Acne is a common skin condition that occurs when oil and dead skin cells clog the skin’s pores, causing mild to severe outbreaks of pimples (zits), blackheads, and cysts on the skin. Acne occurs mainly on the face, back, chest, shoulders and neck.
Acne primarily affects teens, affecting young men and women about equally. However young men are more likely than women to have severe, longer lasting forms of acne. In contrast, women are more likely to have intermittent acne due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics. While most people outgrow their acne by their 20’s some, especially women, have acne well into adulthood.
Each follicle is connected to a sebaceous gland that lies just underneath the surface of your skin. The sebaceous glands produce oil (sebum) to lubricate and protect the skin, which normally travels up the follicle and out through small holes (pores) on the surface of your skin. However, if your body produces too much sebum, and dead skin cells get trapped in your pores, a 'spot' (blackhead or whitehead) will form. Sometimes the bacterium Propionibacterium acnes, which normally lives on the surface of your skin, causes inflammation (but not infection) in the hair follicles. If the inflammation develops near the surface of your skin, red or yellow spots (pustules) can form. Deeper inflamed lesions (nodules and cysts) can form if the infection is nearer the hair root.
CAUSES OF ACNE:
During puberty, elevated hormone levels stimulate the sebaceous glands to produce more sebum, encouraging spots to form. In women, hormonal changes during their menstrual cycle and pregnancy may trigger acne.
Stress or illness may aggravate acne. Oily cosmetics may alter the opening of the sebaceous glad making the cells more likely to stick together and form acne. Acne can also be hereditary – if both your parents had acne, you have an increased chance of having it too. Further, medicines such as steroid creams and ointments used for eczema, progesterone-based contraceptives and some anti-epileptics may be a rarer cause of acne.
Food seems to have little effect on the severity of acne in most individuals. However, if you find that certain foods such as chocolate or fatty foods and excessive amounts of milk or sweets make your acne worse, it is best to avoid them. In general, a healthy balanced diet is recommended.
TREATING AND MANAGING ACNE:
The treatment of acne is aimed at controlling the symptoms of acne. This involves preventing new spots forming, reducing inflammation in spots that are already present and preventing scarring.
Self-Help Strategies to Manage Acne:
By keeping your skin clean you can help to prevent spots from forming. Gently wash spot-prone areas with a mild soap or unperfumed cleansers (e.g. Cetaphil, Ego QV) in lukewarm water about twice a day. Try not to wash the affected areas more than this, or scrub too hard, as your skin needs a certain amount of oil to maintain its natural condition (and prevent skin dryness and irritation). Try to keep hair clean and off the face and neck, as oil from the hair can make acne worse.
With 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. Further, don’t pick or squeeze pimples as it can make it worse and lead to scarring.
Stress can trigger an outbreak of pimples as it causes the release of hormones that can make oil glands release more sebum into the skin. While stress may be difficult to control, at least you know that the outbreak is due to stress, not a sign that the treatments don’t work.
Self-help treatments for acne take time to improve your skin noticeably, so it's important not to expect a big difference overnight. Your acne may only get better several months after you have been using the treatment regularly.
Some acne treatments can be bought over the counter at the pharmacy. These treatments contain benzoyl peroxide (e.g. Oxy, Clearasil, Benzac). This has antibacterial action and encourages your skin to shed its surface layer of dead cells. Together, these effects reduce inflammation in existing spots and prevent new ones from forming. Treatment containing benzoyl peroxide may cause your skin to become irritated especially to start with. This tends to settle down if you reduce the number of times you use it. You can then build up your use gradually. If the irritation is excessive, stop the medication and speak to your doctor about an alternative.
Medications and Treatment with a Professional
If your acne is not improving with self-help strategies and over-the-counter treatments or if you have more severe forms of acne, you will need to see your doctor. They can prescribe medication after assessing your acne. The may also refer you to a dermatologist. 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 - Unblocks pores of existing acne and prevents new blockages from developing
* Antibiotics - Kills bacteria and reduces inflammation
* Hormonal agents (e.g. contraceptive pill) - Reduces 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
WILL ACNE GO AWAY?
Acne will eventually go away. However, while the condition is still active, there may be episodic flares and improvements. There is no cure for acne but there are treatments and medications that help keep acne under control until it clears with time.