Acne is an inflammatory skin condition, commonly affecting the face,
chest and back. It is one of the most common skin conditions, affecting
up to 80-90% of adolescents. Acne may also occur during infancy due
to the activation of sebaceous glands by maternal hormones in-utero.
It can be a persistent problem, although it spontaneously resolves
after a period of 4-5 years in about 70% of people. Approximately
30% of people continue with their acne into adult life. The incidence
of acne at the age of 40 is reported to be 1% in men and 5% in women.
Causes
Acne is caused by the overactivity of the sebaceous (oil) glands.
Sebaceous glands are active due to the hormone testosterone. Testosterone
is produced in men from the testes and in women from the ovaries
and the adrenal gland. Although testosterone levels are usually
normal in people who develop acne, the sebaceous glands are overly
sensitive to the hormone. Over production of oil leads to a greasy
feel to the skin. In addition, there is a change in the growth of
the cells lining the follicular canal (pore). Instead of dislodging
normally and being carried away by the oil (sebum) when they die,
these cells become sticky and stick to the inner surface of the
gland and gradually build up a partial blockage.
Symptoms
The partial blockage of the pore is called a microcomedone and is
the precursor of all inflammatory and non-inflammatory spots in
acne. Bacteria start to multiply within the blockage, which leads
to inflammatory lesions or red papules. As part of the healing process,
the body recruits white blood cells which destroy the bacteria but
lead to the formation of pus, leading to comedones (blackheads),
small pimples, large pustules, or painful swollen cysts. There are
many myths surrounding the causes of acne, which include:
- only teenage spots - you'll grow out of it.
- eating too much chocolate and too many chips.
- not keeping your skin clean enough.
Acne can be a devastating psychological disease commonly affecting
the face, neck, chest, shoulders and back. The latest survey by the
Acne Support Group shows that 12% of people with acne feel suicidal
as a result of having the condition. Whilst it is a very common skin
condition, it need not be left untreated and leave a person feeling
so desperate that they want to take their own life.
Treatments
There are many treatments available, which need to be given at an
early stage to prevent scarring. Treatments are generally longterm,
however with encouragement and support a person can improve their
skin substantially.
First line treatment for acne includes creams or gels containing
the active ingredient benzoyl peroxide, which is available from
chemists. Salicylic acid is also available from chemist shops and
can be effective in comedonal (blackhead) type acne. Antibiotics
are a very popular treatment for acne. These help to reduce inflammation,
whilst killing the bacteria. Other treatments include preparations
containing the hormone therapy cyproterone acetate (females only).
For those who have not responded to systemic and topical therapies,
isotretinoin, which is a synthetic vitamin A, can be very useful.
This is a hospital-only drug and can achieve up to 95% positive
results in patients. There are many potential side effects from
this drug and hence the patient will need monitoring by their dermatologist.
Generally, treatments need to be taken for two months before any
improvement is noticed (the ‘two month rule’).
For further information contact:
Acne Support Group,
PO Box 9, Newquay TR9 6WG
Reg. Charity No. 1026654.
Tel: 0870 870 2263
Email: alison.dudley@btopenworld.com
Website: www.stopspots.org
The Acne Support Group provides information and support to those
people affected by acne and those people affected by rosacea. Information
and services available to members include:
- a comprehensive information pack.
- confidential advice.
- a lively and informative newsletter
For more information and resources for both healthcare professionals
and patients, please visit:
Information reproduced by kind permission of The Skin Care Campaign.
Click here
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