Acne is a disorder which affects the skin’s oil glands and hair follicles causing spots to appear – typically on the face. There is a link to changes in hormones during puberty, the menstrual cycle or pregnancy.
The small holes in your skin (pores) connect to oil glands beneath the skin. These glands produce an oily substance called ‘sebum’. The pores connect to the glands by a canal, called a follicle.
Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the surface of the skin.
Sometimes the hair, sebum and skin cells clump together to form a plug. The bacteria in the plug can cause swelling. When the plug starts to break down – a pimple grows.
Most pimples are found on the face, neck, back, chest and shoulders. Acne is not usually a serious health problem but it can cause scars.
Acne treatments can be used to control the production of new spots, although medication does not offer a complete cure.
Acne is most common among teenagers and younger people and occurs in 80% of those aged 11-30. Girls aged 14-17 and boys aged 16-19 suffer most. However, those over the age of 25 may also suffer with 5% of women and 1% of men in this age group requiring medication to control their condition.
There is nothing to suggest that acne is directly caused by poor hygiene, sexual activity, or eating certain foods. However, if you have acne these things can exacerbate the condition. It can run in families, but it does not necessarily mean that if your parents had acne you will get it too.
There are many types of pimples – the most common types are:
• Whiteheads – pimples that stay under the surface of the skin • Blackheads – pimples that rise to the skins surface and look black (the black colour is not from dirt) • Papules – small pink bumps that can be tender • Pustules – pimples that are red at the bottom and have pus on top • Nodules – large, painful, solid pimples that are deep in the skin • Cysts – deep, painful, pus-filled pimples that can cause scars
Treatment options vary based on the type of acne a patient has. There are topical treatments available which will act to unclog pores, (topical retinoids –don’t worry about brands here –.check if we want to make specific recommendations on this), topical treatments which prevent the pores from becoming blocked and targeting the bacteria which cause acne (benzoyl peroxide – again need to check about making specific recommendations ) and topical antibiotics which work to eliminate the bacteria which cause acne ).
There are also oral antibiotics which a patient may be prescribed but this will be based on many factors our GP will consider before prescribing.
Mild to moderate acne can be effectively treated with a combination of a deep pore cleanser such as benzoyl peroxide, which prevents the clogging of pores, and a topical antibiotic or sulphur medication to combat the bacteria. For some patients, topical prescription medication, retinoic acid, can help speed the time it takes to clear up the outbreak.
Acne is easily recognised by the appearance of the spots and by their distribution on the face, neck, chest or back. There are several varieties of acne and by answering some simple questions our doctor will be able to tell you which type you have.
•Avoid frequent face washing, twice a day is plenty •Use a mild cleanser or soap •Limit the use of make-up •Try to avoid squeezing blackheads, whiteheads and spots •Avoid vigorous scrubbing, using abrasive soaps/cleansing granules or exfoliating agents when washing acne-affected skin •Avoid picking acne as it is liable to make the condition worse
If you struggle to control your acne with non prescription medication, you may want to try something more targeted. Our online consultation service with our expert doctor will help you to ascertain what you need to best treat your symptoms. If medication requiring a prescription is deemed the best option, our GP can help.
•topical retinoids •topical antibiotics •azelaic acid •antibiotic tablets •in women, the combined oral contraceptive pill
People with severe acne tend to have many breakouts, covering their face, chest, and back. It can also extend past the jawline to cover the neck and sometimes, it develops on the buttocks. These breakouts tend to be painful. When severe acne clears, scars are often left behind.
•If you develop nodules or cysts, they need to be treated to avoid scarring •Do not squeeze or pick spots, as this can lead to scarring •Be patient as treatments can take up to three months to work
Severe acne takes time to clear but perseverance with the right medication can deliver positive results.
Many studies have found that acne can lead to poor self-esteem, depression, or anxiety so finding the treatment that works for you can be transformative.
•Myth: Toothpaste cures spots. •Fact: Toothpaste is antibacterial but it also contains substances that can irritate and damage your skin – best to use a product formulated specifically for the job.
•Myth: Washing your face can cure Acne. •Fact: It’s true that washing the face each day gets rid of dead skin cells, excess oil, and surface dirt, but too much cleansing or washing too vigorously can lead to dryness and irritation — which can actually make acne worse
•Myth: Squeezing spots makes them go away faster. •Fact: Squeezing pushes bacteria further into the skin, making the area around the acne even more reddened and inflamed. Try to avoid it where possible.
Q: How do I know if my spots are caused by acne?
A: The nature of the spots will help our doctor to make a diagnosis. The more information you can share the easier it will be for the nature of your condition to be assessed. Ideally, if you are able to provide a picture this can be emailed in confidence to our secure customer services email address. Make sure you include a reference to your order number.
Q: How do I know what type of acne I have?
A: Our doctor will make a diagnosis based on the information you provide. If you can provide photos of the affected area that can really help.
Q: Could poor diet be making my acne worse?
A: The British Association of Dermatologists’s patient leaflet says there is “little evidence that any foods cause acne, such as chocolate and fast food”. However it is believed that restricting refined processed carbohydrates (such as sugar, white flour and white pasta) can reduce acne. Research from the British Medical Journal also shows that a diet high in dairy, particularly skimmed milk, can increase severity of acne.
Q: Will wearing makeup make my acne worse?
A: Anything that clogs your pores may be exacerbating your acne. Try switching brands to something which minimises clogging (look for toiletries with the label noncomedogenic). If the outbreak is along your hairline, switching to a different hair product may help.