Keeping acne at bay
ACNE has long posed a spot of bother for its sufferers, with nine out of 10 teenagers developing some degree of this treatable yet troublesome condition. 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.
WHAT CAUSES ACNE?
Small sebaceous glands, which lie just under the skin, produce oil called sebum lie which comes to the surface through tiny pores. Due to hormonal changes during the teenage years more sebum is produced, making the skin feel greasier and providing the basis for the formation of acne.
Acne is aggravated by monthly hormonal changes, sweating heavily or humidity, tick 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.
There are lots of myths surrounding acne. However, 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. And sunbathing or sunbeds have not been proven to help clear acne.
* 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.
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. An example is antibiotics, which 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 hormonal 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, and 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.