What is acne?
Acne is a skin condition that occurs when your hair follicles become clogged with oil and dead skin cells.Bacteria in the skin multiply, which can cause pain and swelling (inflammation) beneath the blockages.
There are different kinds of spots:
- blackheads are small, blocked pores
- whiteheads are small, hard bumps with a white centre
- pustules are spots with a lot of pus visible
- nodules are hard, painful lumps under the skin.
- cystic lesions are painful, pus-filled lumps beneath the surface of the skin
Who gets acne?
Acne usually starts at puberty when increased levels of sex hormones (known as androgens) create an increase in size and oil production of glands.
It’s the most common of skin diseases – affecting 85% of Australians aged 15-24 years old.
Both sexes are susceptible, although teenage boys and young men are more likely to have severe acne owing to their have higher levels of androgens (male hormones like testosterone).
What can worsen acne?
- Stress: during times of stress, cortisol (the stress hormone) increases oil production which can stimulate acne.
- Poor diet: Processed and refined foods including white bread, biscuits and sweets have a high GI, which means they cause a rapid rise in blood sugar levels. This triggers the production of hormones such as insulin, which can make acne worse
- Being overweight: In women and teenage girls, fat can convert ‘good hormones’ (oestrogens) into ‘bad hormones’ that have testosterone-like actions – a contributing factor to acne
- Not exercising enough: Exercise reduces insulin output, which can contribute to acne and also helps reduce stress, another cause for acne breakouts.
- Pregnancy: hormonal acne, it is likely to flare during the first trimester (three months) of your pregnancy. Fortunately, it will probably improve and may even disappear during the last trimester
- Polycystic Ovarian Syndrome (PCOS): affects 12-18% of women of childbearing age with symptoms including hirsutism (excess hair), hair loss, acne, weight gain, irregular periods and fertility difficulties. Sugar and insulin problems further contribute to acne
What are the various treatment options available?
- Retinoids: Retinoid drugs are derived from vitamin A and include tretinoin (Avita, Retin-A, others), adapalene (Differin)It works by preventing plugging of the hair follicles.
- Antibiotics: These work by killing excess skin bacteria and reducing redness.The antibiotics are often combined with benzoyl peroxide to reduce the likelihood of developing antibiotic resistance
- Antibiotics: For moderate to severe acne, you may need oral antibiotics to reduce bacteria and fight inflammation
- Hormonal Treatments (Contraceptive pill and anti-androgens):These can be an effective treatment for women and teenage girls with moderate to severe acne. They work by blocking the effect of hormones called androgens on the sebaceous glands in the skin, thus reducing the production of sebum (oil) e.g. Diane-35, Estelle-35, Yasmin, Yaz etc
- Oral Retinoids: usually recommended for the treatment of severe acne, cystic acne, acne that is not responding to other treatments or acne that is causing emotional distress. Eg Roaccutane. People taking retinoids may need non-oily moisturisers for their lips and face, as well as eye lubricant drops, as they can cause dry skin and eyes
- Spironolactone is another medicine that works as an anti-androgen and can be used to treat acne in some women
- Chemical peels involve having a chemical solution applied to the skin that may help unblock skin pores and improve the appearance of acne-prone skin
- Light therapy may help reduce sebum production in the skin and reduce inflammation. One form of light therapy uses a photoconverter gel applied to the skin area, which is then illuminated by a high-intensity light
ACNE SCAR TREATMENT
Sometimes severe, untreated acne results in acne scars. There are treatments available that can help improve the appearance of acne scarring , these include:
- Microneedling: e.g Dermapen uses micro-needles to penetrate the skin to create micro-channels. This stimulating fibroblasts, for natural collagen production and allows topical cream active ingredients to penetrate deeper into the skin for intense rejuvenation. This treatment is available at The Station. Please contact a member of the team for more information or you may find more information in our Services section
- Dermabrasion or dermaplaning: where a special instrument is used to resurface your skin and reduce or remove remove the depth of scars
- Laser therapy: including laser resurfacing to remove the top layer of skin and non-ablative laser treatment that promotes skin healing through the growth of new collagen in specific areas
- Chemical peels:that remove the top layer of skin to help reduce scarring
- Cosmetic procedures: Fillers, skin grafting etc.
Skin Care Tips You May Find Useful
- Choose a soap-free cleanser for sensitive skin types.Cleanse your face twice a day, using your cleanser to also remove make-up
- Don’t use exfoliants, alcohol or acne wipes, toners, scrubs, granules, masks, peels, steams or have facials (check with your GP first if in doubt)
- Don’t squeeze or pick at pimples or blackheads
- It is important to moisturise whenever necessary, even if you have acne, so your skin may be able to cope with the suggested treatments
- Try to moisturise twice a day, with extra ‘top ups’ during the day if necessary
- It’s best to moisturise immediately after washing your face, before any treatments or sunscreens are applied
- Use oil-free, non-comedogenic lotions i.e. those less likely to clog the pores of the skin. Avoid products with additives
- Many acne treatments will leave your skin sensitive to the sun (this is temporary)
- Wear a broad-brimmed hat, stay out of the full sun, especially between 10am and 2pm (11am and 3pm summer time) and use a sunscreen
- Sunscreens should ideally be SPF 30+ or higher, broad spectrum and applied every 2 hours when outdoors
- Some sunscreens can aggravate acne, so trial and error may be required.It’s best to choose oil-free formulations
When acne starts interfering with your enjoyment of life, it’s definitely time to see a doctor
Acne is a medical condition so the smartest thing you can do is seek medical advice for your pimples, especially if it’s starting to interfere with your enjoyment of life.
Medical treatment can reduce the risk of physical scars and help with the emotional distress acne can sometimes cause. If you have mild or moderate acne, your local GP may be able to prescribe some treatments for you. If your acne is more severe you may need a referral to a skin specialist – a dermatologist.
Some additional reading:
As ever, if you have any queries or concerns contact your local doctor!