Dear Dr. Roach: How do pimples form? Why do they itch? How can I remove them?
— B.B.
Answer: Acne is caused by plugged hair follicles, which are associated with sebaceous (oil-producing) glands. These are more likely to be plugged under control of androgenic hormones; with increased oil production; in the presence of the bacteria Cutibacterium acnes; and with inflammation. These are in turn affected by many factors, such as skin trauma, stress, amount of body fat and diet. Acne is very common in adolescents but can continue to be a problem in women and men in their 50s and older.
Itching is not common with acne, but tenderness is. Itching is more common with drier skin, and I often see itching in people who are treating their acne with excessively drying treatments. This includes washing your skin with too much heat, too often or with too harsh a soap. People who have allergic reactions to acne medications or skin creams may also have dry, itchy skin. Sunlight and heat (and the associated sweating) can be triggers for itching. You really want to avoid scratching or squeezing because this can rupture the acne, causing scarring and potential spread of bacteria. All these worsen symptoms.
Acne is better prevented than removed, since the follicles are a normal part of the skin. Your general or family doctor or a dermatologist can help design a program to reduce acne. Vitamin A derivatives, topical antibiotics and benzoyl peroxide may all be part of a treatment regimen depending on your skin and type of acne.
