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Getting acne....Q&A............(part 3 of 5)

I’ve started getting acne spots. How long do they last? This depends on what type of spots they are and, even then, it can be very difficult to predict what will happen. Some spots will appear and then disappear during the course of a day but others will evolve more gradually through the various stages. Comedones can be very persistent if they don’t get inflamed. Mildly inflamed spots will last 5–10 days before settling down, but can leave a flat red mark (macule) for several weeks. Nodules and cysts may last for weeks or months unless you get some treatment. What is the difference between a whitehead and a yellow- head spot? These two common terms describe quite different types of spot. A whitehead is a closed comedone where the pore is blocked and not open to the air. There is no inflammation (redness). A yellow- head suggests a spot with pus in it. The medical term is a ‘pustule’. Whiteheads may become yellowheads if the blocked pore becomes infected. My daughter is only 9 but she seems
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Reviewing topical retinoids


Most dermatologists consider topical retinoids to be the mainstay of acne therapy. They’re often the first-line prescription treatment for acne and they’re also utilized as long-term maintenance for almost every acne patient. Retinoids are, far and above, the drugs of choice in people who have comedonal(blackhead and whitehead) acne, but they’re also effective at fighting inflammatory lesions, so chances are that your dermatologist will start you off with one of these.

Retinoidsare medications that are derived from vitamin A. Retinoids are comedolytic,which means that they work by making the skin shed more easily so that follicular plugs don’t build up and form
blackheads and whiteheads. In addition to helping you shed your skin, retinoids

  • Indirectly limit the formation of inflammatory lesions by preventing comedones. After all, if comedones don’t ever form,they can’t become big, inflamed pustules and papules.
  • Appear to discourage P. acnes (the bacterial invaders associated with acne) growth.
  • Promote the shedding of skin, which enhances the penetration of other topical anti-acne agents.
  • Help to “plump up” the skin and make enlarged pores (follicular prominence, in dermatologist speak) less obvious.

REMEMBER Several brand-name topical retinoids, as well as generic preparations, are on the market (check out Table 9-1 for information on which brand-name retinoids contain which active ingredient, and read the sidebar in this chapter to get a handle on what a “branded generic” is). Many studies have been performed on the topical retinoids and the results don’t clearly favor the use of one preparation over another. Individuals vary in their response to these
agents and possible side effects, so you and your doctor will work together to find the best prescription for you.
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