Straight talk from a cosmetic dermatologist who deals with it every day

Acne—cysts, nodules, red bumps, pimples, blemishes, breakouts, zits, blackheads, whiteheads, clogged pores—is so common that 85% of us are affected by it at some time in our lives. It is the most common skin disorder in the United States, affecting 40 million to 50 million Americans. The total direct yearly cost of treatment for acne is more than $2.2 billion. By mid-teens, more than 40 percent of adolescents have acne or acne scarring. In adults, 40-55% of women, and 35-40% of men have experienced acne or acne scarring.

Problems with acne occur at an equal rate in males and females as teenagers, and are a major cause of distress at a time in life when appearances and attractiveness to others is central to happiness. I treat it all day long, and am always impressed by the degree of anxiety and depression that accompanies untreated or uncontrolled acne. Studies have shown that teenagers with acne have more than twice the level of depression and anxiety, and almost twice the rate of suicide attempts as teenagers without acne, across all ages, genders, ethnicity, and socioeconomic status.

Among adults with acne, women are four times more likely to have severe acne than men are, and acne problems persist longer. Because of the significant hormonal influence on acne, it is not uncommon for female patients to have acne well into the 50’s with periods of improvement and worsening related to hormonal status, hormonal contraceptives and pregnancy. Premenstrual flare-ups of acne are reported by almost 80% of adult women with acne. Ninety-seven percent of women admit that they pick at acne lesions. The other 3% are lying.

That is a lot of numbers and statistics. However, behind the numbers are a great number of people who deal with acne every day. Acne is so common that the degree of exasperation and discouragement among those who suffer with the condition is often underestimated by those who are spared from it. To the layperson, it seems that acne should be easy to treat, and since it is not a “serious” condition like cancer, it is no big deal. Patients with acne know better, and often get frustrated because, unfortunately, it can be difficult to treat effectively and it often lasts for years.

There are many things that we think should be simple, but aren’t. Acne is one of those. So let’s talk about some of the issues related to acne and acne treatment::

• Why me?
• Why can’t acne be cured rather than just controlled?
• Teenage age
• Adult acne
• Why acne in women is such a challenge
• Hormones and acne
• Cosmetics and acne
• Lifestyle and acne
• Stress and acne
• Food and acne
• Dirt and acne
• Sports and acne
• Medical treatment options for acne
• Which specific birth control pills help acne?
• What about birth control shots, or hormone containing IUD’s or implants and acne?
• Procedure treatment options for acne
• Natural treatment options for acne
• Why you need to follow your dermatologist advice and what happens if you don’t
• Why the side effects of acne treatment come before the improvement in acne
• How to minimize side effects of acne treatment
• Isotretinoin a great medication but one with side effects and risks
• Acne in skin of color
• Treatment of red and brown spots left over after acne
• Treatment of acne scarring
• Is picking at acne always bad?
• Acne myths and truisms

Next: Let’s get started.