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Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Acne

Overview

Acne is the most common skin problem in the United States, affecting millions of adolescents and adults. About 85 percent of teens have acne, and it may continue into adulthood.

Acne is a complex condition in which hormones and other factors can cause the hair follicles in your skin to become clogged. This can create pimples or pus bumps that become visible on your face, neck, back, chest, and shoulders. Acne can be distressing, but there are effective combinations of treatments available that can help you.

Symptoms

The symptoms of acne can be mild to severe, and they include:

  • Pimples, pus bumps, whiteheads, blackheads, and cysts
  • Discoloration of the skin 
  • Pain
  • Swelling
  • Scarring

Severe acne can also lead to other problems. It may affect your emotional well-being, causing depression, embarrassment, or lowered self-esteem. These negative feelings can discourage you from interacting socially, on the job, or at school.

Diagnosis

We can usually diagnose acne by looking at your skin. In most cases, no additional testing is needed.

In rare cases, there are problems with hormone levels that may be linked to a condition called polycystic ovary syndrome, or PCOS. If you are a woman with moderate to severe acne, irregular menstrual periods, and excess hair on the face or body, you may have PCOS or another hormonal imbalance.

Types

There are several different types of acne lesions. Most of the time, if you have acne, you will have a combination of these lesions in varying severity:

  • Blackheads and whiteheads (also called comedonal lesions). These are spots or bumps on your skin, caused when the opening of a hair follicle gets plugged. Because these lesions can progress, it is important to treat them at an early stage.
  • Pimples (also called inflammatory lesions). This type is the classic lesion better known as a pimple or pus bump. When hair follicles get clogged with oil (also known as sebum), the clogged pores become swollen or inflamed, resulting in pimples or pus bumps on the skin.
  • Cysts (known as nodulocystic lesions). These develop when smaller inflamed lesions swell up into larger lesions. These are deep painful lesions that can last from a few days to several weeks and often lead to scarring and discoloration.
  • Scars are the last stage of acne resulting from severe inflammatory lesions. They are usually permanent.

Comedonal lesions, also known as blackheads and whiteheads.

Example of an inflammatory lesion, also known as a pimple or pus bump.

Nodulocystic acne, also called an acne cyst.

Nodulocystic acne, also called an acne cyst.

Acne scar.


Causes

The following factors cause acne:

  • Increased stickiness of the cells in the hair follicles, combined with sebum (oil), creating a plug in the hair follicle
  • Increased production of sebum, or oil, especially during adolescence, when hormones increase
  • Increased growth and activity of bacteria called Propionibacterium acnes, also known as P. acnes

As you go through puberty, some hormones cause your skin to produce more oil. This oil combines with a buildup of debris and shedding skin, causing hair follicles on your face and other acne-prone areas to plug up. This causes the acne lesions.

More sebum results in an increase in the number of bacteria (P. acnes) on the skin surface. As bacteria break down surface oil and interact with your immune system, your skin becomes irritated and inflamed. This causes acne pimples to form. 

Because the highest concentration of the sebaceous or oil glands is present on the face, chest, and back, these are the areas where acne usually develops.

Hormonal changes

Hormones are one of the most important causes of acne. Several kinds of hormonal changes can affect this condition, including: 

  • Puberty brings a surge in sex hormones, resulting in an increase in sebum production by the sebaceous glands in our skin.
  • Menstrual periods can cause acne to flare up because of hormone level changes during the menstrual cycle.
  • Polycystic ovary syndrome (PCOS) is characterized by severe acne, excess hair growth, premature loss of hair on the scalp, and irregular menstrual periods.
Diet

The role of diet in acne remains controversial. It is best to avoid foods that make your acne worse. Some studies suggest that milk and other dairy products may increase the risk or severity of acne because of the animal hormones they contain.

Foods rich in carbohydrates, such as simple sugars found in candy, cookies, and other baked goods, may make acne worse. There is no good evidence that chocolate or fried foods cause or worsen acne.

Stress

Stress and tension have been shown to worsen acne. When we are stressed, our body releases cortisol – a natural steroid hormone that further increases your skin's production of oil.

Medications

Certain medications are known to worsen acne. These include medications that contain steroids such as prednisone, methyl prednisolone, topical steroids, and some psychiatric medications such as lithium.

Other factors
  • Oil-based cosmetics may worsen acne by clogging your pores. We recommend that you try water-based "non-comedogenic" cosmetic products if you have acne.
  • Overwashing the skin. Using rough washcloths or aggressively scrubbing your skin to try and remove dirt may make your acne worse by causing irritation and inflammation. Dirt is not the cause of acne.
  • Heat and friction. Helmets, bra straps, shoulder pads, adhesive tape, orthopedic casts, and other constricting items that rub against the skin may worsen acne.


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This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.