Clearing up acne myths

Discover why you get it, and how to get rid of it

ONE of the most common skin conditions worldwide, acne affects between 20% and 50% of the population – depending on which study you’re reading – and between 80% and 90% of adolescents.

“Acne can be very emotionally distressing to those affected,” says dermatologist Dr Ulrich Ohnemus. “It’s often not so much a matter of how many pimples, blackheads and whiteheads you have, but how problematic you feel them to be.”

Roughly speaking, there are three forms of acne in terms of the severity of symptoms, he notes.

Acne begins with excess production of sebum, an oily secretion of the sebaceous glands in the skin, giving the skin an oily sheen. The small glands are usually attached to hair follicles, which can become plugged with sebum and dead skin cells.

This often causes pimples, or comedos, the medical word for blackheads and whiteheads.

When the plugged follicles become inflamed with bacteria, the condition is called acne papulopustulosa, most common during puberty.

Inflammation that develops deep inside follicles, producing cyst-like lumps under the skin that can be painful, is known as acne conglobata. Pronounced, interlinked lumps, sometimes accompanied by a feeling of illness, is acne fulminans.

“It’s not easy to answer the question of where acne comes from, as there’s often a complex interaction of several factors,” Ohnemus points out.

Genetics and hormonal changes play the largest role in how much sebum is secreted, which he says is why so many people have problems with pimples during puberty.

Studies have identified another, less influential factor, namely diet. Full-cream milk and fatty foods, for instance, are sometimes said to encourage acne. Psychological factors such as stress can also affect sebum production, says Ohnemus, adding that susceptibility to acne ultimately depends on the skin’s sensitivity to all of these factors.

Cosmetologist Martina Hofmann sees improper skin care as a further possible cause of acne. “Most people have no idea what their skin needs,” she remarks.

“Particularly skin prone to acne is often very sensitive, and anti-pimple products dry it out.”

Her acne treatment starts with an analysis of the person’s skin type. “In a conversation, I check off all the factors, such as diet, stress, smoking, care routine, medications and so forth,” she says. Then she draws up an individually tailored skin care programme that uses cosmeceuticals.

Ohnemus also discusses a skin care routine with patients after assessing the severity of their acne.

“Skin with acne should be cleaned mornings and evenings with a mild, antibacterial cleansing gel from a chemist’s shop or pharmacy, and in some cases a non-greasy skin emollient should be applied,” he says. “A chemical peel is recommended just once a week.”

Should skin care measures prove inadequate, Ohnemus says, there are highly effective medications that reduce sebum production and are anti-inflammatory.

“It’s important not to wait too long, especially in serious cases of acne, otherwise there can be scarring” that may be permanent.

Is it okay to pick or squeeze a pimple that crops up, or will this leave a scar?

“Ideally you should go to a medical cosmetology specialist,” Ohnemus advises. “If this isn’t possible, you can pop it yourself. When doing so, you should wear disposable gloves and disinfect the skin both before and after.”