Acne
The doctors at Framingham Pediatrics have completed a thorough acne "Learning Community" with the Pediatric Dermatology staff at Boston Children's Hospital. We follow the same treatment protocols used in their dermatology clinics, and we are able to consult with them by telephone regarding the care of our patients when necessary. We are proud to be able to bring you the same acne care in our offices for most acne patients that you would get from the experts at Boston Children's Hospital, ranked among the best in the nation!
Acne is the most common skin problem treated in the US. More than 85% of adolescents and 10% of adults have the whiteheads, blackheads or pimples on their cheeks, chest, shoulders and back. Some people develop more pimples than others and for these people we can offer treatment to make them look better now and prevent permanent scarring in the future.
What is acne?
The typical acne lesions result from a combination of factors. First the hair follicle becomes blocked with dead skin cells. Next, in response to hormones like those increased with puberty, there is an overproduction of sebum (an oily substance made in the follicles.) Finally, a skin bacterium, Propionibacterium acnes (P. Acnes), which grows well in the plugged up follicle, causes inflammation and a pimple.
Rubbing, scrubbing with astringents, and picking or popping the pimples will only make them worse and make the face more irritated.
Food has no direct effect on the production of sebum so eating chocolates, sweets or french fries will not make your acne worse.
In some people untreated acne can lead to cysts and permanent scarring.
Treatment
Treatment of acne is directed at its causes. The choice of which type of medication to use is based on how bad the acne is.
- Always start with a mild moisturizing soap to gently wash the skin. Harsh soaps can irritate the skin and make acne worse.
- There are many acne medicines available without a prescription. We recommend an over the counter cream with benzoyl peroxide. If you are not happy with how this is working, we encourage you to came in for an appointment with your provider.
If the severity of your acne is mild to moderate your doctor will prescribe for you a topical cream, gel or ointment. Tretinoin (Retin A, Differin, etc.), a topical form of Vitamin A, that breaks up the blocked hair follicles and helps to correct the overproduction of skin cells. Topical antibiotics, like benzoyl peroxide 2.5%-10%, erythromycin, cleocin T or benzamycin, a combination of benzoyl peroxide and erythromycin, decrease the amount of P. Acnes in the hair follicle by direct contact. They may be used alone or in combination with other medications. The major side effects of these medicines include peeling skin, dryness, facial redness, sun sensitivity and allergic contact sensitization.
If the acne is more severe oral antibiotics such as tetracycline, minocycline, doxycycline and erythromycin can be added to reduce bacteria in the hair follicles and decrease inflammation. The major side effects include stomach upset and sun sensitivity.
Finally, if the acne is very severe, Isotretinoin (Accutane) an oral form of Vitamin A, can be used to reduce sebum production, shedding of dead skin and inflammation. However, there are a number of very significant side effects including birth defects in pregnant women, dry skin, poor night vision, hair loss, muscle aches, joint pains, headaches and sun sensitivity. Isotretinoin can only be prescribed by a dermatologist, and we will refer you to one if we feel that this treatment is indicated.
The bottom line
Through education about what causes acne, dispelling myths and proper treatment your pediatrician can help you look your best now and in the future.
- Arrange an appointment to talk with us about your acne.