Acne is a very common skin condition characterized by comedowns (blackheads and whiteheads) and pus-filled spots (pustules). It usually starts at puberty and varies in severity on the face, neck, back and chest. It can persist long in some people

Picture of acne

Acne is a mixture of the following: oily skin, blackheads and whiteheads, red spots, yellow pus-filled pimples, cysts and scars.

What causes acne?

The sebaceous (oil-producing) glands of people who get acne are sensitive to certain hormones in blood, which are present in both men and women. These cause the glands to produce an excess of oil. At the same time, the openings of the glands are clogged.

The acne bacterium lives on everyone’s skin, but in those prone to acne, these bacteria can multiply. This triggers inflammation and the formation of red or pus-filled spots.

Some acne can be caused by medication given for other conditions or by certain contraceptives. Some tablets taken by body-builders contain hormones that trigger acne and other problems. Acne can rarely be caused by hormonal disturbance. In these cases there is unusual hair growth on the face and body or scalp hair loss, irregular periods.

Acne treatment

Acne treatments fall into the following categories:

Topical treatments, i.e. those that are applied directly to the skin

Oral antibiotics, i.e. taken by mouth

Oral contraceptive pills

Isotretinoin capsules

Other treatments

Topical treatments

are usually the first choice for mild to moderate acne. They should be applied to all of the face and not just to individual spots, usually every night or twice daily. There are a variety of topical anti-acne agents, such as benzoyl peroxide, antibiotics, retinoids, azelaic acid and nicotinamide.

Oral antibiotic treatment Usually a type of tetracycline, which is sometimes taken in combination with a suitable topical treatment. Antibiotics need to be taken for at least two months, and are usually continued until there is no further improvement, may be up to six months. Some should not be taken at the same time with food

, Oral contraceptive treatments

Some types of oral contraceptive pills help females who have acne. The most effective contain a hormone blocker (for example, cyproterone) which reduces the amount of oil the skin produces. It usually takes at least three to four months for the benefits to show. These tablets increase the risk of blood clots especially for people who smoke, are overweight or have others in the family who have had blood clots.

Isotretinoin

This is a powerful and highly effective treatment composed of vitamin A acid, which benefits most patients. The course of treatment depends on the body weight of the patient. However, it can be prescribed only under the supervision of a consultant dermatologist. Effective contraception must be used for four weeks before treatment, all over the period of treatment, and four weeks after treatment. During treatment the skin becomes dry, particularly around the lips. Regular application of a lip moisturizer is necessary. The improvement is progressive throughout the course of treatment, and the course must be completed according to the body weight. Do not be disappointed if progress seems slow.

Many of people have benefited from this drug without serious side effects.

Other treatments

There are many forms of light and laser therapy for inflammatory acne but these forms of treatment are usually ineffective in the treatment of severe inflammatory acne. Laser resurfacing of facial skin to reduce post-acne scarring requires the skills of an experienced laser surgeon. Laser treatment should not be done for at least one year after completing a course of isotretinoin

Self care

Try not to pick or squeeze your spots as this may cause scarring. Treat acne as soon as it appears to avoid permanent scarring.

Wait at least two months before you see much improvement..

Some topical treatments may dry or irritate the skin when you start using them. If your face goes red and is irritated by a lotion or cream, stop treatment for a few days and try using the treatment less often and then build up gradually.

Make-up may help your confidence. Use products that are oil-free or water-based. Choose products labelled ‘noncomedogenic’

Cleanse your skin and remove make-up with a mild soap or a gentle cleanser and water, or an oil-free soap substitute. Scrubbing too hard can irritate the skin and make your acne worse.

There is some evidence that chocolate and “fast foods” cause acne. Your health will benefit from a balanced diet including fresh fruit and vegetables.