What is acne?

Acne is a skin condition that occurs when the oil-secreting glands in the skin are clogged and become inflamed or infected.

These glands occur mainly on the face, back and chest, so these areas are the main sites for acne.

Acne is associated with increased grease production, therefore people with acne often notice and complain of the greasiness of their skin.

How common is acne?

Many young people will have a few acne spots at some time but around 15% will have more troublesome spots called acne.

Acne usually starts in the early teens and, if not treated, peaks between the ages of 17 and 21 years. Most people are acne-free by the time they are 25, although, in a few people, acne may persist to the age of 40 or older.

Acne is also common just before a woman’s monthly period.

What causes acne?

Grease glands:

These are controlled by the sex hormones and this is why acne starts at puberty. However acne is seldom due to an excess of these hormones but is usually due to an excessive response of the grease glands to normal hormone levels.

It is not clear why and how blackheads and whiteheads develop, but the grease secreted by the sebaceous glands (any of the simple or branched glands in the skin that secrete an oily substance) probably plays a part in their formation.

Skin bacteria:

After puberty, the skin of the face and upper trunk, with or without acne, contains bacteria. These bacteria get into the ducts of the grease glands where they make chemicals that eventually penetrate the deeper parts of the skin. This does not mean acne is infectious. It is due to the action of normal skin bacteria on the abnormal quantity and quality of grease produced by acne sufferers.

What are the symptoms of acne?

  • Blackheads.
  • Whiteheads.
  • Pimples (some filled with pus).

These skin eruptions can be painful and, in some cases, spots may become large and tender. These are called nodules and may lead to scarring — scars may be raised from the skin surface (keloid scars) or depressed (atrophic scars).

How is acne treated?

Acne spots can usually be kept under control but continuous treatment may be necessary for many years.

Treatment is aimed at cleaning out the pores, keeping oil and dirt out of the pores, and reducing inflammation.

Your doctor or nurse will discuss your skin care and assess which products, such as soaps, you should continue using and which you should stop using. They will also discuss the various options for treatment.

Possible treatments for acne are:

  • Topical treatment: This is treatment that is applied to the skin. Some topical treatments are also available from your chemist — the most effective topical treatments that can be bought over the counter contain benzoyl peroxide. Topical treatment must be applied to the entire affected area and not just to the spots and it should be continued to keep the spots under control.
  • Oral antibiotics: These are the most frequent oral treatments. They reduce the number of skin bacteria and also reduce inflammation.
  • Hormonal treatment: Ordinary contraceptive pills have little or no effect on acne, but there are other hormonal treatments that can reduce excessive grease production.
  • There are other strong treatments related to vitamin A. These are only likely to be prescribed by a specialist after your doctor has referred you for assessment in the more serious cases where other treatments have failed.
What can I do?

What is the long-term outlook?

Acne is usually one of the most straightforward of the persistent skin conditions to treat, but it must be treated sooner rather than later. Do not be embarrassed to go to your doctor about this condition. Help is available.

Early treatment minimises the risk of scarring.

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