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Acne Myths
By Dr. Kenneth Dickie
Jul 15, 2008 - 12:42:37 AM

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Myth 1:   Certain types of food like pizza, chocolate and junk food causes acne.

There have been no scientific links made between food and acne.   That doesn’t mean you can eat junk food as your main dietary staple.   Skin, like every other organ and system in your body, is affected by what you eat.   If you eat plenty of vegetables, fruits, fibres, and drink sufficient amounts of water, not only will you be healthier, but your skin will radiate!   You don’t have to completely avoid all of your favourite foods (like chocolate), but remember that what you eat affects your overall health, and that includes the health of your skin.   Keep in mind that different foods can produce allergic reactions in some people.   If you consistently notice a skin reaction after eating a certain food (including chocolate), it makes sense to ask for a doctor’s help in investigating a possible allergy.   In the mean time, avoid those foods.


Myth 2: Sexual intercourse causes acne.

Oddly enough, acne and sexual intercourse are related, though not in a way that most would expect.   Sexual activity doesn’t cause acne and acne doesn’t cause sexual activity.   The process that links sex and acne actually begins with the sex drive, which is affected by androgens, particularly testosterone.   So, while sexual intercourse does not cause acne, increased levels of androgens, which do cause acne, may also heighten the sex drive.   It is this increased level of androgens that accounts for the connection between acne and sex.


Androgens are partially responsible for an increase in the production of oil (called sebum) by the sebaceous glands in the skin.   In the presence of bacteria called P. acnes, this additional sebum leads to acne.   Here’s how it happens:   Sebum brings cells to the surface of the skin where they are sloughed off.   When there is excess oil, the opening of the oil gland (called a duct) gets clogged.   Excess oil and old cells plugging the duct are called a comedo.   When the plug stays just below the surface of the skin it is light in colour (a white head).   When the plug enlarges, its dark tip forms a blackhead.   Contrary to popular belief, this dark colouring is not caused by dirt, but by a build-up of melanin, the pigment in the skin.   Bacteria may also form in the clogged pores to cause red inflamed pimples.


Myth 3:   Acne is caused by poor hygiene .  

This is not true.   No matter how hard you scrub your skin, those dark spots won’t go away.   In fact, vigorous washing can aggravate acne.   That is why you should wash your face no more than three times a day.   Wash the skin gently with lukewarm water and pat it dry.


Oily hair doesn’t cause acne any more than dirt does.   Wash your hair no more than once a day.   If you wash it too often it can dry out and your skin may even produce more oil to compensate.   If you have breakouts around the hairline, consult your dermatologist.   Ask about shampoos that can improve this condition. One acne causing hygiene tip involves touching the face.   As mentioned above, bacteria contributes to inflamed, puss-filled pores.   Many people don’t realize how much they touch their face during the day, nor do they realize the amount of bacteria their hands can carry.   To reduce the risk of spreading P. acnes bacteria, stop touching your face, and all areas of the skin where you are prone to breakouts!


Myth 4:   Sunlight cures acne.

Sunlight cannot cure acne, although it may give the pores a tighter appearance and a tan can sometimes mask acne.   However, sunlight can also damage the skin. In general, sunlight’s benefits don’t outweigh the costs.   If you have acne that you can’t resolve with over-the-counter acne products, don’t head for the beach.   Specially trained doctors can help you decide on a safe skin treatment that won’t cause cancer or make you look older than you really are.


Now that you are clear about some of the causes of acne, how can you get rid of it? There are several solutions.   First of all, there are many helpful over-the-counter acne products such as soaps and creams containing benzoyl peroxide.   Benzoyl peroxide works by killing P. acnes, the bacteria that infects clogged pores.   However benzoyl peroxide does not address the overproduction of oil, so you’ll need to use it continuously, or your acne may return.


If over-the-counter products don’t work for you, see a specialist.   He of she may give you a prescription for either a topical treatment (applied to the skin) or systemic (taken orally) antibiotic.   Systemic antibiotics are often particularly good for severe cases of acne, because they eliminate the bacteria deep in the glands, at a level that topical creams cannot reach.   Systemic antibiotics are also often good for acne in hard-to-reach areas, like the back, where you may not be able to apply cream.


Common prescription treatments include retinoids, like Retin-A (which is topical) and Accutane (which is systemic).   Retin-A treats moderate to severe acne by unclogging pores and normalizing the way the skin grows and sheds cells.   Accutane treats acne by reducing the oil output.   Like retinoid, it also improves the way that the skin sheds, and it reduces P. acne bacteria as well. Accutane is the only treatment that addresses all of the factors that cause acne.   For this reason, it is often the most successful treatment method.

Retin-A may be combined with more comprehensive skin care programs such as the Obagi program.   These programs not only improve the results of acne treatments, but also rejuvenate the skin by promoting healthy collagen balance in the skin.


Women with acne problems may also benefit from hormonal treatments.   Oral contraceptives, which provide female hormones, are often prescribed for women with acne particularly when acne outbreaks are related to menstruation.   In women, these female hormones help counteract the effect of the male hormones that stimulate excess oil production.


The options don’t stop there. Plastic surgeons also occasionally use chemical peels to treat superficial acne.   This procedure uses a chemical solution to strip off the damaged outer layers of skin, leaving behind a new outer layer of smoother, clearer skin.   Other procedures, like laser skin resurfacing, micro-dermabrasion and dermabrasion, may be used to correct the scars often left from earlier bouts of acne.


Have a plastic surgery question for Dr. Dickie?   If so, e-mail us at info@BahamasInstituteOfPlasticSurgery.com .   Dr. Kenneth Dickie is certified by the Royal College of Physicians and Surgeons of Canada in Plastic Surgery.  He specializes in Cosmetic Plastic Surgery as well as Plastic, Reconstructive, and Hand Surgery.   Dr. Dickie has been in clinical practice since 1984, and is currently a member of the Canadian and American Societies of Plastic Surgery, and the Canadian and American Societies of Aesthetic Plastic Surgery.   For a consultation, please contact the Bahamas Institute of Plastic Surgery at (242) 351-1234 or toll-free 1(242)300-1235.


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