Acne - a troublesome but treatable condition

By Dr Michelle Cooper

Published 10/11/2015 | 00:00

Dr Michelle Cooper. Photo Eye Focus
Dr Michelle Cooper. Photo Eye Focus

Acne is a common cause of 'spots' mainly affecting the 12 to 25 year age group.

 It usually affects the face but may also appear on the back, neck, and chest areas.  Acne has long posed a spot of bother for its sufferers, with 9 in 10 teenagers developing some degree of this treatable yet troublesome condition.

CAUSES

Small sebaceous glands which produce oil called sebum lie just under the skin surface. Tiny pores (holes) on the skin allow the sebum to come onto the skin surface. During teenage years, due to hormonal changes, more sebum is produced, making skin feel greasier.

Many things can aggravate acne including:

- Monthly hormonal changes.

- Sweating heavily or humidity.

- Thick or greasy make-up.

- Picking and squeezing spots may cause further inflammation and scarring.

- Tight clothing such as headbands and tight bra straps.

- Medications such as the progestogen-only contraceptive pill, phenytoin (treatment for epilepsy), and steroids.

COMMON MYTHS

There is no evidence to suggest that acne is caused by poor hygiene, chocolate, sweets, fatty foods or stress. Acne cannot be cured by drinking lots of water. Sunbathing or sunbeds have not been proved to help clear acne.

SKIN CARE

Twice daily facial washing with mild soap and lukewarm water using a soft facecloth is recommended. Scrubbing and using abrasive soaps, cleansing granules, astringents, or exfoliating agents is not advised as they may cause further inflammation.

Although heavily advertised, antiseptic washes are unlikely to make any difference.

Blackheads cannot be cleaned off. The black tip of a blackhead consists of melanin (skin pigment) and cannot be removed by cleaning or scrubbing.

Some topical acne treatments (described below) may dry the skin. If this occurs, the use of a fragrance-free, water-based moisturiser cream is advised.

TREATMENT OPTIONS

Treatments are available in either topical or tablet form. Various gels, lotions, and creams are widely available.

- Benzoyl peroxide is a common topical treatment which kills bacteria, reduces inflammation and helps to unplug blocked pores.

- Retinoids help unplug blocked pores and also have an effect on reducing inflammation. Retinoids should be avoided if pregnant or if there is an intention to become pregnant.

- Topical antibiotics reduce the number of bacteria and reduce inflammation.

- Azelaic acid works by unplugging blocked pores.

Tablets may also be used to treat acne.

- Antibiotics work by killing bacteria that contribute to the cause of acne and have a direct effect of reducing inflammation.

- The combined oral contraceptive pill may help some women in cases where acne is related to monthly hormone changes.

- Isotretinoin greatly reduces the amount of sebum produced. Used in severe cases, it is normally prescribed by a specialist.

HOW LONG IS TREAMENT NEEDED?

It is normal to take up to four to six weeks for any noticeable improvement. However, it can take up to four months - sometimes longer - to achieve maximum response to treatment. Once cleared, acne commonly flares again and a 'maintenance' regime for a 4-5 year period may be required.

For support and further information please visit www.irishskinfoundation.ie/skin-conditions/acne-the-facts

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