(1) Dear Alice,

What medications do you recommend for acne?


(2) Dear Alice,

I would like to know something about acne. I am a high school student, and have gotten acne. I got it for more than two years, and would like to find a way to cure it. I currently use Neutrogena's Acne face wash, Neutrogena's overnight acne treatment, and some face washers. They have decreased, but I really want them to be gone.

I also read that fatty foods don't contribute to acne, but any case, I still eat low-fat foods for healthy reasons.

I hope you can help me. Thanks a lot for your help.

Anxious about Acne

Dear Pimples and Anxious about Acne,

Acne is a skin disorder that can affect people at all ages, from infancy to old age. The years from adolescence to middle age tend to be the most troublesome as far as acne is concerned. Acne treatment seeks to clear up existing acne and prevent more from developing. Many aspects of acne are targeted to remedy the problem; they are grouped into three main factors — hormones, bacteria, and inflammation.

With the onset of adolescence and its accompanying increase in hormonal secretion, the body is bombarded with changes. The sebaceous glands (glands in our skin that produce and excrete sebum, a fluid that helps keep our skin lubricated) often overproduce sebum. The end result is the enlargement and clogging of the glands of the face, shoulders, chest, and back; and, a pimple or blackhead, what is referred to as a "comedone" in the medical world, is formed.

This situation gives rise to the second factor, bacteria, specifically Propionibacterium acnes (P. acne, for short). P. acne thrive in the environment created by the overproductive sebaceous gland where they set up shop, only to further aggravate skin troubles. The third factor, inflammation, is the body's response to clogging of the gland and subsequent bacterial invasion. As it tries to fight the bacteria, inflammation starts, and anti-inflammatory cells are sent to the site — this leads to the formation of a cyst or pustule.

Over-the-counter products, such as those Anxious about Acne mentioned, are sufficient for many people to control their acne. Generally, these products come in only one strength or dosage, which may work for a while (or not at all), but, in the future, may fail to control acne. If these don't work, stronger medications are available. Ask your health care provider or dermatologist. Be aware that one visit may not be enough to remedy your acne. Acne medications tend to affect people differently depending on skin type, classification, and severity of acne. You may, therefore, need to experiment with a few treatments before finding the "formula" that works for you.

One aim of acne treatment is to prevent pores from becoming clogged in the first place. An unclogged and healthy pore becomes an uninviting place to bacteria (and that's good news for you!). Astringents, benzoyl peroxides, retinoic acids, and glycolic acids all work to prevent pores from clogging. Antibiotics, either taken orally or applied topically, can be used to control some types of acne. In order to decrease the inflammation associated with some cases of acne, topical corticosteroids are used to suppress immune cells in the acne-ridden areas. For really bad cases of acne, talk with your health care provider about stronger medications that act by shrinking sebaceous glands. If you're a woman, certain birth control pills may help, too, because they help prevent excess secretion of androgen hormones, which work to decrease the effects hormones have on the sebaceous gland. Dermatologic surgery, such as incision and drainage or freezing, can also help unclog and clear pores, as well as reduce inflammation.

You're right, it is a myth that certain foods, like chocolate or potato chips, will induce or aggravate acne. However, if you notice that your acne flares up more often when you eat a particular food, then don't eat it. It is also a myth that dirt causes acne, and that scrubbing your face with a buffer will help control it.

For more information about acne — types, causes, home treatments, and preventive measures — check out Greasy foods lead to acne and gallbladder problems? in the Go Ask Alice! archives. Additionally, the American Academy of Dermatology has more information about acne.


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