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  Acne Treatment: Pinpoint the Trigger

Acne Treatment: Pinpoint the Trigger

by Jerry K. L. Tan, MD, FRCPC

From the occasional pimple during times of stress to the familiar breakouts before menses, acne affects almost all women at some time in their lives.

While acne commonly develops during the preteen and early teen years, it can also arise in young adulthood and persist for years. Studies show women feel more frustrated by acne than men do-adult women even more so than teenage girls. Why? Dealing with a chronic disorder typically associated with puberty can lead to great frustration. But don't despair if you have acne, effective treatment is available.

How acne happens

Your skin is studded with thousands of oil glands that produce sebum to moisturize and enhance the skin's ability to act as a protective barrier. Sebum within each gland is carried to the surface through pores. The highest density of oil glands is found on your face, especially at the nose, forehead and mid-cheek areas. The largest oil glands are found on the back and mid-chest. This explains in part why acne appears mostly on the face, chest and back.

But what actually causes acne is still unknown. Researchers suspect hormones play a role in pore blockage and increased oil production. A blockage creates the build-up of oil within the pore to form blemishes such as blackheads and whiteheads. "Zits" appear when acne bacteria multiply within the blocked pore, resulting in inflamed red bumps or pustules. Some of these large sacs of oil may rupture leading to large red lumps (also called nodules).

Unfortunately, you may inherit acne-prone skin-particularly the type susceptible to the more severe, scarring forms of the condition.


For some patients acne can be aggravated by:

  • Thick, pore-blocking creams
  • Clothing, hats, helmets or pads that retain sweat or moisture
  • Long hair that brushes the skin on your back, neck, and face
  • Hair gels and sprays where they may touch your skin
  • Sleeping on damp hair

While diet has not been conclusively shown to be an acne trigger, some women may notice certain foods aggravate their skin. Try excluding these foods for two or three weeks and see if your skin improves.


Fortunately, therapy can reduce acne, minimize the risk of scars and improve your skin's appearance. Treatment begins with discovering your acne triggers and learning what treatments will help you control the condition. Choosing cosmetics appropriate for your skin is important, too.

Acne treatment ranges from cleansers, topical gels and creams for mild acne to antibiotic or hormonal pills for moderate cases. Accutaneä may be prescribed for severe cases. Acne staining can be treated with exfoliating creams and facials while scarring may require the use of fillers, dermabrasion or laser treatments. Full compliance with a treatment program is the key to success.

About the author:
Jerry K. L. Tan, MD, FRCPC is an Adjunct Professor, Faculty of Medicine, University of Western Ontario, Windsor, Canada. He is also Director, Acne Research and Treatment Centre, Windsor, Canada. Dr. Tan's area of specialty: acne and rosacea.