Blemishes on your new baby's face aren't necessarily acne, however. Tiny white bumps that are there at birth and disappear within a few weeks are called milia, and they're not related to acne. If the irritation looks more rashy or scaly than pimply, or it appears elsewhere on your baby's body, he may have another condition, such as cradle cap or eczema.
Genetics is thought to be the primary cause of acne in 80% of cases.[2] The role of diet and cigarette smoking is unclear, and neither cleanliness nor exposure to sunlight appear to play a part.[2][13][14] In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum.[5] Another frequent factor is excessive growth of the bacterium Cutibacterium acnes, which is normally present on the skin.[15]
Hormonal activity, such as occurs during menstrual cycles and puberty, may contribute to the formation of acne. During puberty, an increase in sex hormones called androgens causes the skin follicle glands to grow larger and make more oily sebum.[12] Several hormones have been linked to acne, including the androgens testosterone, dihydrotestosterone (DHT), and dehydroepiandrosterone (DHEA); high levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) have also been associated with worsened acne.[42] Both androgens and IGF-1 seem to be essential for acne to occur, as acne does not develop in individuals with complete androgen insensitivity syndrome (CAIS) or Laron syndrome (insensitivity to GH, resulting in very low IGF-1 levels).[43][44]
Acne vulgaris is diagnosed based on a medical professional's clinical judgment.[15] The evaluation of a person with suspected acne should include taking a detailed medical history about a family history of acne, a review of medications taken, signs or symptoms of excessive production of androgen hormones, cortisol, and growth hormone.[15] Comedones (blackheads and whiteheads) must be present to diagnose acne. In their absence, an appearance similar to that of acne would suggest a different skin disorder.[28] Microcomedones (the precursor to blackheads and whiteheads) are not visible to the naked eye when inspecting the skin and can only be seen with a microscope.[28] There are many features that may indicate a person's acne vulgaris is sensitive to hormonal influences. Historical and physical clues that may suggest hormone-sensitive acne include onset between ages 20 and 30; worsening the week before a woman's period; acne lesions predominantly over the jawline and chin; and inflammatory/nodular acne lesions.[1]
Doxycycline is another of the tetracyclines that's equally effective in treating acne. It comes in generic versions and also as the branded Doryx and Acticlate which are easier on the stomach. Originally FDA approved for the treatment of rosacea, Oracea is a non antibiotic dose of doxycycline that is often used as an acne treatment, as well. Taken orally, it can be used as solo therapy or in combination with a topical acne treatment regimen. More severe cases of acne might need higher doses of doxycycline, but since Oracea is not an antibiotic, many patients can be "down-graded" to Oracea after improvement and it's suitable for longterm use as it doesn't cause antibiotic resistance.

C. acnes also provokes skin inflammation by altering the fatty composition of oily sebum.[45] Oxidation of the lipid squalene by C. acnes is of particular importance. Squalene oxidation activates NF-κB (a protein complex) and consequently increases IL-1α levels.[45] Additionally, squalene oxidation leads to increased activity of the 5-lipoxygenase enzyme responsible for conversion of arachidonic acid to leukotriene B4 (LTB4).[45] LTB4 promotes skin inflammation by acting on the peroxisome proliferator-activated receptor alpha (PPARα) protein.[45] PPARα increases activity of activator protein 1 (AP-1) and NF-κB, thereby leading to the recruitment of inflammatory T cells.[45] The inflammatory properties of C. acnes can be further explained by the bacterium's ability to convert sebum triglycerides to pro-inflammatory free fatty acids via secretion of the enzyme lipase.[45] These free fatty acids spur production of cathelicidin, HBD1, and HBD2, thus leading to further inflammation.[45]


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Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.
Systemic therapy refers to acne medication that is taken by mouth. Antibiotics like tetracycline, minocycline, doxycycline, or erythromycin may treat moderate to severe acne by targeting bacteria and reducing inflammation. Other systemic therapies include oral contraceptives, which can reduce acne in some women, spironolactone, an anti-androgen hormone pill, and isotretinoin (high-dose prescription vitamin A). Isotretinoin is used only in certain severe, cystic acne cases, or in cases where other treatments don't work. A course of isotretinoin treatment requires regular appointments with your dermatologist.
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Oral antibiotics are recommended for no longer than three months as antibiotic courses exceeding this duration are associated with the development of antibiotic resistance and show no clear benefit over shorter courses.[86] Furthermore, if long-term oral antibiotics beyond three months are thought to be necessary, it is recommended that benzoyl peroxide and/or a retinoid be used at the same time to limit the risk of C. acnes developing antibiotic resistance.[86]
Accutane (isotretinoin) has a mixed reputation, but among dermatologists it’s the finisher for patients with severe acne. “If you have an acne patient that doesn’t respond to anything, [Accutane] can really be a game changer,” board-certified dermatologist Adam Friedman tells SELF. Accutane is an oral retinoid, and it has all the same benefits of a topical retinol but is even more effective.

Shah often recommends over-the-counter retinols or prescription retinoids to her acne-prone patients. “I find that compared to other treatments they are beneficial for not just treating acne but also preventing new acne from forming as they help prevent that initial stage of the follicle getting clogged,” she says. “They can also help with some of the post acne [problems] such as hyperpigmentation.” But keep in mind if you have sensitive skin (or eczema or rosacea), a prescription retinoid might be too strong an option. However, your dermatologist can recommend an over-the-counter retinol with a low concentration (0.1 to 0.25 percent), which might be better tolerated. Retinol also isn’t a quick fix. It takes time to see results, and it’s something you’ll have to keep using to maintain its benefits. Shah also mentions that retinol plays well with other acne treatments on the list. "Retinol can be combined with other over-the-counter or prescription medications such as benzoyl peroxide, topical antibiotics, and oral medications. The right combination depends on the severity of the acne and your skin type."
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How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. (If you're feeling bloated, now's the time to do it.) The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash, like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($7), with a benzoyl peroxide spot treatment, such as Murad Acne Spot Fast Fix ($22). If you're still seeing zits, "visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.

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Therefore, it is very important that you wear sunscreen everyday, with an SPF of 30.Of note, after SPF 30, there are decreasing marginal returns in UVB protection. The % of UVB protection as a function of SPF Value is a log graph and plateaus after SPF 30. Therefore, there is not much difference in protection between SPF 40 and 50. Sunscreens with an SPF 100 are banned in some countries.
Baby acne is a common condition that affects many babies within several weeks to several months of age. Most pediatricians agree that the best treatment for baby acne is nothing at all, since the condition is natural and will clear up quickly enough as long as the baby's face is gently washed. Under severe conditions, though, your baby's doctor may recommend a stronger treatment. Here's what you need to know about getting rid of baby acne.

The side effects depend on the type of treatment you use. Generally, for topical, over-the-counter creams, you can watch out for stinging, redness, irritation and peeling — these side effects usually don’t go any deeper than the skin. Others, like oral antibiotics or hormonal medications, could come with new sets of complications, so we suggest talking to your doctor before pursuing the treatment.
Baby acne generally lasts longer with breast-fed babies, since the same residual, oil-triggering hormones that the baby was exposed to in the uterus can come through the mother's milk, too. As a result, it often begins clearing up as your baby is weened off of breast-milk. It may even clear up sooner if your baby's oil glands have matured enough to handle the hormones before then.
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Topical and oral preparations of nicotinamide (the amide form of vitamin B3) have been suggested as alternative medical treatments.[133] It is thought to improve acne due to its anti-inflammatory properties, its ability to suppress sebum production, and by promoting wound healing.[133] Topical and oral preparations of zinc have similarly been proposed as effective treatments for acne; evidence to support their use for this purpose is limited.[134] The purported efficacy of zinc is attributed to its capacity to reduce inflammation and sebum production, and inhibit C. acnes.[134] Antihistamines may improve symptoms among those already taking isotretinoin due to their anti-inflammatory properties and their ability to suppress sebum production.[135]
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.

Postinflammatory hyperpigmentation (PIH) is usually the result of nodular acne lesions. These lesions often leave behind an inflamed darkened mark after the original acne lesion has resolved. This inflammation stimulates specialized pigment-producing skin cells (known as melanocytes) to produce more melanin pigment which leads to the skin's darkened appearance.[35] People with darker skin color are more frequently affected by this condition.[36] Pigmented scar is a common term used for PIH, but is misleading as it suggests the color change is permanent. Often, PIH can be prevented by avoiding any aggravation of the nodule, and can fade with time. However, untreated PIH can last for months, years, or even be permanent if deeper layers of skin are affected.[37] Even minimal skin exposure to the sun's ultraviolet rays can sustain hyperpigmentation.[35] Daily use of SPF 15 or higher sunscreen can minimize such a risk.[37]


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The Pore Targeting Treatment gel and Complexion Perfecting Hydrator moisturizer slip on nicely, with the former powered by skin-loving glycerin and the latter by a whole slew of delicious ingredients, like licorice root extract, sodium hyaluronate, bisabolol, and allantoin. The three-step solution is easy to use and makes cleansing the face a quick, efficient process.
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.
Your skin is your largest organ, and it does a lot more than simply prevent you from spilling out all over the place. Skin cells are constantly replacing themselves, making a journey from the inner edge of your epidermis (your skin's outermost layer) to the outside of your skin. As a skin cell ages and approaches the skin's surface, the dying cell flattens out. Once on the surface, it joins countless other dead skin cells and forms a protective layer that helps protect you from bacteria and viruses.
Medical conditions that commonly cause a high-androgen state, such as polycystic ovary syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors, can cause acne in affected individuals.[45][46] Conversely, people who lack androgenic hormones or are insensitive to the effects of androgens rarely have acne.[45] An increase in androgen and oily sebum synthesis may be seen during pregnancy.[46][47] Acne can be a side effect of testosterone replacement therapy or of anabolic steroid use.[1][48] Over-the-counter bodybuilding and dietary supplements are commonly found to contain illegally added anabolic steroids.[1][49]
Efforts to better understand the mechanisms of sebum production are underway. The aim of this research is to develop medications that target and interfere with the hormones that are known to increase sebum production (e.g., IGF-1 and alpha-melanocyte-stimulating hormone).[10] Additional sebum-lowering medications being researched include topical antiandrogens and peroxisome proliferator-activated receptor modulators.[10] Another avenue of early-stage research has focused on how to best use laser and light therapy to selectively destroy sebum-producing glands in the skin's hair follicles in order to reduce sebum production and improve acne appearance.[10]
How to Handle It: Consider salicylic acid your secret weapon. "This beta hydroxy acid helps remove excess oil and exfoliate dead cells from the skin's surface to keep pores clear," says Zeichner. Try Clinique's Acne Solution Clearing Gel, a two-time Best of Beauty winner that packs both salicylic acid and sea whip extract — an ingredient with skin-soothing properties — to help counteract the dryness sometimes caused by salicylic acid. The formula does double duty: It works as a spot treatment for mild to moderate acne and as a nightly allover treatment for pimple prevention. And since it dries clear, you can wear it to fight zits whenever, wherever.
This at-home skin peel available at Sephora tightens pores, reduces oil, helps retexturize skin and diminishes dark spots. It's paraben and sulfate free, non-comedogenic and isn't tested on animals. Use this peel each week as part of your clear skin regimen to help even out skin tone and gently remove unhealthy top skin layers, revealing new, healthier skin underneath. 
Alternative and integrative medicine approaches used in the treatment of acne include fish oil, brewer's yeast, probiotics, oral zinc and topical tea tree oil. More research is needed to establish the potential effectiveness and long-term safety of these and other integrative approaches, such as biofeedback and traditional Chinese medicine. Talk with your doctor about the pros and cons of specific treatments before you try them.
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