What is Acne

Acne or acne vulgaris is an extremely common skin condition mostly affecting teenagers but can often carry on into adulthood. It is particularly associated with adolescence, as this is a time when significant hormonal changes take place. The condition usually improves by the time sufferers are in their mid 20’s however some people may continue to experience symptoms into their 40s and 50s. The skin condition is characterised by red, inflamed, raised and often painful spots typically occurring on the face, chest and back but can develop anywhere on the body. Acne symptoms tend to be easily recognised however there are six main types of spots which are whiteheads, blackheads, pustules, nodules, papules and cysts.

What causes acne?

The first development of acne is often associated with puberty or pregnancy because this is the time when changing levels of hormones such as androgens can trigger acne. Androgens affect oil glands in the skin of the face, neck, back, shoulders and chest. They make the glands grow bigger and produce more oil (sebum) which can often lead to the development of acne because these glands can become blocked and support the development of bacterial infections.

Other less common causes can include medication conditions such as polycystic ovary syndrome (PCOS), Cushing’s syndrome and some medication like the oral contraceptive pill. Certain cosmetic products and skin products which are especially greasy can also contribute to the formation of acne.

Self-help strategies for acne

Suggestions to manage acne include:

  • Cleansing – using cleansers specifically developed for acne-prone skin can help. Regular washing of your skin is vital to help reduce the amount of bacteria on your skin and keep sebaceous glands from becoming clogged. Don’t overdo it though. Too much cleansing can cause other skin problems, such as dryness or skin irritations. Try to keep hair clean and off the face and neck, as oil from the hair can make acne worse.
  • Make up – choose water-based, oil-free products where possible to avoid worsening acne by clogging the pores with oils or powder. Make up should be thoroughly removed before going to bed.
  • Don’t squeeze – picking and squeezing pimples can make it worse and lead to scarring.
  • Stress – this can trigger an outbreak of pimples as it causes the release of hormones that can make oil glands release more oil onto the skin. This is why pimples seem to magically appear on stressful days, such as at the time of an exam or special date. While stress may be difficult to control, at least you know that the outbreak is due to stress, not a sign that the treatments do not work.

What kind of acne treatments are there?

In mild cases, patients can treat symptoms with over the counter products which contain ingredients such as benzoyl peroxide or salicylic acid which work by cleaning and gently peeling the skin and drying up excess oil. Mild irritation can occur with such treatments. If this happens, take a short break from treatment and restart after a few days.  It is a good idea to talk to a pharmacist before you buy a product to find out which treatment might be the most useful for you.

If your acne is not improving with over-the-counter treatments or if you have more severe forms of acne, you will need to see a doctor so they can prescribe medication, if appropriate, after assessing your acne. They may also refer you to a dermatologist if required. Medications can lead to huge improvements in how the skin looks and can reduce the number of new pimples.

Medical treatments are topical or oral and can include:

  • retinoids, which unblock pores of existing acne and prevent new blockages from developing
  • antibiotics to kill bacteria and reduce inflammation
  • hormonal agents, such as the contraceptive pill, to reduce the amount of androgen in the body and therefore oil secretion.

Doctors may also recommend more than one acne treatment, as different treatments work differently to fight acne. Fixed-combination products are also available, which blend together two treatments into one product.

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