Acne Content from the guide to life, the universe and everything


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Faculty of Medical, Clinical and Veterinary Sciences

Skin Problems

Human Skin | Dry Skin | Psoriasis | Eczema | Greasy Skin | Dandruff | Acne | Rosacea | Seborrheic Dermatitis | Skin Cancer | Non-melanoma Skin Cancer | Melanoma | Hereditary Skin Cancer | Sensible sun exposure

Pretty much everyone will have had the odd spot or zit at some time, but for people with acne the problem can be far more distressing. Four in every five people will have acne at some stage of their lives, many suffering needlessly because of a lack of information and support. Not only is it embarrassing, it can also be extremely painful, and the subsequent scarring lasts a lifetime. There is no reason to give up - acne is treatable.

So Who Gets it?

Mostly teenagers, but don't kid yourself that you're immune if you're over 20. Acne can persist well into the 40s1, and in women it can flare up or begin during pregnancy.

So What Causes it Then?

A combination of hormones, bacteria and genetics.

Hormones, specifically testosterone, stimulate the sebum, a type of oil produced by the skin, which maintains both suppleness and waterproofing abilities. However, too much can hamper the ability of the pore to excrete it onto the surface of the skin, where it belongs. Instead it accumulates within the pore.

Fluctuating hormone levels mean that women often notice that their acne worsens just before their period starts. Pregnancy and ovarian cysts can also be causes.

Bacteria - specifically Propionibacterium acnes find this accumulation of sebum to be an ideal breeding ground. The bacteria breed rapidly, causing a zit, spot or blackhead to develop behind a blockage of the pore.

Quite what blocks the pore is not understood. It is thought that a genetic predisposition may cause the skin cells within the pore to shed faster than normal, blocking the exit of the pore and allowing the sebum to accumulate. The result of this is that acne tends to run in families.

There are other things that can make acne worse.

Humid, hot environments seem to make acne worse. The extra moisture on the skin causes the pores to swell slightly, so the pore blocks even easier than it usually would. Similarly, sunlight may also make it worse, although this might not be obvious for a few weeks - the action of sunlight on skin can cause the pores to close, although the sun will dry the skin slightly, which only initially appears to help.

Poor diet doesn't cause acne. Chips and chocolate aren't going to make things worse - equally though, eating a healthy, balanced diet and drinking plenty of water will benefit general health, which in turn will help.

So What Can be Done?

Go into any chemist or look on the shelves of any supermarket and the choice of spot treatments is quite staggering. Lotions, scrubs, sticks, gels - the marketing departments of many of these companies have had a real field day. Be aware though - any treatment sold off the shelf, in the UK at least, will be very mild. Probably quite useful to someone with greasy skin, who gets the odd spot, but for the vast majority of acne sufferers, certain thing these will do is empty your pockets.

The first stop for effective acne treatment is the pharmacist, who should give sound advice on the OTC2 treatments available.

Benzoyl peroxide is widely thought to be one of the most effective treatments for mild acne, and comes in many different guises. Lotions, gels or creams come in differing strengths. In using Benzoyl peroxide there is the chance of experiencing side effects including redness, irritation and a burning sensation. Sometimes these go away with continued use - if not, speak to the pharmacist or a doctor. This can take a month or two to work, so providing the side effects aren't too bad, stick with it.

If this doesn't help, go and visit the doctor, there are a lot of treatments available only on prescription. Be warned though, some of these can take six months to work, although many will work more quickly.

Antibiotics, both in tablet and lotion form, can be very effective. Tablets are usually prescribed for a course of six months, and then tailed off gently, to avoid triggering a flare-up.

Topical vitamin A derivatives are very good for blackheads, but it can irritate the skin.

Doctors will often mix treatments - for instance prescribing both an oral antibiotic and a benzoyl peroxide product. Although some of items prescribed may be non-prescription, by prescribing a specific item the doctor can ensure that the correct type and strength of product is being used.

Squeezing Spots

Definitely something which should be done in private, but there can't be many people that haven't been tempted to bust a zit at some point. A few do's and don'ts about zit squeezing:

If the spot is red - don't even touch it. Squeezing now will only force the contents deeper into the skin and make it even angrier.

If the spot is yellow - squeeze away. Wash your hands first, and then gently use the side of your thumb and the end of one finger. Be sure to stop, however, once the pus has been pushed out. Squeezing out blood or clear fluid is only going to damage your skin. Afterwards, always dab the area with a mild antiseptic or tea tree oil.

If it's green - don't touch it. The spot is infected.

1Adult acne should not to be confused with a completely unrelated problem sometimes called acne rosacea, that usually affects adults.2Over-the-counter treatments are only available from pharmacies.

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