Acne, What it is ?

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Acne usually starts in puberty, but it affects adults too. Around 80% of teenagers get some form of acne, and there are many myths about what causes it. Here are the facts and details of treatments. 

Acne consists of spots and painful bumps on the skin. It's most noticeable on the face, but can also appear on the back, shoulders and buttocks. Severe acne can cause scarring.

What causes acne?

Acne is mostly due to the way skin reacts to hormonal changes. The skin contains sebaceous glands that naturally release sebum, an oily substance that helps protect it. During puberty, raised levels of the hormone testosterone can cause too much sebum to be produced. This happens in both boys and girls. 

The sebum can block hair follicles. When dead skin cells mix with the blockage, it can lead to the formation of spots. Bacteria in the skin multiply, which can cause pain and swelling (inflammation) beneath the blockages. 

There are different kinds of spots:

• Blackheads are small, blocked pores.

• Whiteheads are small, hard bumps with a white centre.

• Pustules are spots with a lot of pus visible.

• Nodules are hard, painful lumps under the skin.

Inflammatory acne is when the skin is also red and swollen. This needs to be treated early to prevent scarring. 

Try not to pick or squeeze spots as this can cause inflammation and lead to scarring. Spots will eventually go away on their own, but they might leave redness in the skin for some weeks or months afterwards. 

Acne can become worse during times of stress. In women, it can be affected by the menstrual cycle. Sometimes, acne can occur during pregnancy.

If you have acne, wash your skin gently with a mild cleanser and use an oil-free moisturiser. Scrubbing or exfoliating can irritate the skin, making it look and feel sore. 

Myths

There are several myths about what causes acne: 

Food. Many people say that eating chocolate or greasy food causes acne, but this isn't true. There isn't any evidence that acne is caused by what you eat. However, eating a balanced diet is good for your general health so aim to eat as healthily as you can.

Bad hygiene. Some people believe that acne is caused by bad personal hygiene, but this is not true. If you are going to get acne, you will get it no matter how much you clean your skin. Too much cleaning can make the condition worse by removing the protective oils in your skin.

Make-up. There is also a myth that wearing make-up can cause spots, but there is no evidence that this is the case. The less you touch your skin, the fewer bacteria will be spread to your skin. If you wear make-up, wash your hands before putting your make-up on and always remove it before going to bed. 

Treatments

Acne will usually go away on its own, but it can take many years. There are treatments that can help clear acne more quickly. Over-the-counter treatments can help with mild acne. Ask a pharmacist for advice on which treatment could help and how long you will have to use it. You may not see results for several weeks. 

If over-the-counter treatments don't help, treatments are available on prescription. Your GP can assess how bad your acne is and discuss the options with you. Don't be afraid to tell your GP how your acne affects your life and how it makes you feel. 

Mild, non-inflammatory acne consists of whiteheads and blackheads. Treatments include gels or lotions that can contain retinoids (vitamin A), topical (applied to the skin) antibiotics, benzoyl peroxide (which is antibacterial) or azelaic acid. 

These medications, or a combination of them, can also be used to treat mild-to-moderate inflammatory acne, which has some pustules and nodules. It can take up to eight weeks before you see a difference in your skin, and treatment may need to be continued for six months. 

In women, contraceptive pills that contain oestrogen can help clear acne. 

If acne is severe, your GP can refer you to a dermatologist who may prescribe a stronger medication called isotretinoin (Roaccutane). Find out about acne treatments, including isotretinoin.

Some light and laser therapies claim to help get rid of acne. However, few if any of these are available on the NHS.

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