There is very little mystery about how a pimple is created. It essentially starts with hormones causing the sebaceous gland to create some amount of excess oil that can't get out of the pore in an even flow, possibly caused by a misshapen pore lining. This backed-up oil, along with a buildup of dead skin cells, form a blockage and eventually clog the pore. A specific type of bacteria (called propionibacterium acnes) existing deep in the pore thrives on the oil and dead skin cells, multiplies, and causes the area to become inflamed. This combination of events results in a pimple (Sources: Drugs, 2003, volume 63, issue 15, pages 1579-1596 and Advances in Dermatology, January 2003, pages 1-10).
Over-the-counter and prescription options abound for fighting blemishes, which makes it a confusing battle to mount, because there isn't one routine or medication (or combination of therapies) that works for everyone. Finding the right combination is the goal, which often requires experimentation, but a good place to start is with the topical disinfectant benzoyl peroxide.
A study involving more than 600 participants described in the Lancet last year found benzoyl peroxide the most effective treatment for treating blemishes when compared to oral antibiotics (such as tetracycline), topical antibiotics (such as erythromycin), or combination treatments. Oral tetracycline suffered in the comparison because of the common problem of eventual bacteria resistance to antibiotics.
Beyond a reduction in breakouts, the study also noted that benzoyl peroxide was the most cost-effective treatment for acne. Even more surprising was the conclusion that patients and doctors should be aware that expensive, prescription medications may not be necessary. If your breakouts aren’t responding to benzoyl peroxide the way you hoped, then other options should be discussed with your dermatologist.
(Sources: Lancet, December 2004, pages 2188–2195; and www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract).
Battling Blemishes with Lasers?
Without question, lasers and other related (light or radio) frequency devices can be used by qualified medical personnel for a range of viable beauty treatments. More recently, lasers, light, and radio devices are being used to treat acne. While some dermatologists are enthusiastic about this new use for their expensive office equipment, the consensus of many is that treating acne with lasers is not only time-consuming, but the results are neither that impressive, nor an improvement over topical treatments. These treatments are definitely nowhere close to offering the possibilities of a cure the way Accutane does. In fact, many dermatologists believe that lasers and light or radio-frequency devices should be a last resort for treating acne after other medical options have failed. Their logic has to do not only with the questionable results, but also with the high cost because most insurance plans do not cover laser treatments for acne.
Right now, lasers, light, and radio devices are far more effective when used to treat acne scarring than as an option to try to prevent breakouts (Sources: Journal of the American Medical Association, June 2004, pages 2834–2839 and Cosmetic Dermatology, December 2004, pages 789–793).
Can Eating Habits Cause Breakouts?
For the most part the answer is no. There are limited studies looking at the role diet plays in causing and/or treating acne. For some individuals an allergic reaction to certain foods such as nuts, salmon, or dairy products can trigger inflammation in the pore, resulting in blemishes. Research indicates that dietary supplements, such as zinc or vitamin A, are most likely not effective for treating acne. Plus, these supplements may very well be unhealthy if too much is taken (Sources: Journal of Pediatric Hematology and Oncology, October 2002, pages 582-584 and Journal of the American Academy of Dermatology, August 2002, pages 231-240).
