Acne can range in severity from mild to severe and life changing. We review acne & possible treatments
What is acne?
Acne is a very common skin condition, where blackheads, whiteheads and pus-filled spots get formed. The blackheads and whiteheads in acne are called ‘comedones’, and the pus-spots are ‘pustules’. The most common type of acne is ‘acne vulgaris’
What causes acne?
Acne comes from the oil-producing glands (sebaceous glands) that are around the base of hairs. In people who get acne, the glands are very sensitive to hormone changes, especially those that happen in puberty. This is why acne tends to happen in teenagers, but can also be seen in people in their 20s or 30s, or those who take certain medications or supplements.
The hormone changes cause the glands to produce excess oil, and to get clogged up with dead skin cells. The excess oil and blockage causes the acne whiteheads and blackheads (the ‘blackhead’ is the visible plug of oil and dead skin cells). The excess oil also allows a bacterium called ‘Propionibacterium acnes’ to thrive and multiply. This bacterium usually lives on everybody’s skin and causes no problems, but when it multiplies in acne it causes inflammation and the formation of red or pus-filled spots.
Where can you get acne?
Acne usually happens on the face, chest and back
Is acne genetic?
Acne can sometimes run in families and genetic factors can play a part in acne, but usually no cause can be found and often no-one else in your family has had acne
Is acne contagious?
No, acne is mostly due to hormone changes, and so is not contagious. You can’t spread acne from one person to another. The bacterium that causes inflammation (Propionibacterium acnes) in acne is present on everyone’s skin anyway, and so being in contact with other people won’t put them at any increased risk of forming acne
What is the best acne treatment?
Acne is not curable as such, but can be very much improved. There are a number of different acne treatments available, including:
Topical acne treatment: These include creams and gels that are put straight onto the skin, and are usually tried first as many can be bought in the shops or pharmacy. Other stronger acne creams and gels are usually prescribed by your doctor. The ingredients vary, and can be antibiotics, benzoyl peroxide, nicotinamide, azelaic acid and retinoids (eg adapalene, tretinoin or isotretinoin). The instructions should be read very carefully, as if the acne treatment is used wrongly then it might not work or, worse still, cause more harm.
Antibiotic acne treatment: If gels and creams haven’t worked on your acne, then antibiotics might be given by your doctor to take orally (by mouth), usually as pills. This is usually erythromycin or tetracycline, and may be given for a few months or until the acne improves. Again, the instructions should be read very carefully. Antibiotics can cause side-effects including tummy upset, and so they might need to be stopped if the side effects get too bad
Isotretinoin: This is a very powerful and effective acne treatment, but can have serious side effects so can only usually be prescribed by a consultant Dermatologist. It can cause issues in pregnancy, and can cause depression. As acne itself can make you feel quite low in mood anyway, this further depression can lead to suicidal feelings. The skin and lips can become dry during treatment, and often the acne will worsen for the first few weeks before improving
Laser acne treatment: This is a relatively newer form of treatment, but does show real improvement in some people with acne. The laser treatment is usually pretty painless and only takes a few minutes to perform in an out-patient or clinic setting (you don’t need to stay in hospital). A number of treatments might be needed before you see an improvement
Foods that improve acne: There is no convincing evidence yet to show that any particular foods or diets have an effect on acne. Many people believe chocolate makes their acne worse though, and if you do find that any particular food makes your acne worse then these foods should of course be avoided if possible
What problems can acne cause?
Apart from how acne looks, the inflammation can be very sore and sometimes needs antibiotics to help calm it down. One of the main side-effects of acne is the scarring that can happen, especially when on the face. Try to avoid picking or squeezing the acne spots, as this could make scarring worse. Whilst acne scars are permanent, there are a number of way to improve the appearance including laser resurfacing, dermabrasion, peels, make-up and surgery. This is best in the hands of someone who specialises in acne scar treatment
This information is for general knowledge only, and does not replace the advice of a qualified specialist. If you have any concerns regarding any health issues, or are thinking of starting any treatment, this should be under the guidance and advice of a doctor or other specialist