Acne

What is acne?

Acne is probably one of the most common skin conditions and affects many people across the world, mainly between the ages of 12 and 24. It is more common in teenagers and young adults but some people in their forties and fifties still struggle with acne.

Most pimples are found on the face, neck, back, chest and shoulders. Acne is not a serious health threat but, if it is not treated correctly, it may cause scars.

The pores in your skin connect to oil glands through a follicle. These glands produce an oily substance called sebum and inside the follicles, oil carries dead skin cells to the surface of the skin. Sometimes the hair, sebum and skin cells will clump together into a plug. The bacteria in the plug causes swelling and when the plug starts to break down, a pimple grows.

There are different types of pimples and the most general types are:

• whiteheads: pimples that stay under the surface of the skin;
• blackheads: pimples rise to the skin's surface and look black, but the black colour is not from dirt;
• papules: small pink bumps that can be tender;
• pustules: pimples are red at the bottom and have pus on top;
• nodules: large, painful, solid pimples that are deep in the skin; and
• cysts: deep, painful, pus-filled pimples that cause scars.

What causes acne?

The exact cause of acne is unknown, but doctors think that certain factors (or a combination of factors) are involved. Some of these factors could be:

• an increase in hormone levels during teenage years;
• hormonal changes during pregnancy;
• starting or stopping birth control pills;
• hereditary;
• certain types of medication; and
• greasy makeup.

Acne treatment

A general practitioner, family physician or dermatologist could treat a skin condition like acne. With an integrated treatment plan, the doctor will aim to heal existing pimples, stop new ones from forming and prevent scarring.

Early treatment is the best way to prevent scars. Your doctor may suggest over-the-counter or prescription medication. Some acne treatments are applied topically (directly to the skin) and others may be oral medication. You may also receive a combination of the two during your treatment. 

Please note that if you take Roaccutane®, Tretoderm®, Isotrex®, Retin-A® or other similar drugs, there are several issues to discuss with the prescribing doctor such as dosage, contra-indications in pregnancy and general contra-indications, interaction with other drugs (e.g. antibiotics), duration of treatment and side effects.

Skincare

• Use a mild cleanser in the morning, evening and after exercising. Don't scrub the skin - it may worsen the problem.
• Try not to touch, squeeze, pinch or pop pimples - you may spread the inflammation or develop scars or dark spots on your skin.
• You may try both electric and safety razors to shave your beard to see which one works best. Ensure that you use sharp blades with safety razors. It helps to soften your beard with soap and water before applying shaving cream. Shave lightly and only when you need to.
• Stay out of the sun. Many acne medications may cause sunburn. Being exposed to the sun on a regular basis may also cause wrinkles and increase the risk of skin cancer.
• Choose makeup carefully and ensure that it is oil free.
• Allow enough time for your acne products to take effect. Ask your doctor or dermatologist how much time each particular product requires, but it usually takes up to eight weeks before you can see an improvement.
• Always use your medication as instructed by your doctor or dermatologist.

There are some factors that may worsen acne, such as: 

• changing hormone levels in teenage girls and adult women at two to seven days before the start of their menstrual cycle;
• pressure from bike helmets, backpacks or tight collars;
• pollution and high humidity;
• squeezing or picking at pimples;
• hard scrubbing of the skin;
• sporting equipment that rubs against your skin;
• airborne grease; and
• oily hair. If your hair is naturally oily, keep it out of your face and wash it daily.

References 

American Academy of Dermatology, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)