Pimple scar treatment

Acne (acne vulgaris) is a common skin condition characterized by comedones (whiteheads and blackheads), papules, pustules, and cysts. Acne mostly affects areas of skin with dense sebaceous follicles, such as face, upper neck, chest, back and shoulders. Depending on severity, acne can be inflammatory or noninflammatory. Acne lesions are commonly referred to as pimples, blemishes, spots, or zits.

Acne occurs most commonly during adolescence, affecting most teenagers to some extent, and often continues into adulthood. In adolescence, acne is usually caused by an increase in androgens. For most people, acne diminishes over time and tends to disappear after one reaches early twenties. However, some individuals will carry this condition well into their thirties and beyond.

Acne develops as a result of blockages in sebaceous follicles, each of which contains a hair and a sebaceous (oil) gland. Hyperkeratinization and formation of a plug of keratin, sebum, and dead skin cells is the initial step. The plug may enlarge to form an open comedone (blackhead) or closed comedone (whiteheads). Comedones are the direct result of sebaceous glands becoming clogged with sebum, a naturally occurring oil, and dead skin cells. In these conditions the largely commensal bacterium Propionibacterium acnes can cause inflammation, leading to inflammatory lesions (papules, infected pustules, or nodules), which results in redness, scarring or hyperpigmentation.

Besides scarring, acne can also cause emotional distress and damage to self-esteem, confidence, personality, and social life. Some people can become significantly depressed if acne is not treated.

Causes
Acne is not caused by dirt. Although blackheads look like dirt stuck in the openings of pores, the black color is simply oxidized keratin. Acne is not contagious or infectious.

The primary causes of acne include:

• Overproduction of sebum as a result of hyperactive sebaceous glands secondary to hormonal activity.
• Irregular shedding of dead skin cells resulting in irritation of the hair follicles.
• Bacteria in the pores. Propionibacterium acnes is the anaerobic bacterium that causes acne.

The factors that have been linked to acne include:

• Genetics. The tendency to develop acne runs in families. A family history of acne is associated with an earlier occurrence of acne and an increased number of retentional acne lesions.
• Hormonal activity, such as puberty and menstrual cycles. During puberty, an increase in androgens causes the follicular glands to grow larger and make more sebum. Acne in adult women may be a feature of an underlying condition such as pregnancy and disorders such as polycystic ovary syndrome. Menopause-associated acne occurs as production of the natural anti-acne ovarian hormone estradiol fails at menopause.
• Inflammation. Skin irritation or scratching will activate inflammation.
• Stress. Research indicates that increased acne severity is significantly associated with increased stress levels.
• Use of anabolic steroids.

Treatment
In general, treatments are approached from the following four directions:

• Normalizing shedding into the pore to prevent blockage.
• Killing Propionibacterium acnes.
• Anti-inflammatory effects.
• Hormonal manipulation.

The following self-care approaches may help lessening the effects of acne:

• Gentle skin washing with a mild, moisturizing soap once or twice a day, including after exercising, can help to remove bacteria and oils that cause acne.
• Shampoo hair daily and keep the hair out of your face.
• Avoid touching your face with hands or fingers.
• Avoid squeezing, scratch, pick, or rub the pimples, which can lead to scarring and infections.
• Avoid oily cosmetics or creams. Use water-based formulas instead. Remove make-up at night.

Over-the-counter and prescription acne medications include:

• Topical bactericidals, such as over-the-counter bactericidal products containing benzoyl peroxide.
• Topical or oral antibiotics, such as erythromycin or one of the tetracycline antibiotics can kill the bacteria that are harbored in the blocked follicles.
• Topical or oral retinoids. A group of medications for normalizing the follicle cell lifecycle are topical retinoids such as tretinoin, adapalene, and tazarotene. Oral retinoids include the vitamin A derivative isotretinoin (Accutane). Note, isotretinoin can cause severe birth defects and should be not be used by pregnant or sexually active females.

Some other approaches that have been used include birth control pills, chemical skin peeling, surgical drainage of cysts, dermabrasion, and UV exposure, which are often associated with significant risks and side effects.