It Isn’t Just About Acne


Keratosis is a form of acne caused by small, blunt follicles that fail to produce a hair.

When most teens and many adults are asked what they would most like to change about their faces, the unequivocal answer usually is “Acne!” But the truth is that many other color and texture issues cause acne sufferers consternation about their skin. Here’s a look into some treatable skin conditions that excessive focus on acne causes many acne sufferers to overlook.

Chicken Skin

“Chicken skin” is a condition that is best described as permanent bumps on the skin. These tiny bumps look a little like the goosebumps you get when you get cold, but they are actually caused by small, blunt follicles that fail to produce a hair. The medical term for this condition is keratosis pilaris.

Keratosis pilaris is nearly as common as acne in teens, and more common than acne in adults. More common during the winter months than during the summer, “chicken skin” is most noticeable on the outer upper arms and on the thighs. Surplus skin cells accumulate around a hair follicle, and eventually a small, thin, curly hair may emerge.

In India, some people get a very similar condition called erythromelanosis follicularis faciei et colli, which causes reddening of the skin on the face and the formation of brown spots on bumpy skin.

What can be done about this skin condition? Tretinoin topical or glycolic acid (up to 12%) is used to break up excess skin. Prescription Differin or Tazorac may also be used. It’s very useful to apply moisturizer to treated skin to keep pores open so the condition does not come back.

Facial Shine

When people who have oily skin acne get their blemishes under control, they usually still have to deal with facial shine. An hour or two after cleansing skin, oil accumulates on the brow and nose and gives the face a shiny appearance.

If you don’t wear makeup, controlling facial shine is not difficult. Just use any good brand of blotting papers to soak up excess skin oils once or twice a day. It’s possible that brands that are made with a substance called zinc PCA (or zinc pyrrolidone carboxylic acid) will gradually reduce oil production in your skin over a period of three to six weeks, but you may not get enough of this skin treatment from the blotting paper itself to make a big difference. It may also help to use creams that contain at least 3% green tea extract, such as Paula’s Choice HydraLight Healthy Skin Refreshing Toner, for Normal to Oily/Combination Skin.

Granuloma Annulare

Granuloma annulare is a skin condition that can cause flesh-colored or purple papules up to 2 inches (5 cm) in diameter. These skin lesions can occur anywhere on the body, but they are most common on the neck, face, scalp, palms of the hands, and soles of the feet. They occur when the immune system attacks collagen in the skin and sends white blood cells called macrophages to remove the dead tissue. The condition is most common in children aged 2 to 10, but it can also occur in teens and adults up to the age of 30.

Granuloma annulare is treated with:

  • Accutane, or
  • Liquid nitrogen treatment, or
  • Treatment with a coal-tar derivative called psoralen that has to be activated by sunlight or a UV lamp.

The condition can also be treated with high-dose steroid drugs but these can leave treated skin thin and pale. Doctors also prescribe combinations of antibiotics for this condition but it is important to use sunscreen if you get antibiotic treatment, to prevent excessive pigmentation on treated skin.


Impetigo is an infection of the skin caused by staph or strep bacteria. Unlike acne, impetigo infections usually enter the skin through a tiny break in the skin rather than staying inside a pore. Staph infections usually are transmitted skin to skin although strep infections may land on the skin after spending several weeks in the throat and nose. Staph infections cause blisters that pop open but strep infections are more likely to scab over.

The most common treatment for impetigo is an antibiotic invented in 1949 called called neomycin. This antibiotic works about 90% of the time, although there are some strains of staph and strep bacteria that are resistant to it.  There is another antibiotic called mupirocin that is usually more effective than neomycin but to which some bacteria are also resistant. There is a medication called retapamulin for resistant infections. Both mupirocin and retapamulin require a doctor’s prescription, but neomycin is available over the counter.

Gently washing off crusts of skin left by impetigo speeds healing. Be sure not to share wash cloths, towels, bed linen, or clothing with a child or family member who has this infection.


An astonishing number of adults who have acne also have wrinkles. Fortunately, alpha- and beta-hydroxy acids help both skin problems.

Wrinkles can occur even in preadolescent children, but they usually don’t start until after age 30. The outermost layers of the skin become less organized. The skin cells that once fit together like bricks in a wall begin to shift around. Some areas of skin are tighter and others are looser. The “ground substance” underneath the skin begins to weaken and produces less collagen for making fibers that hold the skin in place. All of these effects work together so that wrinkles form.

The kinds of skin peels you can do at home remove the very topmost layer of cells lying on the surface of the skin. They also stimulate activity in the ground substance underneath the skin so that it makes more collagen for fibers that hold the skin in its normal contour. Alpha- and hydroxy-acid peels also break up the clumps of dead skin that clog pores and cause blemishes while they smooth out fine lines and wrinkles.

Any product that contains at least 1% salicylic acid at a pH between 3 and 3.9 will open pores and stimulate growth of new, smooth skin. For the product to do you some good, it has to be a gel or a lotion, not a wash that you rinse down a drain before the salicylic acid has a chance to recondition your skin. Some good product choices include ProActiv Solution Clarifying Night Cream for normal to oily skin and Exposed Skin Care Clearing tonic for dry to normal skin.

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