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Do a Google search for "how to get rid of acne fast" and you'll see plenty of websites telling you to eat better for clear skin. But are there really foods that cause acne, or is that an old wives' tale? Dermatologist Hilary Baldwin, MD, of the Acne Treatment and Research Centre in Morristown, New Jersey, says the answer isn't really simple at all. "The simple answer is, we don't know. So far studies have suggested that high-glycemic index diets (those with lots of white foods like potatoes, pasta, bread, rice and sweets), as well as diets high in skim-milk dairy products and whey protein supplements might be associated with worsening of existing acne but are less likely to cause acne," Baldwin says.
The use of antimicrobial peptides against C. acnes is under investigation as a treatment for acne to overcoming antibiotic resistance. In 2007, the first genome sequencing of a C. acnes bacteriophage (PA6) was reported. The authors proposed applying this research toward development of bacteriophage therapy as an acne treatment in order to overcome the problems associated with long-term antibiotic therapy such as bacterial resistance. Oral and topical probiotics are also being evaluated as treatments for acne. Probiotics have been hypothesized to have therapeutic effects for those affected by acne due to their ability to decrease skin inflammation and improve skin moisture by increasing the skin's ceramide content. As of 2014, studies examining the effects of probiotics on acne in humans were limited.
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The earliest pathologic change is the formation of a plug (a microcomedone), which is driven primarily by excessive growth, reproduction, and accumulation of skin cells in the hair follicle. In normal skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle. However, increased production of oily sebum in those with acne causes the dead skin cells to stick together. The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone. This is further exacerbated by the biofilm created by C. acnes within the hair follicle. If the microcomedone is superficial within the hair follicle, the skin pigment melanin is exposed to air, resulting in its oxidation and dark appearance (known as a blackhead or open comedo). In contrast, if the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).
The main hormonal driver of oily sebum production in the skin is dihydrotestosterone. Another androgenic hormone responsible for increased sebaceous gland activity is DHEA-S. Higher amounts of DHEA-S are secreted during adrenarche (a stage of puberty), and this leads to an increase in sebum production. In a sebum-rich skin environment, the naturally occurring and largely commensal skin bacterium C. acnes readily grows and can cause inflammation within and around the follicle due to activation of the innate immune system. C. acnes triggers skin inflammation in acne by increasing the production of several pro-inflammatory chemical signals (such as IL-1α, IL-8, TNF-α, and LTB4); IL-1α is known to be essential to comedo formation.
Ablative lasers deliver an intense wavelength of light to the skin, removing thin outer layers of the skin (epidermis). In addition, collagen production is stimulated in the underlying layer (the dermis). Patients are typically numbed with local anesthetic and the ablation is done as an outpatient procedure. CO2 and erbium are the ablative lasers most often used for acne scar treatment.
^ Jump up to: a b GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
For an overnight solution or something that covers a larger surface area (rather than a smaller spot-treatment), Zeichner also recommends Neutrogena’s rapid-clear leave-on mask. The idea is that you spread benzoyl peroxide all over your face, but it’s not a wash-off mask, so you’re getting a prolonged exposure to the antibacterial peroxide. He says it’s helpful for treating the pimples you have and preventing new ones from popping up.
But Accutane has mixed reviews for a reason. It makes the skin super dry and sensitive, which means it’s important to keep moisturizers and lip balm nearby while you’re on the treatment. Oh, and don’t even think about waxing your eyebrows (just imagine your skin ripping off). There’s another downside to Accutane: It requires a lot of paperwork and office visits. Since isotretinoin can cause birth defects, you have to come into the dermatologist once a month to get a pregnancy test and take a lengthy survey with embarrassing questions about your sex life to prove that you are using sufficient birth control. These precautions are intense, but dermatologists agree that the final results for Accutane are like no other. “This is one of the few medicines that I can look [patients] in the eye and guarantee them it will work,” says Friedman.
Does your infant have more pimples than an eighth-grader? Just when she seems ready for her close-up — head rounding out nicely, eyes less puffy and squinty — baby acne might be next. This pimply preview of puberty is incredibly common, usually beginning at 2 to 3 weeks of age and affecting about 40 percent of all newborns. Fortunately it’s temporary, and it doesn’t bother your baby a bit. Here’s what to do in the meantime.
The costs and social impact of acne are substantial. In the United States, acne vulgaris is responsible for more than 5 million doctor visits and costs over US$2.5 billion each year in direct costs. Similarly, acne vulgaris is responsible for 3.5 million doctor visits each year in the United Kingdom. Sales for the top ten leading acne treatment brands in the US in 2015, have been reported as amounting to $352 million.
How to Handle It: Your best bet is benzoyl peroxide. "Benzoyl peroxide can kill acne-causing bacteria and reduce inflammation," says Zeichner. Try a cream like the La Roche-Posay Effaclar Duo Dual-Action Acne Treatment ($37), which also exfoliates with lipo-hydroxy acid. Be aware that it can seriously dry out skin so moisturize well after you use it.
Another once-daily gel your dermatologist might prescribe for acne is Aczone 7.5 percent. The active ingredient, dapsone, is both antimicrobial and anti-inflammatory, and it’s proven to help with blackheads, whiteheads, and deeper painful pimples. Oftentimes, Aczone is used alongside other acne treatments. And like many of those other remedies, Aczone can cause skin to dry out.
You've probably seen the Proactiv clear skin system advertised on television at some point over the last several years, but does it work? Proactiv is one of the better acne remedies out there for mild cases of inflammatory and noninflammatory acne, hormonal acne and adult acne. The starter kit comes with a gentle benzoyl peroxide exfoliating cleanser, a glycolic acid pore cleanser, and a benzoyl peroxide repairing treatment.
Retinoids and retinoid-like drugs. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A and include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage). You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It works by preventing plugging of the hair follicles.