II. Management: Exacerbating factors to avoid

  1. Medications that exacerbate acne
    1. Androgenic steroids (e.g. Danazol, Testosterone
    2. Corticosteroids
    3. Lithium
    4. Oral Contraceptives
    5. Isoniazid
    6. Phenytoin (Dilantin)
  2. Environment
    1. Hot
    2. Greasy (fast-food kitchen, garage)
  3. Oil based Cosmetics
    1. Cosmetics with Lanolin or petroleum jelly
    2. Oil based Shampoos or Sunscreens
  4. Emotional Stress
  5. Physical Pressure (acne mechanica)
    1. Tight chinstrap
    2. Helmet

III. Management: Myths (non-causes of Acne Vulgaris)

  1. Foods DO NOT worsen acne
    1. Pizza
    2. Nuts
    3. Sweets
    4. Chocolate
  2. Acne is not a result of poor hygiene
    1. Constant washing does not improve acne
    2. Scrubbing dries and irritates skin further

IV. Management: General recommendations

  1. Do not squeeze lesions
    1. Forces pus into Dermis
    2. Causes inflammation and scarring
  2. Limit washing face to 2-3 times per day
    1. Avoid abrasive soaps
    2. Gear soap to skin condition
      1. Skin dry: Purpose soap
      2. Skin oily: Dial soap
  3. Change cosmetics to water based products

V. Management: Skin of Color (e.g. black, asian, hispanic)

  1. Skin of Color is more susceptible to scarring, Keloids and Postinflammatory Hyperpigmentation
  2. Be aware of skin and hair products (e.g. cocoa butter, olive oil) that may exacerbate acne
    1. Many of these products are used more commonly in Skin of Color communities
  3. Start acne topical medications at less irritating, lower concentrations
    1. Increase dose slowly to reduce Postinflammatory Hyperpigmentation
    2. Retin A 0.025% cream every other day (instead of 0.05% gel daily)
    3. Benzoyl Peroxide 2.5% (instead of 5-10%)
    4. Azelaic Acid (Azelex, Finacea) may be indicated if Postinflammatory Hyperpigmentation is already present

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window