Acne
This fact sheet is for people who have acne.
Acne is a skin condition that causes spots. Most people affected by acne are between the ages of 12 and 25, however, men and women in their 30s and 40s can also suffer. There are many treatments available to help deal with this condition.
What is acne?
Acne is a skin condition that usually causes one or more of the following:
* Blackheads (comedones)
* whiteheads
*reddish or yellow spots
* Smooth skin
*Mark
Acne usually affects the skin of the face, back, neck, chest and arms and the severity of the condition can vary.
Acne affects people of all colors. The processes that cause acne in people with dark or brown skin are exactly the same, but the effect is changed by skin pigmentation.
Acne is very common and affects about 80 in 100 people aged 11-30 at some point.
Skin
Just below the surface of the skin are many small sebaceous glands.
Small pores (holes in the skin) allow sebum to come to the surface of the skin. Hair also grows from these pores.
Illustration showing the structure of the skin
illustration showing the structure of the skin
What causes acne?
Acne is caused by overactivity of the sebaceous glands that secrete oily substances on the skin.
The sebaceous glands of people with acne are particularly sensitive to normal blood levels of a naturally occurring hormone called testosterone in both men and women.
In people with acne, testosterone triggers the sebaceous glands to produce excess sebum. At the same time, the dead skin cells lining the opening of the hair follicles (the tubes that hold the hair) do not shed properly and clog the follicles.
These two effects together lead to a build-up of oil in the hair follicles. This leads to the formation of blackheads and whiteheads.
For some people, their acne does not progress past this stage.
"However" in other people, oil buildup in the hair follicles creates an ideal environment for a bacterium called Propionibacterium acne to grow.
These bacteria are usually harmless on your skin, but when this ideal environment is created, they multiply. They feed on sebum and produce substances that cause a reaction from your body's immune system. This irritates the skin and produces the redness associated with the spots.
In more severe 'inflammatory acne', cysts develop beneath the surface of the skin. These acne cysts can burst, spreading the infection to the surrounding skin tissue. This may result in scarring.
What makes acne worse?
There are many things that can make your acne worse. These include the following:
* Picking and squeezing the spots can lead to further swelling and scarring.
* Stress can make acne worse in some people, although it is not clear why,
* Outbreaks can be affected by hormonal changes that occur during the menstrual cycle in women.
Another cause can be excessive production of male hormones such as testosterone from conditions such as polycystic ovary syndrome. For more information, please see the separate BU PA fact sheet Polycystic Ovary Syndrome
* Some birth control pills, can make acne worse. This is due to the type of progestin hormone in some pills, while some other types of birth control pills can improve acne - see the treatment section below. Your GP will advise you which contraceptive pill to take
* Some medicines can make acne worse. For example, some medications taken for epilepsy, and steroid creams and ointments used for eczema. If you suspect that it is making your acne worse, do not stop the medication as prescribed, but tell your doctor. An option can be an option
* Steroids can cause acne as a side effect
Treatment
Acne can cause you a lot of emotional discomfort, but there are many treatment options to help you deal with the problem. No treatment will completely 'cure' your acne. Treatment aims to prevent new spots from forming, repair existing ones, and prevent scarring.
Home remedies
It's important to keep spot-prone areas clean, so wash the affected area twice a day with a non-perfume cleanser. 1,6 Skin requires a certain amount of oil to maintain its natural state, so avoid aggressive washing with strong soaps.
There are many over-the-counter remedies available at pharmacies to treat mild acne. These usually contain antibacterial agents such as benzoyl peroxide (such as Boxy and Clearasil Max).
As well as its antibacterial effect, benzoyl peroxide can dry out the skin and encourage it to shed the surface layer of dead skin. Together, these effects make it harder for pores to become blocked and infection to develop.
Benzoyl peroxide can cause redness and peeling, especially to begin with. It settles down if you reduce the number of times you use it. Then you can gradually increase your usage.
No home remedy for acne will work right away. It can take weeks, if not months, before significant effects are noticeable. If home remedies don't work after two months, or you have severe acne, you should see your doctor.
Prescription drugs
Your GP may start your treatment by prescribing a preparation containing benzoyl peroxide. If this doesn't work, or if you have more severe acne, there are several other treatment options that you can either rub on your skin (topical) or take in tablet form (oral).
Topical treatment
There are a number of topical treatments that you can prescribe, including those listed below:
* Atelier acid is an alternative to benzoyl peroxide and may not damage your skin as much as benzoyl peroxide
*Topical retinoids are medications based on vitamin A, which are rubbed into the skin once or twice a day. 7 They work by encouraging the outer layer of the skin to become flaky.
* A topical antibiotic lotion applied to the skin can be used to control P. acne bacteria, Treatment needs to be continued for at least six months. There are medications available that combine an antibiotic with other acne medications.
Oral treatment
There are several oral remedies that you can try, listed below:
*Oral antibiotics (tablets), such as tetracycline, may be prescribed for inflammatory acne. They should be taken daily for about three months, although it may take four to six months to see benefits. The success of this treatment may be limited because strains of bacteria are often resistant to common antibiotics. Antibiotics do not prevent clogged pores, so treatments to prevent blackheads, such as benzoyl peroxide, are often prescribed at the same time.
* Some types of oral contraceptive pills help women who have acne.
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