Acne
This fact sheet is for people who have acne.
Acne is a skin condition that causes spots.
What is acne?
Acne is a skin condition that typically causes one or more of the following:
* blackheads (comedones)
* whiteheads
* red or yellow spots
* greasy skin
* scars
Acne typically affects the skin of the face, back, neck, chest and arms and the severity of the condition can vary.
Acne affects people of all skin colors.
Acne is very common and affects about 80 in 100 people aged 11-30 at some time.
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Acne
This fact sheet is for people who have acne.
Acne is a skin condition that causes spots.
What is acne?
Acne is a skin condition that typically causes one or more of the following:
* blackheads (comedones) 2,3
* whiteheads2,3
* red or yellow spots2,3
* greasy skin2,3
* scars2,3
Acne typically affects the skin of the face, back, neck, chest and arms and the severity of the condition can vary.1,4
Acne affects people of all skin colors.
Acne is very common and affects about 80 in 100 people aged 11-30 at some time.4
The skin
The surface of the skin has lots of small sebaceous glands just below the surface.
Tiny pores (holes in the skin) allow the sebum to come to the skin surface.
Illustration showing the structure of skin
Illustration showing the structure of skin
What causes acne?
Acne is caused by the overactivity of the sebaceous glands that secrete oily substances onto the skin.
The sebaceous glands of people with acne are especially sensitive to normal blood levels of a hormone called testosterone, found naturally in both men and women.
Testosterone in people prone to acne triggers the sebaceous glands to produce an excess of sebum.
These two effects combined cause a build-up of oil in the hair follicles.
For some people, their acne does not progress beyond this stage.
However, in other people, the build-up of oil in the hair follicles creates an ideal environment for a bacterium called Propionibacterium acne to grow.
These bacteria normally live harmlessly on your skin, but when this ideal environment is created, they grow. They feed off the sebum and produce substances that cause a response from your body’s immune system.
In more severe ‘inflammatory acne’, cysts develop beneath the skin’s surface.
What makes acne worse?
There are a number of things that can make your acne worse. These include the following:
* picking and squeezing the spots may cause further inflammation and scarring1
* stress can make acne worse in some people, although it is not clear why1,
* in women, outbreaks may be affected by the hormonal changes that occur during the menstrual cycle1,
* excessive production of male hormones such as testosterone from conditions such as polycystic ovary syndrome may be another cause.5 For more information, please see the separate BUP A fact sheet Polycystic ovary syndrome
* some contraceptive pills, may make acne worse. This is due to the type of progestin hormone in some pills, whereas some other types of contraceptive pills can improve acne – see Treatments section below. Your GP will advise you which contraceptive pill to take
* some medicines can make acne worse. An alternative may be an option
* steroids can cause acne as a side effect
Treatment
Acne may cause you considerable emotional distress, but there is a range of treatment options to help you tackle the problem. No treatment will completely ‘cure’ your acne.
Home treatment
It is important to keep spot-prone areas clean, so wash the affected area twice a day with an unperformed cleanser.1,6 The skin needs a certain amount of oil to maintain its natural condition, so avoid aggressive washing with strong soaps.
There are a number of over-the-counter remedies available from pharmacies to treat mild acne. These usually contain antibacterial agents such as benzoyl peroxide (example: OXY and Clearasil Max).
As well as its antibacterial effects, benzoyl peroxide can dry out the skin and encourage it to shed the surface layer of dead skin.
Benzoyl peroxide can cause redness and peeling, especially to start with.
No home treatments for acne will work immediately.
Prescription medicines
Your GP may start your treatment by prescribing a preparation containing benzoyl peroxide. If this does not work, or if you have more severe acne, there are a range of other treatment options that you can either rub onto your skin (topical) or take in tablet form (oral).
Topical treatments
There are several topical treatments you may be prescribed, including those listed below:
* topical retinoids (example: Adaline) are medicines based on vitamin A, which are rubbed into the skin once or twice a day.7 They work by encouraging the outer layer of skin to flake off
* a topical antibiotic lotion applied to the skin can be used to control the P. acne bacteria. Preparations that combine an antibiotic with other acne medication are available (example: Benjamin, which combines an antibiotic with benzoyl peroxide)
Oral treatments
There are several oral treatments you may be prescribed, including those listed below:
* oral antibiotics (tablets), such as tetracycline, can be prescribed for inflammatory acne. They should be taken daily for around three months, although it might take four to six months for the benefits to be seen.7 The success of this treatment can be limited because the strains of bacteria are often resistant to the common antibiotics. Antibiotics do not prevent pores from becoming blocked so treatment to prevent blackheads, such as benzoyl peroxide, is often also prescribed at the same time
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