Acne

Acne is one of the more common skin conditions which usually affect teenagers although adults can contract this in later years. Most people experience acne in their lifetime which means it has come to be seen as a normal part of adolescence along with mood swings and a strong desire for independence.

Did you know that around 80% of teenagers get acne (source: www.nhs.uk)

Why do boys get acne more than girls?

There is definitely a gender imbalance with acne. It affects more teenage boys than girls although girls are not exempt from this condition. In fact, adult women can develop this in their 30’s and during the menopause which is due to fluctuations in their hormone levels.

And fluctuating hormones are the main reason for adolescent acne. But the reason why boys are more prone is the male hormone testosterone. Find out more below.

Causes of acne

The teenage years are marked by rising hormone levels which have a dramatic effect on the bodies of boys and girls.

High levels of the male hormone testosterone cause an excess production of sebum (oil) from sweat glands within the skin which results in greasy looking skin. This is worse in boys whose skin is naturally oily as this predisposes them to this condition.

Normal behaviour by the sebaceous glands

The sebaceous glands release this oily liquid over the skin which acts as a moisturiser. Sebum combines with dead cells within the hair follicles which fill up, leaving the rest of the sebum to spread out over the skin. If the process works correctly the skin remains nice and smooth.

Abnormal behaviour by the sebaceous glands

What happens in puberty is that the sweat glands (or sebaceous glands) increase in size and produce more sebum due to the effect of hormones. This excess sebum along with dead cells blocks the follicles and the openings to them which allow bacteria to form. This results in the skin condition acne which appears as a variety of spots, e.g. blackheads.

Types of acne

There are two types of acne:

  • Inflammatory acne
  • Non-inflammatory acne

Inflammatory acne occurs if excess sebum flows into nearby tissues, causing pustules and cysts. These types of spots are extremely red and swollen and must be treated sooner rather than later to prevent scars forming.

Non-inflammatory acne is used to describe blackheads and whiteheads which form on the surface of the skin.

Both of these cause painful swellings and acute self-consciousness about one’s appearance.

Adult acne

With adults, many women find that they experience an outbreak of acne around the time of their next period. Pregnancy also triggers an outbreak, usually in the first trimester (3 months).

Other causes of acne

These include anabolic steroids, oral contraceptives (women only) and medical conditions such as polycystic ovary syndrome and Cushing’s syndrome. Many women experience acne during the menopause due to a fall in oestrogen levels and an increase in male hormones.

Types of acne

Acne results in the development of spots, mainly on the face although they can appear on the back, shoulders, chest and even the upper arms.

This takes the form of any of the following:

  • Blackheads and whiteheads: also known as comedones
  • Pustules: also known as pimples
  • Nodules: solid lumps under the skin which are also painful
  • Papules: pinhead sized spots
  • Cysts: deep, pus filled spots which can result in scarring

Blackheads and whiteheads are the most common form of acne. Cysts are the worst form of acne and can lead to scarring.

Acne myths

Acne is NOT caused by chocolate or chips. And it isn’t caused by make up or poor hygiene either. Contrary to popular belief it is not caused by masturbation and you cannot catch acne from another person.

Picking or popping spots or pimples does not cause acne to go away. In fact it can makes things worse as doing so only spread the bacteria further around the skin. Do this too often and scars will form.

Does stress cause acne? No but it can make it worse. Stress triggers the release of cortisol and other hormones which put a strain on all areas of the body including the sweat glands. And it is the sweat glands which are responsible for the production of sebum which triggers an outbreak of acne. The more sebum that is produced the greater the extent of the outbreak.

If you are prone to acne and are stressed then don’t be surprised if your acne worsens as a result. Look at the root causes of your stress and deal with those before dealing with your acne.

Symptoms of acne

These include an outbreak of spots on the face and upper areas of the body. These spots are red and swollen in appearance and in some cases, can be painful as well.

Treatment for acne

In some cases the acne will clear up by itself although this takes a long time. But there are shortcuts such as over the counter medications which are useful for mild cases of acne.

If these fail to work then ask your GP for advice. He or she will determine the extent of your acne (the severity) and prescribe a course of treatment accordingly.

Don’t feel embarrassed about seeking medical advice as acne can cause a great deal of psychological distress. Many sufferers find that they lose their confidence and self-esteem as a result and become socially isolated.

Your treatment will depend upon the type of acne you have. If you have blackheads and/or whiteheads then a topical cream or gel can help. Other options include antibiotics and retinoids (Vitamin A based therapies).

These are ideally suited to mild to moderate forms of acne. But severe cases will need to be seen by a dermatologist. Your GP will arrange a referral.

The dermatologist will prescribe an oral retinoid such as Roaccutane or recommend alternative treatments such as photodynamic therapy or a chemical peel.

Your GP will also recommend an ‘acne self help’ routine: this will include washing the affected areas with a special cleanser and using water based products on your skin. Find out more in our skin care advice section.