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Currency: September 18, 2016
Relevance: states ten tips for preventing acne, some are reasonable and obvious while others are important tips that people may not have previously known.
Authority: article was reviewed by Stephanie S. Gardner, MD who has been practicing dermatology for the past 20 years. May be reliable but the source is not because the website contains many ads.
Accuracy: these tips are accurate but it does not promise clear skin these are just highly suggested tips- other websites have stated some of the same ones and they do have reasons that back them up
Purpose: To educate/inform

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1. Keep your face clean. Whether or not you have acne, it's important to wash your face twice daily to remove impurities, dead skin cells, and extra oil from your skin's surface. Washing more often than twice daily is not necessarily better; it may do more harm than good. Use warm, not hot, water and a mild facial cleanser. Using a harsh soap (like deodorant body soap) can hurt the already inflamed skin and cause more irritation.

Avoid scrubbing your skin harshly with a washcloth, an exfoliating glove, or loofah (a coarse-textured sponge). Gently wash it with a very soft cloth or your hands. Always rinse well, and then dry your face with a clean towel. (Toss the towel in the laundry hamper, as dirty towels spread bacteria.) Also, use the washcloth only once.

2. Moisturize. Many acne products contain ingredients that dry the skin, so always use a moisturizer that minimizes dryness and skin peeling. Look for "noncomedogenic" on the label, which means it should not cause acne. There are moisturizers made for oily, dry, or combination skin.

3. Try an over-the-counter acne product. These acne products don't need a prescription. Most of them have ingredients such as benzoyl peroxide, salicylic acid, glycolic acid, or lactic acid, which curb bacteria and dry your skin. They may cause drying or peeling so start with a small amount at first. Then you can adjust how much you use and how often. Another option is a new OTC topical retinoid gel. It works to actually keep the acne from forming. Use these products with caution if you have sensitive skin.

4. Use makeup sparingly. During a breakout, avoid wearing foundation, powder, or blush. If you do wear makeup, wash it off at the end of the day. If possible, choose oil-free cosmetics without added dyes and chemicals. Choose makeup that is labeled as "noncomedogenic," meaning it should not cause acne. Read the ingredients list on the product label before buying.

Continued

5. Watch what you put on your hair. Avoid using fragrances, oils, pomades, or gels on your hair. If they get on your face, they can block your skin's pores and irritate your skin. Use a gentle shampoo and conditioner. Oily hair can add to the oil on your face, so wash your hair often, especially if you're breaking out. Got long hair? Keep it pulled away from your face.

6. Keep your hands off your face. Avoid touching your face or propping your cheek or chin on your hands. Not only can you spread bacteria, you can also irritate the already inflamed facial skin. Never pick or pop pimples with your fingers, as it can lead to infection and scarring.

7. Stay out of the sun. The sun's ultraviolet rays can increase inflammation and redness, and can cause post-inflammatory hyperpigmentation (dark discoloration). Some acne medications may make your skin more sensitive to sunlight. Limit your time in the sun, especially between the hours of 10 a.m. and 2 p.m., and wear protective clothing, such as a long-sleeved shirt, pants, and a broad-brimmed hat. Whether you have pimples or not, always apply a broad-spectrum sunscreen with SPF 30 or higher at least 20 minutes before sun exposure. Look for "noncomedogenic" on the sunscreen label to make new pimples less likely. Read the ingredients on the product label to know what you're putting on your skin.

8. Feed your skin. Most experts agree that certain foods, like chocolate, don't cause pimples. Still, it makes sense to avoid greasy food and junk food and add more fresh fruits and vegetables and whole grains to your diet. Dairy products and foods high in processed sugar may trigger acne. Avoid these.

Regular exercise is good for your whole body, including your skin. When you exercise, avoid wearing clothing or using exercise equipment that rubs your skin and may cause irritation. Shower or bathe right after exercise.

10. Chill! Some studies link stress with the severity of pimples or acne. Ask yourself what's making you feel stressed. Then look for solutions.

When in doubt, check with a dermatologist to see if you need more treatment to prevent or stop acne.

Sources

SOURCES:

Stathakis. V. Australasian Journal of Dermatology, 1997.

Nguyen, Q. American Family Physician, 1994.

Chiu, A. Archives of Dermatology, 2003.

Teenagers Today.com web site: "Best Face Forward."

About.com web site: "Acne ... Pimples ... and Zits, Oh My!"

FDA.

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1. Keep your face clean. Whether or not you have acne, it's important to wash your face twice daily to remove impurities, dead skin cells, and extra oil from your skin's surface. Washing more often than twice daily is not necessarily better; it may do more harm than good.

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Currency: February 1, 2018
Relevance: To show what acne is and how to treat it
Authority: Written by Diane Berson who is a M.D. at the Medical College of Cornell University
Accuracy: All information is by the U.S Department of Health and Human Services
Purpose: To show how get rid of acne or to prevent it

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If you have scarring, your dermatologist may suggest surgery to help heal acne lesions and remove scarring. A laser can reshape scar tissue and reduce redness. Dermabrasion is a type of surgery that can remove surface scars and reduce the depth of deep scars.

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Currency: November 27, 2017
Relevance: discusses facts, treatments, and reasons of acne
Authority: the author is Christian Nordqvist, no information was given about the author.
Accuracy:  MedicalNewsToday is responsible for the article and the website has been a reliable source since 2003.
Purpose: to educate/inform

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Acne is a chronic, inflammatory skin condition that causes spots and pimples,especially on the face, shoulders, back, neck, chest, and upper arms.

Whiteheads, blackheads, pimples, cysts, and nodules are all types of acne.

It is the most common skin condition in the United States, affecting up to 50 million Americans yearly.

It commonly occurs during puberty, when the sebaceous glands activate, but it can occur at any age. It is not dangerous, but it can leave skin scars.

The glands produce oil and are stimulated by male hormones produced by the adrenal glands in both males and females.

At least 85 percent of people in the U.S. experience acne between the ages of 12 and 24 years.

Fast facts on acne

Here are some facts about acne. More detail is in the main article.

Acne is a skin disease involving the oil glands at the base of hair follicles.

It affects 3 in every 4 people aged 11 to 30 years.

It is not dangerous, but it can leave skin scars.

Treatment depends on how severe and persistent it is.

Risk factors include genetics, the menstrual cycle, anxiety and stress, hot and humid climates, using oil-based makeup, and squeezing pimples.

Home remedies

Acne is a common skin problem.

There are many suggested home remedies for acne, but not all of them are supported by research.

Diet: It is unclear what role diet plays in worsening acne. Scientists have found that people who consume a diet that offers a good supply of vitamins A and E and of zinc may have a lower risk of severe acne. One review describes the link between acne and diet as "controversial," but suggests that a diet with a low glycemic load may help.

Tea-tree oil: Results of a study of 60 patients published in the Indian Journal of Dermatology, Venereology, and Leprology suggested that 5-percent tea-tree oil may help treat mild to moderate acne.

Tea: There is some evidence that polyphenols from tea, including green tea, applied in a topical preparation, may be beneficial in reducing sebum production and treating acne. However, the compounds in this case were extracted from tea, rather than using tea directly.

Moisturizers: These can soothe the skin, especially in people who are using acne treatment such as isotretinoin, say researchers. Moisturizers containing aloe vera at a concentration of at least 10 percent or witch hazel can have a soothing and possibly anti-inflammatory effect.

Causes

Human skin has pores that connect to oil glands under the skin. Follicles connect the glands to the pores. Follicles are small sacs that produce and secrete liquid.

The glands produce an oily liquid called sebum. Sebum carries dead skin cells through the follicles to the surface of the skin. A small hair grows through the follicle out of the skin.

Pimples grow when these follicles get blocked, and oil builds up under the skin.

Skin cells, sebum, and hair can clump together into a plug. This plug gets infected with bacteria, and swelling results. A pimple starts to develop when the plug begins to break down.

Propionibacterium acnes (P. acnes) is the name of the bacteria that live on the skin and contributes to the infection of pimples.

Research suggests that the severity and frequency of acne depend on the strain of bacteria. Not all acne bacteria trigger pimples. One strain helps to keep the skin pimple-free.

Hormonal factors

A range of factors triggers acne, but the main cause is thought to be a rise in androgen levels.

Androgen is a type of hormone, the levels of which rise when adolescence begins. In women, it gets converted into estrogen.

Rising androgen levels cause the oil glands under the skin to grow. The enlarged gland produces more sebum. Excessive sebum can break down cellular walls in the pores, causing bacteria to grow.

Other possible triggers

Some studies suggest that genetic factors may increase the risk.

Other causes include:

some medications that contain androgen and lithium

greasy cosmetics

hormonal changes

emotional stress

menstruation

Treatment

Treatment depends on how severe and persistent the acne is.

Mild acne

A variety of steroidal and non-steroidal creams and gels are available to treat acne, and many are effective.

Mild acne can be treated with over-the-counter (OTC) medications, such as gels, soaps, pads, creams, and lotions, that are applied to the skin.

Creams and lotions are best for sensitive skin. Alcohol-based gels dry the skin and are better for oily skin.

OTC acne remedies may contain the following active ingredients:

Resorcinol: helps break down blackheads and whiteheads

Benzoyl peroxide: kills bacteria, accelerates the replacement of skin, and slows the production of sebum

Salicylic acid: assists the breakdown of blackheads and whiteheads and helps reduce inflammation and swelling

Sulfur: exactly how this works is unknown

Retin-A: helps unblock pores through cell turnover

Azelaic acid: strengthens cells that line the follicles, stops sebum eruptions, and reduces bacterial growth. There is cream for acne, but other forms are used for rosacea.

It is advisable to start with the lowest strengths, as some preparations can cause skin irritation, redness, or burning on first use.

These side effects normally subside after continued use. If not, see a doctor.

Treating moderate to severe acne

A skin specialist, or dermatologist, can treat more severe cases.

They may prescribe a gel or cream similar to OTC medications but stronger, or an oral or topical antibiotic.

Corticosteroid injection

If an acne cyst becomes severely inflamed, it may rupture. This can lead to scarring.

A specialist may treat an inflamed cyst by injecting a diluted corticosteroid.

This can help prevent scarring, reduce inflammation, and speed up healing. The cyst will break down within a few days.

Oral antibiotics

Oral antibiotics may be prescribed for up to 6 months for patients with moderate to severe acne.

These aim to lower the population of P. Acnes. The dosage will start high and reduce as the acne clears.

P. acnes can become resistant to the antibiotic in time, and another antibiotic is needed. Acne is more likely to become resistant to topical rather than oral antibiotics.

Antibiotics can combat the growth of bacteria and reduce inflammation.

Erythromycin and tetracycline are commonly prescribed for acne.

Oral contraceptives

Oral contraceptives can help control acne in women by suppressing the overactive gland. They are commonly used as long-term acne treatments.

These may not be suitable for women who:

have a blood-clotting disorder

smoke

have a history of migraines

are over 35 years old

It is important to check with a gynecologist first.

Topical antimicrobials

Topical antimicrobials also aim to reduce P. acnes in patients with moderate to severe acne. Examples are clindamycin and sodium sulfacetamide.

The dermatologist may prescribe a topical retinoid.

Topical retinoids are a derivative of vitamin A. They unclog the pores and prevent whiteheads and blackheads from developing.

Examples of topical retinoids prescribed in the U.S. are adapalene, tazarotene, and tretinoin.

Isotretinoin

This is a strong, oral retinoid, used for the treatment of severe cystic acne and severe acne that has not responded to other medications and treatments.
It is a strictly controlled medication with potentially serious side effects. The patient must sign a consent form to say that they understand the risks.
Adverse effects include dry skin, dry lips, nosebleeds, fetal abnormalities if used during pregnancy, and mood swings.

Patients who take isotretinoin must avoid vitamin A supplements, as these could lead to vitamin A toxicity.

Types

Stress can be a key trigger of acne in some cases.

Acne pimples vary in size, color, and level of pain.

The following types are possible:

Whiteheads: These remain under the skin and are small

Blackheads: Clearly visible, they are black and appear on the surface of the skin

Papules: Small, usually pink bumps, these are visible on the surface of the skin

Pustules: Clearly visible on the surface of the skin. They are red at their base and have pus at the top

Nobules: Clearly visible on the surface of the skin. They are large, solid, painful pimples that are embedded deep in the skin

Cysts: Clearly visible on the surface of the skin. They are painful and filled with pus. Cysts can cause scars.

Prevention and management tips

Here are some tips for looking after skin that has acne or is prone to it.

Wash your face no more than twice each day with warm water and mild soap made especially for acne.

Do not scrub the skin or burst the pimples, as this may push the infection further down, causing more blocking, swelling, and redness.

Avoid popping pimples, as this makes scarring likelier.

A specialist can treat a pimple that requires rapid removal for cosmetic reasons.

Refrain from touching the face.

Hold the telephone away from the face when talking, as it is likely to contain sebum and skin residue.

Wash hands frequently, especially before applying lotions, creams, or makeup.

Clean spectacles regularly as they collect sebum and skin residue.

If acne is on the back, shoulders, or chest, try wearing loose clothing to let the skin breathe. Avoid tight garments, such as headbands, caps, and scarves, or wash them regularly if used.

Choose makeup for sensitive skin and avoid oil-based products. Remove makeup before sleeping.

Use an electric shaver or sharp safety razors when shaving. Soften the skin and beard with warm soapy water before applying shaving cream.

Keep hair clean, as it collects sebum and skin residue. Avoid greasy hair products, such as those containing cocoa butter.

Avoid excessive sun exposure, as it can cause the skin to produce more sebum. Several acne medications increase the risk of sunburn.

Avoid anxiety and stress, as it can increase production of cortisol and adrenaline, which exacerbate acne.

Try to keep cool and dry in hot and humid climates, to prevent sweating.

Acne is a common problem. It can cause severe embarrassment, but treatment is available, and it is effective in many cases.

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Acne is a chronic, inflammatory skin condition that causes spots and pimples,especially on the face, shoulders, back, neck, chest, and upper arms. Whiteheads, blackheads, pimples, cysts, and nodules are all types of acne. It is the most common skin condition in the United States, affecting up to 50 million Americans yearly.

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Currency:  October 31st, 2017
Relevance: Informs you on the relevance of acne on teenagers and people of all ages
Authority: It is a professional organization of nurses and doctors from across America.
Accuracy: Since this is a large group of doctors they are considered to be very accurate
Purpose: To inform readers about the symptoms and causes of acne

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Overview

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It causes whiteheads, blackheads or pimples. Acne is most common among teenagers, though it affects people of all ages.

Effective acne treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.

Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems.

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Symptoms

Acne signs vary depending on the severity of your condition:

Whiteheads (closed plugged pores)

Blackheads (open plugged pores)

Small red, tender bumps (papules)

Pimples (pustules), which are papules with pus at their tips

Large, solid, painful lumps under the skin (nodules)

Painful, pus-filled lumps under the skin (cystic lesions)

Acne usually appears on the face, forehead, chest, upper back and shoulders.

When to see a doctor

If self-care remedies don't clear your acne, see your primary care doctor. He or she can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor who specializes in the skin (dermatologist or pediatric dermatologist).

For many women, acne can persist for decades, with flares common a week before menstruation. This type of acne tends to clear up without treatment in women who use contraceptives.

In older adults, a sudden onset of severe acne may signal an underlying disease requiring medical attention.

The Food and Drug Administration (FDA) warns that some popular nonprescription acne lotions, cleansers and other skin products can cause a serious reaction. This type of reaction is quite rare, so don't confuse it with any redness, irritation or itchiness that occurs in areas where you've applied medications or products.

Seek emergency medical help if after using a skin product you experience:

Faintness

Difficulty breathing

Swelling of the eyes, face, lips or tongue

Tightness of the throat

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Causes

Four main factors cause acne:

Excess oil (sebum) production

Hair follicles clogged by oil and dead skin cells

Bacteria

Inflammation

Acne typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands.

The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it's exposed to the air.

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne.

Certain things may trigger or worsen acne:

Hormonal changes. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, particularly in women, can lead to breakouts too.

Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium.

Diet. Studies indicate that consuming certain foods - including carbohydrate-rich foods, such as bread, bagels and chips - may worsen acne. Further study is needed to examine whether people with acne would benefit from following specific dietary restrictions.

Stress. Stress doesn't cause acne, but if you have acne already, stress may make it worse.

Acne myths

These factors have little effect on acne:

Chocolate and greasy foods. Eating chocolate or greasy food has little to no effect on acne.

Hygiene. Acne isn't caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.

Cosmetics. Cosmetics don't necessarily worsen acne, especially if you use oil-free makeup that doesn't clog pores (noncomedogenics) and remove makeup regularly. Nonoily cosmetics don't interfere with the effectiveness of acne drugs.

Complications

People with darker skin types are more likely than are people with lighter skin to experience these acne complications:

Scars. Pitted skin (acne scars) and thick scars (keloids) can remain long-term after acne has healed.

Skin changes. After acne has cleared, the affected skin may be darker (hyperpigmented) or lighter (hypopigmented) than before the condition occurred.

Risk factors

Risk factors for acne include:

Age. People of all ages can get acne, but it's most common in teenagers.

Hormonal changes. Such changes are common during puberty or pregnancy.

Family history. Genetics plays a role in acne. If both of your parents had acne, you're likely to develop it too.

Greasy or oily substances. You may develop acne where your skin comes into contact with oil or oily lotions and creams.

Friction or pressure on your skin. This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks.

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Learn more about this common skin condition, including causes, treatments and simple skin care steps you can do at home to help control it.