Once acne scarring has occurred, a variety of resurfacing techniques, as well as collagen implant therapy, can be used to improve the appearance of the damaged skin.

Acne Treatment

First of all, try to discover and eliminate any food that encourages acne. For example, you yourself may know that chocolate is responsible. Don't arbitrarily cut out all desserts and fats, as they are an important part of the food you eat. Just go easy on rich foods, greasy foods, and chocolate and search for the other ones which you should avoid entirely because they irritate your skin.

Keep the skin, particularly on the areas where acne is most apt to appear, such as the face, chest, and back, very clean. Plain soap and fairly hot water are best, Scrub with a clean washcloth, but not so hard you hurt the skin. Follow by a cold rinse. Change towels at least daily. Avoid all creams and greasy lotions. Do not plug the pores with heavy make up or use "pore closing" beauty aids. If you have pimples, don't squeeze them; I know this will take all your will power. Apply a compress wetted with hot water; this will encourage drainage and healing. Hide the offending spot with Acnomel cake, which will also help to heal the pimple. Acnomel cream is stronger, and I think it should be used only under a doctor's direction. To get rid of blockheads, soak in warm sudsy water to loosen them, and press gently with a comedone extractor which can be purchased at most drugstores; don't use your fingers. If the blackhead comes out easily, touch the spot with rubbing alcohol (70 percent). If it doesn't come out, leave it alone for a while.

This is the best way to handle ordinary, mild cases of acne. Severe cases require treatment that only a doctor can provide. For severe cases, tetracycline antibiotics taken internally are often helpful. Alternatively, when carefully applied to the skin according to individualized medical direction, vitamin A acid and benzoyl peroxide may be dramatically effective. With expert care, the outlook for greatly diminishing or even completely controlling acne is excellent now. With such care, too, there is far less likelihood of permanent scarring.

Even if acne has scarred your face, medical science can help. "Planing" with a rotary, highspeed brush may be the answer. It consists in removing the outer layer of pitted skin, leaving the portion that contains the glands and hair follicles. New skin, rosy at first and then fading to a normal color, grows in from the bottom up.

Remember that "planing" is a surgical operation, although not a major one. It must be performed by a competent doctor, with the same aftercare that follows any operation. Never go to a "beauty specialist" for this kind of treatment. In fact, never go to anyone except a doctor, preferably a skin specialist (a dermatologist), for acne.

You probably call them pimples, blackheads, and whiteheads; we doctors call them acne vulgaris. This condition is so characteristic of youth that I can't help wondering who coined the slogan, "Keep that schoolgirl complexion." As boys and girls approach maturity, their glandular activity increases, including that of the sebaceous glands of the skin. In girls this may become pronounced at the time of their menstrual periods.. Certain foods increase the activity of the sebaceous among the worst offenders being chocolate, nuts, sharp cheeses, and fat or greasy food. If the pore opening is small or clogged by dirt or heavy cosmetics, the fatty material made by the sebaceous gland accumulates, and a "bump" appears under the skin or perhaps a whitehead or a blackhead (a comedone). Blackheads are not due to dirt, but to the discoloring effect of air on the fatty material in the clogged pore. If this substance becomes infected, as it often does, a pimple results. The temptation to squeeze the unsightly pimple should be resisted. A hard push, and the membrane around the pimple is broken, so that the infection spreads to the surrounding tissue; it also spreads on the surface unless it is carefully washed off. The result more pimples, and sear tissue or pits.

Pimples develop when oil glands attempt to push the thick, buttery oil through tiny pore openings. The oil contains irritating substances that backfire into the surrounding tissue creating a mosaic of papules (red bumps), pustules, cysts, and blackheads. Subsequent scarring may ensue from damage to the skin's underlying architectural framework. Damage from severe acne to the architectural building blocks of the skin may actually make the skin susceptible to premature biological aging. For example, deep creases may appear between the nose and the comer of the mouth in the early twenties rather than in the forties.

Active acne can be devastating. In its aftermath, the acne prone person may be left physically and psychologically scarred. The key is prevention and early intervention through the help of a skin specialist. A variety of topical medications, which are applied directly to the skin may suffice for mild acne. More aggressive acne, however, may require systemic medications such as Minocin (minocycline), a potent yet low risk antibiotic. This is taken by mouth in the form of a capsule. Such medications may be combined with regular treatments of ultraviolet light therapy, cortisone injections, and liquid nitrogen sprays. When acne is resistant to all other forms of treatment, a medication known as Accutane (isotretinoin) may be required. This derivative of vitamin A is a very potent medication which has some side effects, so the decision to use it is weighed carefully by the doctor in consultation with the patient.