Acne doesn’t have to be a losing battle

By Ann Marie D’Onofrio

Do you live your life in fear—fear of an acne breakout that is? Have you found yourself excited for a big day to arrive whether it is your prom, your wedding or just a hot date night but worried a dreaded outbreak could ruin everything?

If so, you are not alone. Acne can be a major embarrassment and many experts underestimate the self-consciousness and social stigma that comes to those that suffer from it. It is not uncommon for people with acne to experience feelings of depression, anxiety, alienation and isolation.

For those reasons, it is not hard to understand why many people spend a lot of time and money trying to find a way to clearer, brighter and acne-free skin. To figure out the best path to clear skin, it is important to understand exactly what acne is, the “do’s & don’ts, underlying causes and the best treatment options specific to you.


What is acne? Pimples, whiteheads, blackheads, cysts and pustules all fall under the umbrella of acne. It’s a condition that often initially manifests at the start of puberty (85% of teens get acne, usually beginning at age 11 for girls and around 13 for boys) and many times lasts into the early 20s. Older adults can also suffer from acne, and many women notice that it worsens during pregnancy and monthly just before menstruation.


So, what really causes acne? No, it’s not chocolate and it’s not greasy fast-food, despite what your mother has told you. Sorry, mom, but the American Academy of Dermatology does not recommend dietary changes to manage acne because the data just doesn’t support it. Recent studies have shown a possible correlation between acne and high glycemic diets as they relate to sugar and increased sebum production, but so far, the results are inconclusive and not statistically significant.

The short and scientific answer is acne is caused by a bacterium called Propionibacterium Acnes. The long answer is it starts when the skin’s oil-producing glands become overactive causing oily sebum to become trapped in the pores and hair follicles. The clogged pores then become the ideal environment for those pesky little P. Acnes microbes to set up shop and start multiplying.

The process happens like this: A whitehead forms when the pore gets blocked. A whitehead will turn into a blackhead when it becomes exposed to air. Once the bacteria begin to multiply within the clogged pores, then the body’s inflammatory response will kick in resulting in a red, raised, red pimple. If the pimple isn’t able to erupt naturally, then it will fill with pus and fluid to form a cyst. Cysts can be very painful and will often result in scarring of the skin.


The do’s and don’ts of acne

Pimple popping. No matter how tempting it is to pick at or pop your pimples, don’t! Picking at your skin will cause scarring and will result in the breakouts taking longer to heal. It’s best to keep your hands off your face as much as possible to avoid aggravating the bacteria and clogging the pores even further.


Face washing. No matter what you may have been told, acne is not caused by having a dirty face. The truth is that over-washing the skin will cause the oil glands to ramp up oil secretion even more, thus actually worsening the acne. Don’t use anything with alcohol or anything labeled “anti-bacterial.” These ingredients will strip your skin of its protective layer, giving the unwanted bacteria an ideal environment to thrive. Alternatively, do wash your face twice a day (morning and night) with warm water and a mild cleanser. There are some very good over-the-counter cleansers on the market, and a clinician experienced in acne management can recommend the one that is best for your needs. Benzoyl peroxide and salicylic acid are two beneficial ingredients often found in skin cleansers formulated for acne-prone skin.


Moisturizing and sun protection. If you are being treated by a medical professional for your acne, your skin will more than likely be dry from the prescription creams. You’ll need a good moisturizer. Do use an appropriate moisturizer for acne-prone skin. This will be one that is oil-free and noncomedogenic, which simply means that it won’t clog pores. Any good moisturizer will also have an SPF factor of 15 or higher, which is always a critical component no matter what your age or skin type. SPF is especially crucial if your acne is being treated with prescription medications that will make your skin very sun sensitive and prone to sunburn/sun damage.


Makeup. One of the most common questions we get as clinicians when prescribing a treatment plan for our female acne patients is whether or not it’s OK to wear makeup. The answer is always yes, but do choose a foundation that says “noncomedogenic” and “oil-free” on the label. Some brands of foundation, like cleansers, even contain salicylic acid, which can be a beneficial ingredient to help combat acne. And don’t forget to sanitize your make-up brushes and sponges, as unsanitary makeup tools harbor bacteria that will worsen acne and can cause nasty infections. If you do wear makeup, don’t go to bed with makeup on your face. Always remove the makeup at night with a gentle cleanser.


Hair care. Be careful with hair care products and pomades that are oily and may come into contact with your face or forehead, as they will worsen your acne. Do wash your hair daily and keep hair off of your face as much as possible. Also, if you play sports, remember to wash baseball caps and sports helmets regularly.


Treatment options for persistent acne

What if you’ve tried everything and your acne just isn’t getting any better? If you feel like you regularly do everything outlined above with no success, it may be time to seek out the care of a health care professional skilled and experienced in acne treatment.

There are oral prescription medications available, as well as prescription gels and creams that will unblock pores and kill bacteria. A licensed clinician will be able to prescribe a treatment plan to help you when over-the-counter treatments just aren’t enough. In addition to prescription medications, there is also a plethora of effective, in-office treatment options to combat stubborn acne, such as blue-light therapy sessions, lasers and medical grade facials/peels.

The bottom line is there are so many professional acne treatment options available through a licensed health care provider that you should never feel like you’re alone in your struggle with acne. We know acne can do just as much damage to your self-esteem, self-confidence and body image as it can to your skin, so let us help you treat your acne and get back to feeling like the happy, confident person you were meant to be.  


– Ann Marie D’Onofrio, WHNP-BC, MSN, LSO, is the assistant medical director at Premier Wellness Center in Anthem.

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