If you have acne in the 21st century, you’re fortunate. Why?
Because there are so many great ways to treat it and there are
many more to come. But there are no quick cures for acne; in fact,
there aren’t really any cures. The goal of treatment is to manage
your acne, help control it, prevent it from scarring, and help you
look your best. The truth is that acne tends to heal itself over time,
but the right therapy can make your skin look better.
Meeting the players
Until the last couple of decades, there was very little anyone could
do to treat acne. But we’ve now come a long way from the “dark
ages” of arsenic and puppy blood (see the sidebar “Ye olde pimple
remedies”). Now we have excellent methods to treat acne and the
future looks even brighter. There are
Over-the-counter topical (applied to the skin) products that
contain such tried-and-true medicines as benzoyl peroxide
(see Chapter 7 for a complete list of products, their pros and
cons, and how to use them effectively)
Topical antibiotics and retinoids (I discuss these in Chapter 9)
Oral antibiotics (take a look at Chapter 10)
Hormones and anti-androgens for females (see Chapter 11)
Oral retinoids, like Accutane (see Chapter 13)
Chemical peels, special lasers, and lights (see Chapter 14)
Some people also claim that various alternative and complemen-
tary approaches have helped improve their acne (in Chapter 15, I
outline the possibilities and give you my input and advice on such
matters).
Deciding whether to treat yourself
If you’re just starting to get breakouts or you have really mild acne
with a few blemishes here and there, the over-the-counter (OTC),
do-it-yourself route that I describe in Chapter 7 may be just the
ticket for you. Look in the mirror. If you see a few blackheads and
whiteheads or a few pimples, you can probably find ways to treat
them on your own.
You can find many acne products waiting for you at your local
drugstores and cosmetic counters. You can do many things to
improve the appearance of your skin without a prescription if
you’re a teenager just starting to get acne. Shelves are also stocked
with products specifically geared toward adult women.
You can also follow some of my skin-care tips and further ideas to
help you that I bring up throughout the book, like the face-washing
advice I provide in Chapter 2, the tips for healthy skin in Chapter 22,
or the list of things you should never do to your skin in Chapter 23.
Although going to a doctor generally costs more than buying a
cream at your local drugstore, you’ll likely save money in the long
run and get better results than you’ll get by running through the
gamut of OTC acne products.
Relying on the experts
For some folks, acne can be more serious. In fact, by their mid-
teens, more than 40 percent of adolescents have acne severe
enough to require some treatment by a physician or a dermatolo-
gist who is an authority when it comes to acne. And adult women
who are having problems getting their acne to respond to treat-
ment often need to make an appointment with a doctor.
But no matter who you are, you should definitely have your acne
evaluated by a knowledgeable healthcare provider if:
Your acne didn’t respond to home remedies, diets, herbal
medications, facials, special soaps, or nonprescription OTC
treatments.
Your skin can’t tolerate the OTC preparations.
Your acne is widespread and it involves your chest and back.
Your acne is beginning to scar or has already scarred.
Your acne has become more severe.
You are a female who develops facial hair or has irregular
periods (I address this issue in Chapter 20).
You’re not a “do-it-yourselfer” and you want the pros to
handle your acne.
You have dark skin, and patches that are darker than your
normal skin appear after your acne lesions clear. (For treat-
ment considerations particular to folks with darker skin, turn
to Chapter 12.)
In addition, you may need help dealing with acne scars, both the
physical and emotional:
Preventing and repairing scars: Even very mild or occasional
breakouts have the potential to leave permanent scars. There
are now exciting innovations in dermatologic surgery using
lights, lasers, and chemical peels to help improve the appear-
ance of the skin before and after acne has left its marks.
(Check out Chapters 14 and 16 for more information.)
Healing the inner scars: The emotional effects of acne haven’t
always been fully appreciated, but many studies have demon-
strated its damaging psychological impact. Nowadays there is
a much greater interest in preventing and healing the inner
scars of acne. In Chapter 17, I talk about the psychological and
social scars of acne.
Avoiding quickie, quacky cures
Because your acne appears on your face and everyone can see it,
you may feel desperate to make it go away. But because it’s not life
threatening, you may feel reluctant or embarrassed to go to your
healthcare provider about it. Certain people prey on that knowl-
edge. They want to sell you expensive over-the-counter acne
“cures” that don’t do you any good, or get you to order them after
watching testimonial-filled infomercials.
The people giving those acne “testimonials” on TV are almost
always professional actors reading a script. And even those stories
that are “real” generally mean nothing. You can always find one or
two success stories while ignoring 99.9 percent of failures.
Even if it’s on TV, on the radio, the Internet, or in magazines, that
doesn’t mean it’s necessarily true. The world of acne fighting is
filled with snake oils and false promises.
There are promises that guarantee “five day cures” for your acne,
and there are the real slow pokes that state, “try this all time-
tested home treatment for acne and have clearer blemish-free skin
within 30 days of use.” You can find many similar “cures” if you
search the Internet, so check out Chapter 21 where I give you some
roadmaps to some realistic acne advice you can find on the Web.
Also, check out www.quackwatch.com, a nonprofit organization
whose purpose is to combat health-related frauds, myths, fads,
and fallacies pertaining to health-related issues. Its primary focus
is on quackery-related information.
Recognizing Impostors and
Related Conditions
There are several skin conditions that appear to be acne, but that
aren’t acne at all. Rosacea and keratosis pilaris closely resemble
acne, as does another acne look-alike, pseudofolliculitis barbae —
also known as razor bumps. These conditions, among others, are
pretenders that sometimes even fool doctors into thinking they’re
actually acne. There are many ways to control these acne impos-
tors; in Chapters 18 and 19 I show you how to do it.
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