Put Your Best Face Forward, Part 2

That wouldn’t be so bad, Goldman said. But then there is part two. Now you have a lot of oil and it’s clogged up in a little tube. The normal bacteria — called Propionibacterium acnes or P. acnes — which live inside the pores and on the skin, love this oil. They literally gobble it up.
That still wouldn’t be so bad, but the action of the bacteria turns the oil into free fatty acids. And those are very, very irritating to skin.
So now you have all this oil in the pores, clogged up under the skin, with a million times more bacteria making an acid that the skin is sensitive to. What does the body do? It brings in white blood cells to kill off the overabundance of bacteria.

All of this results in a whitehead or a pustule appearing on the skin. To make matters worse, teens try to pop it. Without proper techniques used by a dermatologist, instead of all that stuff coming out, it goes back inside.

Three Ways to Attack Acne
Thanks to knowing the pathogenesis, or what causes acne, we also know what we can do about it, Goldman said. The choices include:

Attack the oil — This may be done by regulating hormones through birth control pills, applying a substance topically that absorbs oil, or in very severe cases of acne, using a very strong prescription drug called Accutane. This drug has many side effects and requires regular monitoring.
Open up the pores — Retin-A or tretinoic acid can be used for this. There are newer products that act similarly to Retin-A, but are less irritating. Keeping the pores open is the single most effective way to treat the milder forms of acne called whiteheads and blackheads, Goldman said.
Kill the bacteria — Oral antibiotics are effective in doing this.
“As dermatologists, we try to counteract all the different factors,” Jaliman said. You start with the milder treatments and work your way up. Exfoliation through different types of light skin peelings in a dermatologist’s office can help get dead skin off. The treatments today are very different than the chemical peels of old. “You don’t have to go into hiding after them,” she said.

What’s important to remember is that no matter what treatment you try it does take time. “Even if you see the best dermatologist in the world, it takes at least two to three weeks to have all the acne gone,” Goldman said. “You have to come back to fine tune the treatment. Is it too irritating, too drying?”

And there are steps that support your efforts in working with a good dermatologist. For example, York-Goldman suggests reducing the stress that plays a role in activating the hormones. As a teen, it’s not a bit too soon to start yoga, meditation or relaxation exercises. If you aren’t sure if stress is a factor, think if a pimple appeared before the big date or an appearance on stage.

Also, York-Goldman recommends knowing your skin type so you can buy the most appropriate cleansers and makeup. If you have oily skin, for example, you don’t want to buy an oil-based makeup. You can test this yourself by applying little rice papers to your skin and see how much oil comes off.

And remember, York-Goldman said, before you apply makeup, use cold water on your face to close the pores.

Sometimes, in the beginning, you have to expend a lot of effort in finding the right dermatologist, the best medication and treatments, and improved methods of cleansing and covering your skin. “But once you know how to take care of your skin,” Jaliman said, “it’s a lot easier to maintain your skin than it is to actually clear it.”

Comments are closed.