The Cause Of Acne
Acne is caused by a blockage of the sebaceous (oil-producing) glands. It is common in teenagers because rising levels of sex hormones stimulate the flow of sebum (oil), which becomes trapped in the glands. Acne can also be aggravated by skin products, such as sunscreens and some other creams which block the pores.
Common Questions On Acne
• Is Acne Due To An Infection?
Acne is not primarily due to an infection, although there may be an overgrowth of normal skin germs in association with acne. It is not contagious.
• Is Acne Due To Allergy?
No.
• Is Acne Simply A Hormonal Disease?
Although certain hormonal conditions can make acne worse, or even cause it, acne is a skin disease. Some women notice that their acne varies through the menstrual cycle and is usually worse just before a period.
• Can I Control My Acne By Changing My Diet?
Changing your diet probably won't help. Foods such as chocolate, dairy products, citrus fruits and cola have been named as possible causes of acne over the years, but the evidence has shown that diet generally plays no role in acne.
• Is Acne Caused By A Lack Of Cleanliness?
No, in fact, excessive cleaning can make your acne worse. It's best to cleanse twice a day - in the morning and at night. Strong antiseptic lotions can irritate the skin without helping the acne.
• Can Acne Benefit From The Sun?
For some people, sunshine or ultraviolet light can help to treat acne, but generally the health risks associated with sun exposure, including skin damage and skin cancers, outweigh the benefits. In some patients acne may flare up in the summer ('summer acne').
• Will My Acne Improve If I Drink A Lot Of Water?
Although drinking water is good for your health, there is no evidence that it will help to treat your acne.
• Will My acne Get Worse If I Sweat?
Sweating can, in some cases, contribute to acne, particularly on the back, shoulders and chest. You should be able to decide if this is the case with you.
• I'm In My 30s. Surely I'm Too Old For Acne?
Unfortunately not! A significant number of people in their 20s, 30s and 40s continue to be troubled by acne and need medical treatment.
Psychological Effects
Acne is a very visible problem and it can have psychological effects, especially for teenagers. Acne on the face can reduce self-confidence and self-esteem, and interfere with forming relationships. These problems are not always understood by parents and friends. Unfortunately, people do still judge a book by its cover, so if you have acne you need understanding, support and above all else, appropriate treatment. It's important to realise that acne can be helped substantially by the good treatments available. It may take a little time for those treatments to work, and there may be some side effects, but progress can certainly be made.
It's a big help if your family and friends understand the psychological effects which can accompany acne. Talk to them about it and give them this sheet to read.
If you're feeling depressed about your acne, psychiatric and psychological support is available. Talk to your GP if you feel you need that support.
Treatment - How To Get Rid Of Acne
Acne comes in different forms, ranging from very mild to very severe. If you have acne, you need to be carefully assessed by a doctor and the nature and causes of your condition identified. In cases of severe acne, your GP may refer you to a dermatologist (a specialist in skin diseases) for assessment and treatment.
• Mild Acne
The milder forms of acne can be treated by simple measures, such as creams and lotions containing benzoyl peroxide that are available over the counter at your pharmacist. These products are usually used once or twice a day and may cause skin dryness and peeling when you first start using them. This will improve with time.
• Moderate Acne
For moderate acne, prescribed medication such as antibiotic solutions, tretinoin cream, other vitamin A derivatives or azelaic acid cream, can be applied to the skin. These acne products can be a little irritating but generally this shouldn't worry you. If these products are not helping your acne, your doctor may suggest taking antibiotic tablets for several months. The contraceptive pill may help women with acne.
• Severe Acne
For severe acne you will need to take antibiotic tablets for several months, but if this is not successful, there is another treatment available called isotretinoin. This is a vitamin A tablet which you take for four to six months. It can have some unpleasant side-effects and can only be prescribed by hospital specialists, but it can cure people with severe acne, particularly if it is causing scarring.
Remember, always rely on your GP's advice for the right treatment for your acne.
By Dr Carol Blow, MB BS, MRCP, MRCGP, DRCOG.
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