Thus far, attempts to effect a cure by altering the hormonal balance within the body have met with no appreciable success. Apparent benefits have been obtained in some cases in which female patients have been given birth-control pills containing sex hormones, but the effects are limited and unpredictable. Research is being continued in this area. But for the present both doctor and patient must cooperate in controlling acne to improve the patient’s appearance and prevent scarring.
For most people, this acne activity will die down by the early twenties—if not before. But this does not mean that the acne should simply be ignored while the teen- ager waits to outgrow it. Even moderate outbreaks of acne may leave permanent damage to the skin or, if given insufficient attention, may progress to more severe stages. And while there are no absolute cures for acne, there are, nevertheless, a number of techniques and procedures that have been found
useful in controlling it.
Most of the methods of combating acne rely mainly on the continuous diligence of the patient himself; but a physician should be consulted for any case of acne that grows progressively worse or widespread, or that does not seem to respond at all to self-treatment. The following paragraphs detail some general and specific measures that the adolescent and his family can take in the management of acne, and also outline some procedures that the doctor may employ. In applying any of these measures, however, it is best for the acne sufferer to maintain a realistic attitude, and recognize that the objective is not cure, but control.
Cleansing of the skin is important and is exclusively the province of the patient himself. However, many physicians will recommend a neutral soap or one that contains an antiseptic, in order to decrease the number of bacteria on the skin surface.
Boys who must shave should try both an electric razor and a safety razor to see which is more comfortable. Whichever type they choose, they should shave as seldom and as lightly as possible to avoid nicking pimples. When they use a safety razor, they should soften the beard first by washing for a full minute and a half with soap and hot water, and always use a sharp blade.
Clothing that comes in contact with affected areas of the skin should be changed and washed frequently. Face towels and pillow cases should also be changed frequently, even daily, if possible.
Hair should be washed thoroughly at least once or twice weekly to remove dirt, excess oils, and the dandruff that often accompanies acne. The demands of fashion notwithstanding, it is best to maintain a short hairstyle or to shampoo daily. Oily or greasy hair lotions or pomades should be avoided, as the scalp is probably already excessively oily. If hairstyle control is desired, a hairspray is preferable to greasy substances, even for boys.
An unusually severe case of acne, this time on a young man’s chest, indicating that the disorder-while it lasts-is not confined to the face. It can also appear on the back, the shoulders, and neck.
Picking or scratching of the face or scalp can only worsen the condition, and should be avoided absolutely. If the doctor feels that removal of blackheads or other facial eruptions is desirable, he will use an instrument specifically designed for this purpose, or will instruct the patient’s parents in the use of the instrument.
Otherwise, the patient should avoid even touching his face unnecessarily. Greasy face creams should not be applied at all; powders if used, should be applied with a disposable cotton ball, rather than a reusable fabric powder puff.
Acne preparations of various kinds may be useful in some cases but the patient will need the doctor’s help in choosing among the great variety available. Numerous medicated creams and lotions are obtainable that may help treat acne and that may also have “cover-up” qualities or characteristics making them suitable for use as a makeup base; but manufacturers’ claims are often rather optimistic, and the doctor’s familiarity with these products will be valuable as a guide. The doctor may also prescribe facial preparations that are not available over the counter.
Antibiotic drugs may be used for patients whose skin eruptions seem to be due in large measure to infection. Small daily doses of a broad-spectrum antibiotic such as a tetracycline or erythromycin may be prescribed by the doctor for a period of a few weeks or months, in order to help control the bacterial aspect of the patient’s acne.
Diet. Despite some popular conceptions to the contrary, no one ever developed acne through eating any particular foods, and no one’s acne has ever been “cured” by removing certain foods from the diet. It is important to remember that adequate and balanced nutrition is one of the body’s most basic defenses against all diseases, including acne.
Acne in boys is complicated by the presence of facial hair. Each new whisker has at its root a small oil gland opening to the skin surface. These glands may become plugged and infected as may any others in the skin.
Sunlight is known to have a beneficial effect in most cases of acne, and this is another reason to engage in reasonable amounts of outdoor recreation.
Radiation therapy should not be used. Ultraviolet-ray treatments may be given to some patients who do not normally receive’ adequate exposure to sunlight. It is the ultraviolet radiation in sunlight that provides the beneficial effect.
Facial planing, also known as surgical planing or dermabrasion, may be employed to remove the scars of severe acne. The physician uses a wire brush rotating at high speed to abrade, or wear down, the surface of the patient’s skin, which is temporarily “frozen” for this purpose. The procedure has its limitations, however, and can also result in complications for some patients. It is used only where the acne scarring is severe, and represents a significant cosmetic and emotional handicap to the patient. Moreover, the technique can be effectively employed only after the acne has ceased to be active—after adolescence has run its full course. To employ facial planing while the basic acne-producing changes are still going on within the body would be useless.
It is unfortunate that acne comes at a time when an individual is most concerned about how he looks to others, and the fact that most of his contemporaries also have acne is of little consolation. But parents can help a teen-ager to realize that good grooming and tasteful dress will more than make up for the presence of a few pimples, and that none of these is so important to the making of real friendships as are a warm and pleasant personality and an active mind.