Do you have pimples or acne? If so, and you are desperate for effective treatment, do read on. As one of the most common skin problems, myths and misconceptions about acne—what it is and how to treat it—abound. As with any skin condition, understanding the truth about your acne is the first step to treating it effectively.

Here, then, are answers to some of the F requently A sked Q uestions ( FAQ s) regarding Pimples or Acne that the dermatologists of the Philippine Dermatological Society (PDS) most often face, as well as facts to nullify the most common misconceptions about this condition.

Q: Is acne caused by dirt trapped in the pores? Can I get rid of blackheads and whiteheads by staying clean, washing as often as possible, and scrubbing the face vigorously with abrasives?

A: No, acne is not caused by dirt. Notice that even the cleanest person who stays in an air-conditioned room without pollution can develop acne. Genetic factors are important to consider since there is a hereditary tendency for dead skin cells to have an abnormal stickiness in the pores of the skin, thereby causing blackheads. Blackheads, or open comedones , are open follicles (the pores from which hairs grow) trapped with dead skin cells (or keratinocytes ) plus oil gland secretions and bacteria.

The dark colour of blackheads is due to deposits of skin pigment or melanin, and is not caused by dirt or lack of hygiene. No matter how much you try to wash and scrub your face, therefore, the blackheads remain. Washing the face too often, especially with harsh medicated or abrasive cleansers, may in fact actually make the acne worse.

When the pores are closed, whiteheads form and are therefore called closed comedones . When increased oil is secreted by the oil (or sebaceous ) glands, and this combines with bacteria called Propionibacterium acnes , the interaction produces the pus that accumulates in the pimple. If not treated, cystic and even hard nodular (lumpy) lesions develop which may cause scarring.

Q: Is acne specifically an adolescent problem? When I am out of my teenage years, will I no longer suffer from acne?

A: Acne is NOT just a problem for teenagers. In fact, there are several kinds of acne ranging from types affecting the newborn (first four weeks of life), infants, children of various ages, adolescents and definitely a variety that appears in adulthood. The common acne, acne vulgaris , is the type most adolescents develop. Statistics show that 90% of teenage boys and girls will come up with some type of acne during puberty. The reason for the eruption in this period is the surge of hormones (called androgens ) that causes an increase of the oil secreted by one’s sebaceous glands.

Unfortunately, adults may also get acne lesions for a number of reasons such as use of comedogenic (acne-causing) products and cosmetics, increase of hormones due to stress or menstruation, use of certain drugs and many others. Do not be surprised, therefore, to see people in their 30′s, 40′s and even 50′s with acneiform (acne-like) lesions.

Q: Will eating oily food, such as peanuts and chocolate, cause an eruption or increase of pimples?

A: There are no scientific studies proving the relationship between food and pimples. The oil glands of the skin are under the influence of the nervous system which is dictated by hormones. Hence oil secretion is triggered by intense emotion or stress, sleeping late, menstruation . . . not food. However, if the acne seems to get worse when eating a specific food, it is best to avoid that food. Furthermore, it is always advisable to eat nutritious food and a balanced diet to ensure a healthy glow inside and out.

Q: Can I save a lot of time, pain and money by pricking or squeezing out my pimple on my own or by self-medicating?

A: One absolute no-no in dealing with acne is manipulation by untrained hands. Trying to remove these deep-seated lesions on your own (pricking, squeezing or picking at them) causes even more damage. These efforts may cause ice-pick scars or unwanted hyperpigmentation (skin darkening) that both cost more, in terms of both time and money, to treat.

Various medications are recommended for the different types and stages of acne—open and closed comedones, lesions with pus, cysts, nodules (lumps) and severely scarring types. It is best to first consult a dermatologist for proper advice rather than to self-medicate. Dermatologists should also

be sought for procedures such as acne removal or surgery wherein each lesion is manually extracted with a specifically designed, appropriate and sterilized tool, or wherein a steroid injection is given to flatten large, solid lesions. It is not advisable to be “treated”, for example, in a beauty parlor. Once scarring develops, other procedures such as chemexfoliation (peeling), dermabrasion or laser resurfacing, and specific medications may be tried.

Q: Will my acne disappear immediately and never return once I start treatment?

A: One important thing to realize regarding acne is that it takes time and effort to stay pimple-free. With just one treatment or application, the eruption will probably come and go depending on circumstances. For example, in females, break-outs may be evident before menstruation or during exams for students.

Some medications are used as maintenance while others are applied only as dictated by the type of acne present. Be patient with topical medications (applied to the skin’s surface, not taken internally).

Stick to the regimen your dermatologist gives you, no matter how tedious it may sometimes get. Also, stay clean, get enough sleep, eat the proper types of food and drink enough water daily for sustained inner health and outer glow.

When in doubt, or when all else fails, your dermatologist will be more than willing to help you with your problems regarding acne, answer all your questions and suggest a treatment strategy individualized for your needs. Instead of hiding in shame because of acne problems, be patient, do not panic, keep the facts presented above in mind, and seek out a trained and accredited dermatologist to find the proper treatment regimen best for you.