply the lotion once a day at bedtime. Redheads and blondes should apply it only every other day for the first 2 weeks because it can be too irritating at first. An amount of lotion the size of a pea should be enough to cover most of your face. You may need to use these creams for several years. If your skin becomes red or peels, you are using too much of the medicine or applying it too often. Try using less of it or applying it less often. You may also need to use Cetaphil moisturizer to soften the skin just before turning in for the night.
In general, it is better not to “pop” pimples, but most teenagers do it anyway. Therefore, do it safely. Never open a pimple before it has come to a head. Wash your face and hands first. Use a sterile needle (sterilized by alcohol or a flame). Nick the surface of the yellow pimple with the tip of the needle. The pus should run out without squeezing. Wipe away the pus and wash the area and your hands with soap and water. Scarring will not usually result from opening small pimples, but it can result from squeezing boils or other large, red, tender lumps. Sometimes these need an antibiotic prescription.
Blackheads are the plugs found in blocked-off oil glands. They should be treated with Benzoyl peroxide 5 percent lotion or gel. This lotion is also excellent for removing thickened skin that blocks the openings to oil glands. Use the lotion as described above for pimples. Blackheads that are a cosmetic problem can sometimes be removed with a blackhead extractor, but these are hard to find in stores. This method is much more efficient than anything you can do with your fingers. Soak your face with a warm washcloth before you try to remove blackheads. If the blackhead does not come out the first time, leave it alone.
Common mistakes in treating acne
- Avoid scrubbing your skin. Hard scrubbing of the skin is harmful because it irritates the openings of the oil glands and can cause them to be more tightly closed.
- Avoid putting any oily or greasy substances on your face. Oily and greasy substances make acne worse by blocking oil glands. If you must use cover-up cosmetics, use water-based cosmetics and wash them off at bedtime.
- Avoid hair tonics or hair creams (especially greasy ones). When you sweat, these substances will spread to your face and aggravate the acne.