Acne is a common skin condition that affects most of us at some point in our lives. Greasy skin and
the development of spots, are common features of this sometimes-embarrassing condition.
Want to learn more about acne and the best treatments?
Keep watching as we will break down here.
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Ok, so what is Acne?
Acne is a condition of the skin that presents, commonly, during our teenage years. Characterised
by oily skin and the development of spots, acne typically affects the face, back and chest.
Up to 95% of people aged 11 to 30 experience acne, meaning most of us will be affected at
some point in our lives. Acne severity can, however, vary vastly between individuals.
Acne develops within your hair follicles. The hair follicles contain A follicle shaft,
a hair, and a sebaceous gland. With acne, we see an increase in sebaceous gland activity.
These glands produce a substance called sebum. Sebum is an oily, waxy substance containing
particles of dead skin and sweat. In addition, keratin, a substance produced by cells within
the hair follicle, causes dead skin cells to stick together. Keratin, therefore, promotes the
formation of blockages within the hair follicle. Bacteria, which naturally live on our skin,
thrive in this environment, causing inflammation, redness and pus formation seen with spots. The
combination of blockages within your hair follicle plus bacterial growth results in acne development.
What are the risk factors for developing acne?
Many factors increase your acne risk.
Sebaceous glands, responsible for the development of acne, are sensitive to hormonal changes,
principally, testosterone and more potent DHT. The hormonal changes we experience
during puberty, are responsible for the development acne during our teenage years.
Acne frequently runs in families. Your genetic makeup influences both
the amount of oily sebum produced and keratin production. In combination,
these factors increase follicle blockages and the development of spots. Therefore,
having a parent or sibling who suffers from acne places you in the higher risk bracket.
Cosmetics can cause the occlusion of follicles.
This, in turn, promotes acne formation by preventing the release of natural skin oils.
Where possible, select cosmetics labelled non-comedogenic, meaning they are non-follicle
blocking. It is further advisable to remove any cosmetics as soon as they are not required.
Dietary factors can also play a role: High glycaemic diets, those high in
sugar and carbohydrates, may worsen your acne. Spikes in blood sugar are believed to promote
inflammation and the production of sebum. Researchers have also identified that cow’s
milk can increase your chance of developing acne. The reason why is not fully understood
but may be linked to the hormones within cow’s milk, which may cause additional inflammation.
If you live in a particularly humid environment, this can promote increased
production of sebum from your glands. Again, promoting Acne development.
Certain medical conditions can increase your risk Polycystic Ovarian Syndrome, a common condition
affecting 10% of women, is known to be associated with acne. The condition is caused by increased
levels of certain hormones. Cushing’s Syndrome
This condition is associated with high levels of blood steroid hormones.
Medications Any medications containing additional hormones
can increase your risk of acne, these include: Hormonal contraceptives, including oral
medications, and implants. Steroid use.
Many clinicians, and patients attribute increased levels of stress as a contributing
factor for worsened acne. However, the research evidence base for this is limited.
It is believed that cortisol, a hormone produc3ed by our body during stressful times,
may increase testosterone and DHT. Subsequently increasing sebum production.
What does ACNE look like?
Individuals with acne may experience a mixture of oily skin,
blackheads, whiteheads, red spots, and pus-filled pimples. Infrequently nodules or cysts may form.
Acne can leave scars on the skin. Scars may leave a depression
or thickening of the skin, plus a potential colour variation compared to the normal surrounding skin.
Don’t forget the impact this condition can have on individuals’ mental health.
Individuals may experience a negative psychological impact
resulting from their acne, manifesting as a low mood or poor self-esteem. In more severe cases,
some experience depression and even thoughts of self-harm or suicide.
If this is the case, please speak with your regular doctor as soon as possible.
Why should I show my doctor?
Acne diagnosis is based on clinical examination. Your
doctor will also assess the severity of your acne.
For inflamed spots, microbial swabs help identify causative bacteria,
helping to tailor treatments. Blood tests support the diagnosis of medical conditions and hormonal
imbalances influencing your acne. Should I squeeze my spots?
You really shouldn't squeeze your spots, however, satisfying this may feel.
Doing this may lead to additional inflammation, infection, and permanent scarring.
How is Acne Treated?
A variety of treatments are available for your acne both over the counter
and on prescription from your doctor. However, do not expect immediate results
as these medications can take several weeks to get their maximal effect.
Some medications are available over the counter, without a prescription.
You can try these without consulting with a doctor. However,
you should consult with a healthcare professional before commencing any treatments,
as not all medications are suitable for everyone. Let's look at these first:
The first group of treatments available over the counter are exfoliators.
Mechanical Exfoliation
Exfoliating scrubs and brushes Many commercial exfoliant washes are available.
They contain abrasive particles helping remove dead skin and oils contributing to acne formation.
Chemical Exfoliators
These don't require abrasion or friction. Chemical exfoliators have the added benefit
of penetrating deeper into pores when compared to mechanical counterparts. Some examples include:
Salicylic Acids Salicylic acid helps break down blockages
within your pores, control sebum production and has the added benefit of reducing inflammation.
Azelaic Acid Of use in those with sensitive skin.
Azelaic acid has a gentler formula than other chemical exfoliators.
Alpha-Hydroxy Acids Different types of alpha-hydroxy acids found can
be found in skincare products, such as: Glycolic acid
Lactic acid Mandelic acid
Citric Acid Tartaric Acid
These medications may have the added benefit of helping reduce skin discolouration caused by acne
Other over the counter treatments include:
Tea Tree Oils These have the
dual action of being antibacterial, helping remove acne-causing bacteria from your skin
and has anti-inflammatory properties.
Benzoyl Peroxide is available
over the counter or on prescription. This medication has three main benefits:
Destroys acne-causing bacteria due to its antiseptic properties
Breaks down excess keratin un-blocking follicles. plus...
Anti-inflammatory effect, reducing swelling and redness of your spots.
Nicotinamide Also, known as niacinamide,
this treatment contains vitamin B3.
It works as: An anti-inflammatory reducing spot swelling and redness
It helps regulate sebum production, and. reduces discolouration left by acne on your skin.
Zinc Available as a topical cream or oral supplement
Zinc possesses an anti-inflammatory effect reducing acne swelling and redness.
Additionally, in mild cases, zinc may help reduce sebum production.
Vitamin A works by
promoting new skin cells to grow, additionally promoting the breakdown of dead skin cells.
Reduction in keratin and oil production, preventing acne-causing blockages.
Vitamin A, additionally, reduces skin discolouration.
More effective treatments are available from your primary care doctor or your consultant
dermatologist. Prescribed medications remain useful for individuals with more severe acne
and those where over the counter treatments have failed.
First, let’s look at the available prescribed topical treatment.
Topical treatments are those applied directly to your skin.
It’s advisable to start on a small area for the first few treatments, and progressively build
up the frequency of use. This is because some of these treatments can be irritating to your skin.
Eventually, these products should be used every night or even twice daily
and applied to all the skin in the affected area.
Retinols
are medications derived from Vitamin A. These medications are more effective than Vitamin A
treatments available over the counter. These treatments are applied once
daily at bedtime.
They work by: Encouraging the growth of new skin cells Help remove dead skin cells and oils from
your pores and promote a reduction in keratin and oil production.
Anti-inflammatory effect, reducing swelling and redness.
Retinoids These are medications derived
from vitamin A, like retinol. However, they are significantly more potent and therefore are a
more effective acne treatment. Retinoids are available
as both topical treatments. These medications encourage new skin cell growth
whilst promoting the breakdown of dead skin cells. Retinoids further regulate sebum and keratin
production, reducing the chances of developing follicle blockages and subsequent spot formation.
Anti-inflammatory properties also reduce the swelling and redness of acne.
Retinoids may further improve skin discolouration caused by acne.
These actions make retinoid medications an effective acne treatment.
Antibiotic creams
These are useful for controlling bacterial levels on the skin.
Occasionally, oral antibiotic treatments are required, to keep acne forming bacteria at bay.
These may be prescribed over a long duration. One commonly prescribed example is lymecycline.
Other oral medications available on
prescription are: Hormonal treatment
This treatment is exclusively available for females who have already started their periods.
Hormonal therapy helps to regulate these hormones, reducing sebum production.
This is achieved using oestrogen-containing contraceptive pills.
Specialist procedural treatments Mechanical Extraction
This procedure is typically only available from your dermatologist.
They use a special instrument to help remove unwanted blockages from
your pores that can contribute to spot formation.
Chemical Peels Strong chemical exfoliation
Causes the shedding/or peeling of the outer layers of the skin, revealing a new layer beneath
Chemical peels break down follicle blockages, preventing new acne formation.
Steroid injection provided by your specialist
and injected directly into inflamed acne lesions. The aim is to reduce
inflammation and pus formation These only forms part of a broader acne treatment
My acne has caused scarring on my face. How can this be managed?
Acne scarring can be distressing. Scarring may present as a thickening or thinning of the skin,
with or without alterations in skin pigmentation.
There are several methods used to help manage this problem.
Cosmetic camouflage Specialist makeup can be used to help
conceal your scars effectively. Laser resurfacing
In the hands of an experienced laser surgeon, laser resurfacing can be an effective
treatment to reduce acne scarring. and, micro-needling or subcision.
Prognosis Acne itself is not a life-threatening
condition. However, Individuals may experience residual physical and psychological scarring. The
negative psychological impact can cause depression and even thoughts of self-harm or suicide.
Fortunately, the clear majority of teenage acne sufferers will
experience resolution at the end of puberty.
Conclusion
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Outro
Of course, this video does not provide individual
medical advice and is intended for informational purposes only.
Do not consider this as a substitute for professional medical advice,
diagnosis, or treatment. Please do not ignore professional
medical advice in seeking treatment because of something you have heard here.
If you believe you may have a medical emergency, immediately call your doctor or ambulance service.