acne head pic

Acne

Spots, pimples, zits, whatever you call them we all suffer from them at some point. It can get especially bad when we venture our way from puberty to adulthood and our hormones go crazy. As if awkward moments with the opposite sex weren’t already bad enough throw an untimely break out into the mix and you may feel like you’re never going to get a hot girl or fit boy out on a date. Acne is not just a bad spot every now again though, it’s a bit more serious than that and it’s a real bummer. If it’s a real bummer that’s affecting you, you may feel embarrassed and alone and acne can lead to problems with self-esteem, confidence and in some cases lead to depression. However, acne is a bummer that affects at least 3 out of 10 young adults and teenagers to the extent of needing medication. There are plenty others out there with the same issues and there is actually a lot you can do to help it get better. Though some people say it just has to run its course many people continue to suffer with acne through university and into their adult life, not dealing with it can lead to permanent skin damage and scars. Understanding acne and some of the treatments on offer may help you to regain healthy skin and the shining confidence needed to get that date.

+   What is it?

As always it’s good to know exactly what is going on. Everyone has hair follicles in their skin all over their body, lads and ladettes alike. Attached to these hair follicles are glands called sebaceous glands that secrete an oil called sebum. The sebum travels up the hair to the skin’s surface and keeps it lubricated. Acne is usually caused when your body makes too much of this oil and too much dead skin. Together they end up blocking the hair follicle and creating the ideal breeding home for bacteria. In turn this leads to the symptoms of acne from blackheads to pustules to cysts (more on these lovely fellows later).

+   Why?

Why is always a great question and in the case of acne there are a few common reasons for why your skin goes into over drive with the oil production:

  • Hormones
    • As we know babies and children don’t get spots but when we hit puberty we all start to produce more androgens a particular set of hormones. These hormones increase the production of oil leading to spots and acne
    • Ladies, if you are on the pill you may find that it causes acne but you may also find that it helps to improve it. People are different. If going on the pill has led you to break out more often than you would like have a chat to your doctor and maybe consider switching which pill you are on
    • Pregnancy can also make your hormones pretty whack. Some women find during pregnancy they suffer from acne even if they never had a problem with it in their past. Definitely worth chatting to your doctor and be aware that some acne treatments can be dangerous to unborn babies so do the research
  • Make up
    • Beware of oily or thick cosmetics. Though it may be tempting to try and cover up spots, it can just make your skin worse and block more follicles. If you do use make-up be sure to remove it before you go to sleep at night and use make-ups that say “non-comedogenic”
  • Diet
    • Though lots of people claim that greasy food and chocolate can make acne worse there isn’t much proof. Dairy and foods high in carbs and sugar that raise your blood sugar levels may cause an increase in acne. You may also find your own personal triggers, I cannot drink more than one fizzy drink without my face exploding into the surface of the moon
  • Medications
    • Certain medicines may cause acne
      • Corticosteroids
      • Androgens
      • Lithium
  • Frequent washing or hot/cold water
    • Frequent washing or washing in water that is too hot or cold can irritate the skin
    • Use luke warm water with a mild cleanser

+   Symptoms

Believe it or not different types of spots have different medical names, different causes and different symptoms/p>

  • Comedones (whiteheads or blackheads)
    • This is the name for what happens when hair follicle openings get blocked with oil, dead skin
    • They will often get a dark appearance hence the name blackhead
  • Papules
    • Papules happen when block pores get infected
    • This leads to raised bumps due to inflammation and infection in the follicle
    • The sight will also probably be red and tender to the touch
  • Pustules
    • These are the classic looking spots or pimples
    • They too are caused by infection in blocked pores
    • Like papules they will get inflamed, look red and have a little white pus (gross but we all know what I’m talking about)
  • Nodules
    • These hide out beneath the skin
    • They are larger solid often painful lumps
    • They are caused due to a buildup of secretions right at the base of the hair follicle
  • Cysts
    • These too are hiding under the surface and are the most common cause of acne scarring
    • They are painful, pus filled lumps under the surface

+   Treatment and Drugs

Acne treatments may take up to 3 months to really see a dramatic change so I know it will suck but try and be patient. Most treatments work in one of four ways. Some of them do all four things but some of them will do just one or two things:

  • Reduced oil production
  • Speeding up the turnover of skin cells
  • Reducing bacteria and fighting infection
  • Reducing inflammation

Over-the-Counter

Over-the-counter usually contain a mild medication such as benzoyl peroxide, salicylic acid or sulfur which will work to dry up oil, kill bacteria and promote the turnover of skin cells. Some may cause mild irritation for the first month but should stop after that. Also consider try regular exercise to help with self esteem and mood.

Prescription

If your acne is really bad and especially if over the counter treatments are not helping after three months you should consider visiting the doctor. The doctor may prescribe you something to help with the acne or refer you to the dermatologist. Prescription acne meds come in two forms, topical (something you apply to the areas of acne) or oral (tablets or pills):

  • Topical – most topical treatments you apply 1 or 2 times a day 20 minutes after you have washed your skin. You should apply sparingly. Most course of topical treatments last for 6 weeks
    • Retinoids
      • Help to reduce oil production and therefore reduce the number of plugged cells
    • Antibiotics
      • Kill bacteria
      • Often prescribed for 6-8 weeks only to stop the bacteria gaining resistance
    • Azelaic acid
      • Kills bacteria and dead skin cells
      • Often used if benzoyl peroxide or retinoids cause side effects
      • Will usually take a month to see effect
    • Benzoyl Peroxide
      • Kills bacteria and prevent dead skin cells forming a plug
  • Oral – the doctor may also prescribe oral medicines along topical treatments for severe acne or if topical medicine alone didn’t work
    • Antibiotics tablets
      • 4-6 week course only to stop bacteria gaining resistance, but sometimes longer courses so listen to your Doctor. They may do blood tests to check your liver from time to time if on those drugs longterm.
      • 6 weeks is the usual time to take to see improvements
      • Antibiotics can sometimes reduce the effectiveness of oral birth control so ask if you should use condoms alongside for the duration of the treatment
    • Oral Contraception
      • Some women find oral contraception helps to reduce their acne
  • Isotretinonin often referred to as roaccutane

This should only be used in extremely severe cases of acne. It can have some unpleasant side effects and can only be prescribed by a dermatologist not a GP

    • It will help to reduce oil production, decrease the amount of bacteria on the skin and reduce the swelling and redness caused by acne
    • Side Effects
      • Inflammation of skin or dryness of skin on lips and nostrils sometimes causing nose bleeds
      • Inflammation of eyelids and eyes (conjunctivitis). This may mean you cannot wear contact lenses for the course of the treatments
      • Blood in Urine
      • Change in blood sugar levels
      • In rare cases it may cause liver or pancreas inflammation or kidney disease
      • Birth defects are a known side effect of the treatment and you will need to start taking the contraceptive pill one month before the treatment, during the treatment and one month after the treatment. You will also need to take a pregnancy test before during or after.
      • Depression
        • There has been a lot of talk about isotretinoin causing severe depression and some high profile cases in the media where teenagers taking the drug have committed suicide. There is not medical proof of the connection and depression is connected with acne. Research does show however, that only 1 out of 10 000 taking the treatment suffer worsening in their depression.

If you're not getting anywhere with your local GP private acne treatment is available online from The Online Clinic. Prices start at £39.95. Click on the ad or, if you want to know more about private prescriptions online read our Strictly Private section.

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