Australian Health Today - - Contents -

Acne, pim­ples, zits, spots… the bane of most teenagers’, and even some adults’, ex­is­tence. Those ir­ri­tat­ing skin im­per­fec­tions can cause teens, in their most sen­si­tive and emo­tional pe­riod of their lives, to be­come self-con­scious about their ap­pear­ance even psy­cho­log­i­cally scarred by the sever­ity of acne. So­ci­etal pres­sures of phys­i­cal per­fec­tion and flaw­less body imag­ing as be­ing the norm hasn’t done any favours by those plagued by an­noy­ing acne, which can be dif­fi­cult to erad­i­cate dur­ing the hor­monal fluc­tu­a­tions of ado­les­cence. That’s not to say that acne doesn’t also at­tack other parts of the body (the back, shoul­ders and chest), but be­cause the face is dif­fi­cult to cover up, fa­cial acne can cause an­guish for many suf­fer­ers.

Adult acne can also be stub­bornly per­sis­tent due to stress and hor­monal im­bal­ance and may have se­ri­ous so­cial im­pli­ca­tions in the work­place or even in the re­la­tion­ship and dat­ing realm. The pur­suit of the per­fect skin com­plex­ion - acne and blem­ish free skin - por­trayed in ad­ver­tis­ing, me­dia and cer­tain celebrity ob­ses­sion, can leave a mone­tary and psy­cho­log­i­cal weight on those af­flicted. Be­ing a bil­lion-dol­lar in­dus­try, those trou­bled by acne will spend hun­dreds, some­times thou­sands of dol­lars on treat­ments, to be rid of those pesky red blem­ishes. The neg­a­tive ef­fects of acne can­not be ig­nored.

“Acne can some­times lead to a neg­a­tive self-es­teem and some in­di­vid­u­als may with­draw from so­cial and sport­ing ac­tiv­i­ties. It is im­por­tant to dis­cuss this with your der­ma­tol­o­gist or doc­tor if it is hap­pen­ing or if you are “feel­ing down” a lot of the time.” says Syd­ney Der­ma­tol­o­gist, Dr. Jo-Ann See.

Acne (Vul­garis) is a very com­mon skin con­di­tion that usu­ally be­gins in ado­les­cence. The hair fol­li­cle and its as­so­ci­ated oil (se­ba­ceous) gland be­come blocked and in­flamed. White­heads, black­heads and in­flamed pus-filled spots de­velop on the face, neck, back and chest be­cause this is where oil glands are largest and most ac­tive.

so what causes acne?

Hor­mones: At around 8 years of age, the adrenal glands start to pro­duce an­dro­gens (male hor­mone) and the amount pro­duced grad­u­ally in­creases dur­ing pu­berty. The se­ba­ceous glands re­spond to an­dro­gens by pro­duc­ing more se­bum and some­times white­heads (closed come­dones) may de­velop in young chil­dren.

se­ba­ceous gland block­age: The skin cells lin­ing the up­per part of the hair fol­li­cle duct are not shed as nor­mal but ac­cu­mu­late and form a plug (come­done). The oil is trapped be­hind it.

Bac­te­ria and in­flam­ma­tion: In­creased num­bers of acne bac­te­ria (Pro­pi­oni­bac­terium ac­nes) ac­cu­mu­late in the duct and con­trib­ute to the in­flam­ma­tion that de­vel­ops in the pim­ples.

ge­net­ics: Hered­i­tary fac­tors con­trib­ute, how­ever it is not known ex­actly how this works.

stress: Adrenal glands pro­duce more an­dro­gens when an in­di­vid­ual is stressed. This can make acne worse.

diet: Cer­tain di­ets may con­trib­ute to the de­vel­op­ment of acne, how­ever good sci­en­tific data is lack­ing.

oc­cu­pa­tion: In rare cases peo­ple work­ing in cer­tain in­dus­tries may de­velop oc­cu­pa­tional acne where strict Work Health and Safety reg­u­la­tions have not been ob­served.

treat­ing acne

The Aus­tralasian Col­lege of

Der­ma­tol­o­gists rec­om­mends us­ing one of the many safe and ef­fec­tive acne treat­ments avail­able. How­ever, it takes pa­tience and per­sis­tence, at least 6 to 8 weeks, to see im­prove­ment in acne re­gard­less of the treat­ment method, which can in­clude top­i­cal treat­ment, an­tibi­otics by mouth, hor­monal ther­apy or sys­temic retinoids (Vi­ta­min A).

Treat­ments aim to re­duce the num­ber of black­heads and white­heads, pim­ple and red bump in­flam­ma­tion, pre­vent scar­ring and min­imise skin dis­coloura­tion. Acne is of­ten char­ac­terised by flare­ups and acne free pe­ri­ods, and Dr. See ex­plains, “This may con­tinue for 3 to 5 years, but with con­sis­tent and per­sis­tent treat­ment the flare-ups can be min­imised and long-term side ef­fects re­duced”


Non-pre­scrip­tion prod­ucts are avail­able and should be ap­plied to the whole acne-af­fected area, not just the in­di­vid­ual spots. Pre­scrip­tion leave-on prod­ucts are usu­ally pre­scribed by your doc­tor or der­ma­tol­o­gist when non-pre­scrip­tion prod­ucts have not been ef­fec­tive, in­clud­ing top­i­cal an­tibi­otics and Vi­ta­min A based creams (retinoids).

For women, as if men­strual cy­cle symp­toms of cramps, mood­i­ness and bloat­ing aren’t enough, acne flare-ups can also be added to the mix. For some women who suf­fer from more per­sis­tent and on­go­ing acne, hor­monal ther­a­pies such as the oral con­tra­cep­tive pill or anti-an­dro­gen ther­apy may be very ef­fec­tive. Some fe­males may have acne as part of poly­cys­tic ovar­ian syn­drome (PCOS). Other hor­monal dis­or­ders as­so­ci­ated with ex­cess an­dro­gen pro­duc­tion can also cause acne and re­quire in­ves­ti­ga­tion from a der­ma­tol­o­gist.

Other treat­ments such as light mi­cro­der­mabra­sion, chem­i­cal peels or laser and light sys­tems may some­times help mild acne. How­ever, th­ese treat­ments may not be ef­fec­tive long term and may need to be re­peated reg­u­larly. They are not suit­able for per­sis­tent, se­vere or scar­ring acne.

Mild le­sions (black­heads and white­heads) can be ex­pressed or re­moved by light diathermy. Larger nod­ules and cysts may be in­jected with steroids to re­duce the in­flam­ma­tion.

tips and ad­vice

• Wash the face with warm wa­ter and a soft face cloth (with a mild soap if de­sired) to re­move oil. If this leaves the face still feel­ing oily, an over-the­counter acne wash or cleanser that con­tains sal­i­cylic acid, gly­colic acid or ben­zoyl per­ox­ide may be help­ful.

• Avoid abra­sive scrubs, ton­ers and cleansers.

• Avoid ap­ply­ing greasy cos­met­ics or greasy sun­screens to acne prone ar­eas.

• Avoid squeez­ing and pick­ing pim­ples as this ir­ri­tates in­flamed le­sions and is more likely to lead to scar­ring.

• Avoid hot hu­mid ar­eas and tight cloth­ing in acne prone ar­eas.

• Fol­low a well-bal­anced, low GI diet com­bined with reg­u­lar ex­er­cise.

acne - be gone!

Un­for­tu­nately, acne doesn’t van­ish overnight and in most cases it im­proves or dis­ap­pears af­ter ado­les­cence. Some peo­ple with a fam­ily his­tory of dif­fi­cult acne or those as­so­ci­ated with hor­monal flare-ups may con­tinue to have acne well into their for­ties. Some­times treat­ment needs to be re­viewed by the pre­scrib­ing doc­tor to “fine tune” man­age­ment and al­ter treat­ment if it is not ef­fec­tive. It is al­ways im­por­tant that the doc­tor ex­plains why any treat­ment is rec­om­mended and what can be ex­pected. In any case, a lot of pa­tience and stick­ing to a treat­ment regime that works, will en­sure those pesky spots dis­ap­pear in good time.

Fur­ther in­for­ma­tion about acne vul­garis All About Acne: Acne Acad­emy:­nea­ Source: Aus­tralasian Col­lege of Der­ma­tol­o­gists www.derm­

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