Acne is a skin condition that develops in the pores around the hair folicles and oil producing glands. Acne is most common in the 14 – 19 year age group although people in their 20’s and 30’s may also suffer from acne.  

Females tend to get acne at an earlier age although males typically have more severe acne. Acne can also appear at menopause in women and for both sexes after taking certain medication.

What Causes Acne?

Acne is caused by an increased level of specific hormones (androgens) usually during puberty. Because of higher hormone levels, the sebaceous glands in the hair follicles produce excessive sebum (oil), and there is greater turnover of skin cells lining the follicles.

Normally sebum helps to remove dead cells from hair follicles. It also spreads over the skin to lubricate and protect it. When too much sebum is produced, and the extra cells clump together, the resultant plug (comedo) blocks the opening of the hair follicles. The blockages lead to mild forms of acne and blackheads.

Pimples, pustules, nodules and deep cysts are more severe forms of acne involving follicle wall breakdown, inflammation, redness and puss. Deeper skin layers are affected and pain and scarring can result.

What Makes Acne Worse?

• Hormones, especially in a women just before her period

• Some medicines and contraceptive pills

• Oil based skin care and make-up products

• Excessive sweating Scratching, squeezing or picking pimples

• Clothing that rubs your skin

• Working with oils or greases, and jobs that make you sweaty and hot

Some people believe that certain foods such as chocolate can cause acne or make it worse. There is actually no evidence to prove this.

Acne can be controlled. You should cleanse your skin gently twice daily to control excess oil. Skin cleansers and medicated washes containing antiseptic agents, are useful in de-greasing the skin and reducing bacteria on the skins surface.

Acne Treatment

The right treatment can reduce the risk that your skin will be damaged or scarred from acne. Treatment products work by removing follicle plugs and opening blocked pores, removing excess grease and bacteria, and reducing inflammation – the factors that lead to the development of acne.

Many topical treatments and products (applied to the skin) and oral medicines (taken by mouth), are available to treat acne. Talk to your doctor or pharmacist about the best treatment for you.

Topical Acne Treatments

Cleansing agents: e.g. mild non-oily skin cleansers. These help control skin oiliness and bacteria.

Benzoyl peroxide: helps shed off excess skin, unblock the hair follicles and decrease skin oiliness. It’s antibacterial properties help to reduce the amount of bacteria on the skin. Benzoyl peroxide is a bleaching agent and can stain clothes and towels. Wash your hands after applying.

Sulphur/Resorcinot: help shed off excess skin and unblock follicles

Clindamycin and erythromycin: antibiotic liquids for pus-filled spots, not blackheads or whiteheads. They are applied to the skin to decrease bacteria and sebum. They are prescription medicines. Your doctor will be able to help decide if they are the right medicines for you.

Topical Retinoids: chemically related to vitamin A, retinoids ‘unplug’ follicles and help unclump cells. These are also available only on prescription and must not be used during preganancy.

If you are using more than one type of topical preparation ensure that you apply at different times so as not to affect one or the others action. Use only small amounts each time (a pea size amount is usually more than enough to treat the face.

Oral acne treatments (all are prescription medicines)

Oral antibiotics: decrease the amount of bacteria on your skin so there is less inflammation.

Hormone contraceptive pills: in females these help regulate hormones that are responsible for acne and greasy skin.

Isotretinoin: Used to treat severe acne that does not respond to other treatment. Can be used as a first-line treatment to prevent scarring.

Like topical retinoids, isotretinoin is a chemical relative of Vitamin A and reduces the formation of sebum. That means fewer skin bacteria and less inflammation of the skin follicles. Isotretinoin generally is not used at the same time as topical anti acne preparations.

Acne treatment time scale

Acne treatments may take a while to work (anywhere from 2-6 months). Don’t stop using the treatment within this time period. If your acne does not improve talk to your doctor or pharmacist. Your should also talk to them about any side effects from, or irritations to, your acne treatment. Some acne treatments tend to dry out the skin during the initial stages but the skin usually adjusts.

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