Acne is a condition that affects the pilosebaceous units under the skin. Each of these units contains a fine hair and a sebaceous (oil-producing) gland, connected to a follicle, or canal. The opening onto the skin at the other end of the follicle is the pore.
Normally, sebum empties onto the skin through the pore. However, during puberty, the hormones cause the sebaceous (oil-producing) glands to enlarge and increase production of oil (sebum). The excess oil can combine with the hair and cells shed from the lining of the follicle, forming a small plug, preventing the oil from reaching the surface. The oily plug provides a breeding ground for Propionibacterium acnes (P. acnes), a bacteria that lives on the skin. Growth of the bacteria causes inflammation, leading to the acne lesion, commonly called a pimple.
There are several different kinds of pimples. The mildest lesions are whiteheads (closed comedos) and blackheads (open comedos). A whitehead is a blocked pore, causing the appearance of a white spot at the opening to the pore. With a blackhead, the pore is open, allowing the dirty plug to be visible through the opening of the pore. A papule is a small inflamed pimple that appears as a tender pink bump on the skin. A pustule is white or yellow and filled with pus. A nodule is a large solid acne lesion embedded deeply into the skin. It is usually painful. A cyst is the most severe type of acne lesion. It is very deep, painful and filled with pus. Cystic acne is often associated with scarring.
Acne is a common skin condition that affects 80 percent of teens and young adults. In most cases, acne disappears by 30. However, some people continue to have acne breakouts during adulthood.
Many cases of mild acne can be treated with over-the-counter products. Patients with moderate symptoms may need extraction, topical retinoids, topical antibiotics, oral antibiotics or oral contraceptives. More severe cases can be effectively treated with an oral drug called isotretinoin (a synthetic form of vitamin A). Most patients who take this drug have complete or near-complete resolution of acne after taking it for 15 to 20 weeks. However, the drug must be used cautiously because it can have side effects, the most serious being birth defects in the developing fetus if taken during pregnancy.
Another treatment for acne is Isolaz™, a therapy using a technology, called Photopneumatics™ (light and vacuum) to treat acne lesions. Mary Lupo, M.D., Dermatologist in New Orleans, LA, says the vacuum suctions the pore, removing the plug, oil, debris and pus. The blue light kills the bacteria inside the follicle and pore. A broadband light helps reduce redness.
Lupo says the treatment causes little to no pain. A single session takes about 20 minutes and patients typically need anywhere from three to six sessions. Patients need to continue using topical acne products to enhance the Isolaz treatment. For most patients the effects last from three to six months.
Isolaz is recommended for patients with mild to moderate acne, those who don’t have an adequate response to traditional therapies and patients who can’t or don’t want to take isotretinoin. Lupo does not recommend the treatment for people with dark skin.
For general information on acne and acne treatment:
American Academy of Dermatology, http://www.skincarephysicians.com/acnenet
National Institute of Arthritis and Musculoskeletal and Skin Diseases, http://www.niams.nih.gov
“Facing Facts about Acne,” Consumer Health Information, Rockville: Food and Drug Administration, January 2010, pp. 1-2.
Gold, M., and J. Biron, “Efficacy of a Novel Combination of Pneumatic Energy and Broadband Light for the Treatment of Acne,” Journal of Drugs in Dermatology, July 2008, Vol. 7, No. 7, pp. 639-642.
Shamban, A., et al., “Photopneumatic Technology for the Treatment of Acne Vulgaris,” Journal of Drugs in Dermatology, February 2008, Vol. 7, No. 2, pp. 139-145.
Wanitphakdeedecha, R., et al., “Photopneumatic Therapy for the Treatment of Acne,” Journal of Drugs in Dermatology, March 2009, Vol. 8, No. 3, pp. 239-241.