ALL ABOUT ACNE
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.
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: www.acne.org.au Acne Academy: www.acneacademy.org Source: Australasian College of Dermatologists www.dermcoll.edu.au