Hydroquinone lightens the skin when applied topically by inhibiting tyrosinase, the enzyme responsible for converting the amino acid tyrosine to the skin pigment melanin, and is used to treat acne-associated postinflammatory hyperpigmentation. By interfering with new production of melanin in the epidermis, hydroquinone leads to less hyperpigmentation as darkened skin cells are naturally shed over time. Improvement in skin hyperpigmentation is typically seen within six months when used twice daily. Hydroquinone is ineffective for hyperpigmentation affecting deeper layers of skin such as the dermis. The use of a sunscreen with SPF 15 or higher in the morning with reapplication every two hours is recommended when using hydroquinone. Its application only to affected areas lowers the risk of lightening the color of normal skin but can lead to a temporary ring of lightened skin around the hyperpigmented area. Hydroquinone is generally well-tolerated; side effects are typically mild (e.g., skin irritation) and occur with use of a higher than the recommended 4% concentration. Most preparations contain the preservative sodium metabisulfite, which has been linked to rare cases of allergic reactions including anaphylaxis and severe asthma exacerbations in susceptible people. In extremely rare cases, repeated improper topical application of high-dose hydroquinone has been associated with an accumulation of homogentisic acid in connective tissues, a condition known as exogenous ochronosis.
In women, acne can be improved with the use of any combined birth control pill. These medications contain an estrogen and a progestin. They work by decreasing the production of androgen hormones by the ovaries and by decreasing the free and hence biologically active fractions of androgens, resulting in lowered skin production of sebum and consequently reduced acne severity. First-generation progestins such as norethindrone and norgestrel have androgenic properties and can worsen acne. Although oral estrogens can decrease IGF-1 levels in some situations and this might be expected to additionally contribute to improvement in acne symptoms, combined birth control pills appear to have no effect on IGF-1 levels in fertile women. However, cyproterone acetate-containing birth control pills have been reported to decrease total and free IGF-1 levels. Combinations containing third- or fourth-generation progestins including desogestrel, dienogest, drospirenone, or norgestimate, as well as birth control pills containing cyproterone acetate or chlormadinone acetate, are preferred for women with acne due to their stronger antiandrogenic effects. Studies have shown a 40 to 70% reduction in acne lesions with combined birth control pills. A 2014 review found that antibiotics by mouth appear to be somewhat more effective than birth control pills at decreasing the number of inflammatory acne lesions at three months. However, the two therapies are approximately equal in efficacy at six months for decreasing the number of inflammatory, non-inflammatory, and total acne lesions. The authors of the analysis suggested that birth control pills may be a preferred first-line acne treatment, over oral antibiotics, in certain women due to similar efficacy at six months and a lack of associated antibiotic resistance.
Atrophic acne scars have lost collagen from the healing response and are the most common type of acne scar (account for approximately 75% of all acne scars). They may be further classified as ice-pick scars, boxcar scars, and rolling scars. Ice-pick scars are narrow (less than 2 mm across), deep scars that extend into the dermis. Boxcar scars are round or ovoid indented scars with sharp borders and vary in size from 1.5–4 mm across. Rolling scars are wider than icepick and boxcar scars (4–5 mm across) and have a wave-like pattern of depth in the skin.
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.
If you've found yourself hoping and wishing for clear skin and wondering how to get rid of acne, you're definitely not alone! It's almost a rite of passage for teens, up to 85 percent of whom will suffer pimples, whiteheads, blackheads, cysts or pustules. Some grow out of it, but not all; acne is the most common skin condition in the US and affects up to 50 million Americans annually. And acne is more than an inconvenience. It can cause both physical and psychological problems including permanent scarring of the skin, poor self-image and low self-esteem and depression and anxiety. Here you'll learn how to prevent acne, the best acne treatment for your skin, the best acne products, home remedies for acne and so much more. Let's start by having a look at what causes acne and how the many different types of acne affect your skin in different ways.
Whereas acne vulgaris clogs pores from the bottom up, acne inversa (or hidradenitis suppurativa) is a form of acne that clogs pores from the top down. It’s caused by excessively rapid skin growth, occluding the mouth of pores with shed skin cells. When the pores are blocked and clogged, they become inflamed and can create pimples and acne lesions. This form of acne is usually observed in intertriginous skin, where two skin areas may touch or rub together. Induced or aggravated by heat, moisture, maceration, friction and lack of air circulation. Examples of these areas include underarms, folds of the breasts, and between buttocks cheeks.
It is widely suspected that the anaerobic bacterial species Cutibacterium acnes (formerly Propionibacterium. acnes) contributes to the development of acne, but its exact role is not well understood. There are specific sub-strains of C. acnes associated with normal skin, and moderate or severe inflammatory acne. It is unclear whether these undesirable strains evolve on-site or are acquired, or possibly both depending on the person. These strains have the capability of changing, perpetuating, or adapting to the abnormal cycle of inflammation, oil production, and inadequate sloughing of dead skin cells from acne pores. Infection with the parasitic mite Demodex is associated with the development of acne. It is unclear whether eradication of the mite improves acne.
Acrokeratosis paraneoplastica of Bazex Acroosteolysis Bubble hair deformity Disseminate and recurrent infundibulofolliculitis Erosive pustular dermatitis of the scalp Erythromelanosis follicularis faciei et colli Hair casts Hair follicle nevus Intermittent hair–follicle dystrophy Keratosis pilaris atropicans Kinking hair Koenen's tumor Lichen planopilaris Lichen spinulosus Loose anagen syndrome Menkes kinky hair syndrome Monilethrix Parakeratosis pustulosa Pili (Pili annulati Pili bifurcati Pili multigemini Pili pseudoannulati Pili torti) Pityriasis amiantacea Plica neuropathica Poliosis Rubinstein–Taybi syndrome Setleis syndrome Traumatic anserine folliculosis Trichomegaly Trichomycosis axillaris Trichorrhexis (Trichorrhexis invaginata Trichorrhexis nodosa) Trichostasis spinulosa Uncombable hair syndrome Wooly hair Wooly hair nevus
Fractional laser treatment is less invasive than ablative laser treatment, as it targets only a fraction of the skin at a time. Fractional lasers penetrate the top skin layers, where its light energy stimulates collagen production and resurfaces the top layer of the epidermis. Treatments typically last between 15 and 45 minutes and effects become visible in 1 to 3 weeks.
In the simplest sense, acne is caused when pores containing hair follicles and sebaceous (oil) glands become clogged. The sebaceous gland is responsible for producing sebum, an oily substance necessary for skin to stay hydrated and soft. However, too much sebum can plug the opening at the top of the pore, trapping a buildup of oil, dead skin cells, and bacteria leading to acne lesions.
Dermabrasion is an effective therapeutic procedure for reducing the appearance of superficial atrophic scars of the boxcar and rolling varieties. Ice-pick scars do not respond well to treatment with dermabrasion due to their depth. The procedure is painful and has many potential side effects such as skin sensitivity to sunlight, redness, and decreased pigmentation of the skin. Dermabrasion has fallen out of favor with the introduction of laser resurfacing. Unlike dermabrasion, there is no evidence that microdermabrasion is an effective treatment for acne.
Salicylic acid and azelaic acid. Azelaic acid is a naturally occurring acid found in whole-grain cereals and animal products. It has antibacterial properties. A 20 percent azelaic acid cream seems to be as effective as many conventional acne treatments when used twice a day for at least four weeks. It's even more effective when used in combination with erythromycin. Prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding. Side effects include skin discoloration and minor skin irritation.