What are the factors that can make acne worse ?

There are a myriad factors that can worsen acne. It can be a change of seasons or residence. Acne can be worsen from makeup or moisturizers that we used or cleansers that we don't use. However, individual might share the same acne triggers as well as different triggers with one another.

We list down the most common factors that leads to the worsening of acne below :

• changing of hormone level in adolescent girls and adult women about a week before the menstrual cycle.
• friction from bike helmets, backpacks or tight gears.
• pollution and hot, high humidity climates.
  Pollution causes dirt which can clogged our pores leading to acne flares.A hot and high humidity climates causes our outer layer of skin to swell tremendously. The pressure from swelling could clogg our pores that cause acne.
• squeezing at pimples.
• hard scrubbing of the skin.
• stress.
  Acne often worsens during period of stress, tension and anxiety. A study by Stanford University published in the Archives of Dermatotology reported that acne suffering students worsened in hte examination period. This indicates changing hormone level during stress may have a significant influence on acne. In additon, acne flares during this time is made worse due to failure to use acne medications regularly.
• durgs
  Drugs such as corticosteroids given orally or by injections, lithium for treating manic depressive illness and testerone pills or injections used by professional athletes and bodybuilders may acts as acne aggravators. Danazol which is sometimes given to women for endometriosis (promote growth of tissue from the uterus on other parts of the body) has a similar effect as testerone which worsen acne.
• poor skin hygience.

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How Often Should I Wash My Face?

Washing the face keeps it clean and oil free. This lessens the chances of having acne flares due to clogged pores and bacteria infection. For this reason, acne sufferers tend to wash their faces excessively to reduce the oiliness of their skin. However, there is no scientific data to show that the lack of face washing causes acne or frequent washing improves the acne condition.

However, over washing or scrubbing your face will not only make your skin irritated and redden but also worsen the inflammatory stage of acne.

Normal washing actually does not affect the reservoir of oil in the follicle which is the place where acne originates. Furthermore, antibacterial soaps that contains triclosan and chlorhexidine which can be irritating to your skin and do not kill P.acnes bacteria. However, a benzoyl peroxide wash does reduce and kill P. acnes bacteria even when used as a cleanser but even with a benzoyl peroxide wash, over washing still irritate the skin.

Sometimes, you may not get acne but an irritant dermatitis (a skin inflammation) that look likes acne. When you treat your face with acne medication, the rashes can get worse. So in these cases, what you should do is wash your face less; twice a day by using a gentle surfactant free cleanser followed by a moisturizer.

Generally, washing in the evening is more important than in the morning. However, if you have heavy exercise and sweat a lot during a particular day, you should get your face wash. Do you know that you should use different products according to the season. A gentle, moisturizing product is more suitable during the winter, with only occasional exfoliation. For the warmer and more humid summer, use a more drying, foaming cleansers and more frequent exfoliation.

Cleansers come in various forms. Some are foaming washes which are drying and irritating while others are nonlathering that is less irritating and foam. Microbeads cleansers exfoliate while they clean and some other types comes in cleansing cloth use with or without water which are great for travel use. Finally, medicated cleansers generally contain benzoyl peroxide, salicylic acid or AHA.

Put in mind that an exfoliating cleanser should be used only once or twice a week or less depending on the sensitivity of your skin. For some acne sufferer, cleanser is the only acne treatment that is needed.

For acne sufferers who are allergic to topical benzoyl peroxide based products, a benzoyl peroxide cleanser may be the ideal solution as their acne treatment. As the benzoyl peroxide is only left on the skin for a few minutes before being rinsed and then followed by a face moisturizer, the chances for getting a skin irritation is very low. However, benzoyl peroxide is still effective in killing the acne causing bacteria even with such short time of contact with the skin. Thus, a benzoyl peroxide cleanser is successful in treating acne with minimum irritation.

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How Do Hormones Affect Acne?

Teenagers normally get acne. Why? This is the time they experience a change of androgen or sex hormones in their body. An increase of androgen hormones in teenagers cause the sebaceous glands to enlarge and increase the sebum production. Excessive sebum production, abnormal shedding of dead skin cells, the "stickness" of the follicle walls and the presence of P. acnes bacteria cause acne flares.

As you can see, the presence of androgen hormones such as testerone, DHEA and 17-Hydroxyprogesterone plays an important role in getting acne on your skin. If there is no androgen hormone, you might not get acne at all. In some acne sufferers, a high hormone level circulating in the blood triggers acne. But for most people, the level of androgen hormone is normal in the blood.It is the abnormal response of the pilosebaceous unit of over accepting the hormones from the normal amount of circulating androgen hormones that make us getting acne.

By blocking the effects of androgens on the sebaceous glands with oral contraceptives, women who are affected by acne and yet show normal amount of androgen level in their blood test can be successfully treated.

In addition to androgen hormones, cortisol hormones also affect acne. Cortisol hormones are released by our body when we are under stress, such as in encountering a dangerous situation. As cortisol suppresses the immune system, it gives the chance for P. acnes bacteria to multiply, leading to a flare of inflammatory acne.

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What Are The Type Of Oral Antibiotics Available?

The most common antibiotics are tetracyline,doxycycline, minocyline, erythromycin and cotrimoxazole. Oral antibiotic can change the normal bacterial flora of women vagina which leads to an overgrowth of the superficial fungus Candida. Women in this condition will discharge a white vaginal fluid for several days to weeks after starting the therapy.

Tetracyline has been proven safe and effective in treating inflammatory acne. The initial dosage prescribed is usually 500 mg for twice a day.This dosage will be maintained for about six weeks by which a significant improvement can be seen. Thereafter a lower dosage is prescribed. As tetracyline absorption is affected by the presence of food and dairy products, it must be taken on an empty stomach or at least one hour before meals.

The side effects of taking tetracyline includes mild gastrointestinal problems such as diarrhea and vomitting. It can also cause discolouration of teeth in children and should not be used during pregnancy.

Doxycyline can be taken with meals as its absorption is not affected by the presence of food. The initial dosage is usually 100 mg for twice a day, taken after meals with water to reduce gastric problem. It also causes a photosensitive rash that is worsen by sun exposure.

Minocycline is a newer version of tetracycline that can be taken together with food. The initial dosage is 50 mg for twice a day. Its side efffects includes dizziness,nausea and a bluish pigmentation of the skin.

Erythromycin is an alternative to acne sufferers who are allergy to tetracycline and for pregnant women. It is as effective as tetracycline. The initial prescribed dosage is usually 500 mg for twice a day. Its side effects include gastrointestinal problem, diarrhea, vomiting and farting. If you are taking carbamazepine to treat epilepsy or theophylline for asthma, you should inform your doctor as these medications might react with erythromycin.

When the above oral antibiotics cannot be taken, it is time to try cotrimoxazole (trimethoprim / sulphamethoxazole). However, cotrimoxazole can cause severe skin rashes. The usual dosage is two tablets for twice a day. Look out for skin rashes or mouth ulcers when you take cotrimoxazole for the first few weeks.

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How Long Does A Pimple Last?

Indeed it takes time for pimples to clear, sometimes months. Comedones (whiteheads and blackheads) can last for weeks or months if not treated. Inflammatory acne lesions clear within a few days to a few weeks. However, red marks that was left after the pimple subsized later on turn to brown color can stay for months; sometimes for as long as 6 months.

In certain case, when an acne heals, another one starts to develop at exactly the same spot. So it appears that the acne can last for months. Cysts have a tendency to occur in the same spot and you may notice that they may have various sizes as time progress. No matter how great the temptations to pick on this lesions, do not ever give in to it as it will only make the cysts prolong and worsen it as well as causing scars on the spot.

Why is it so bad when we pick a pimple? The irritation caused by picking or squeezing your pimple may give you an immediate feeling of satisfaction as you have done something to clear the contents of the pimple and make your skin feel smoother. However, in the short run, what you have done is making the spot redder and prone to having a brown marks or a depressed scar. And it doesn't prevent the pimple from reoccurring at the same spot again.

The main purpose of treating acne is to prevent it from appearing. However, once acne appears, our priorty is to clear the acne in the shortest possible time. Early treatment of acne and avoidance of picking of acne go a long way in keeping scarring at bay. To properly identify what cause acne in your case, try to avoid applying acne medications that irritated your skin. Note down anythings that you do differently that cause the acne flare. It can be due to new cream or gel that you use, or certain medications that you stop using. Or is it exams just around the corner ?

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Are We Supposed To Pop Blackheads and Whiteheads?

In general, it is recommended that you does not squeeze or pop your pimples. Squeezing pimples make them worse and can cause scarring as you might cause damages to the surrounding skin tissues and pushing the pus content and bacteria deeper into the skin. Of course there is exceptional case in which you can squeeze pimples such as when they are ready to pop.

Whiteheads are a type of comedones which contain inactive P. acnes bacteria. The sebum content are blocked under the pores with no opening to the surface. That means they don't have any "heads".

Whiteheads content can only be removed with popping with extreme force as there are no opening on the spot. This might leads to inflamed lesion being developed and skin tissues damages. Therefore, whiteheads should never be squeeze at all cost.

Even though the above rule for whiteheads apply to blackheads as well, there are cases where the blackhead should be squeezed. Maybe it shouldn't be done by you but by a dermatologist.

Squeezing of blackheads contents only provides a temporary solution to clear the sebum in those particular spots, they will come back again very soon. A typical example is the blackheads that are located in your nose.

For self help acne sufferers, you can squeeze the blackheads with a blackheads remover tool. Follow proper procedures carefully when squeezing the blackheads with this tool.

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Why do my acne have no reaction to the standard treatments?

Specific medical conditions that you have may cause and aggravate acne. Acne sufferers with these medical conditions normally have more severe acne that do not respond to standard acne treatment.

Women who have an excess of androgen hormone normally have irregular periods, excessive hairiness and oiliness, male pattern baldness and deepening of the voice. They may show no improvements at all when treated with the standard acne treatment.

What causes the excess androgen hormone in women? Having polycystic ovarian syndrome in women is one of the most common causes. Women with polycystic ovarian syndrome have large and cystic ovaries, resulting in an imbalance in the hormones produced by the ovaries. The concerned women have oily skin, acne and irregular menstrual periods and usually obese, hairy and sub-fertile.

Another cause is due to Cushing's Syndrome in which the body contains too much cortisol (a glucocorticoid hormone) that results from an excess production by the body or from prolonged ingestionof steroid tablets such as prednisolone and dexamethasone) or from repeated injection of steroids for other medical conditions such as eczema and asthma.

Cushing's Syndrome causes face obesity "moon face", neck obesity "buffalo hump" and body obesity.Limbs won't be affected. Being hairy, skin thinning, easy to bruise and having purplish stretch marks (striae) are signs of Cushing's Syndrome as well.

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