Acne Explained
What is acne?
This is one of the commonest skin conditions. It most frequently affects teenagers, but can also persist into or develop in adult life.
What is the cause of acne?
The main problem in acne is blockage of the grease gland (sebaceous gland) which is associated with a hair follicle.
There may be an inherited factor with acne, in some families and there are genetic studies currently assessing this.
There are also contributory hormonal factors, as acne commonly becomes a problem at puberty.
The blockages in the grease gland can be seen as white bumps under the skin. (These are called microcomedones). If the skin covering the microcomedone is removed, then the blockage can be seen. (This is called a comedone). If this blockage becomes inflamed, red spots can be seen. If these spots are left for long enough, they develop into inflamed nodules and cysts (nodulocystic acne).
What are the treatments for acne?
Contrary to popular thought, diet plays no role in the development of acne.
Acne-prone skin does tend to be greasy, but many of the treatments for acne make the skin quite dry, so moisturizers should be used, but only the oil-free varieties. Make up can also be used on acne-prone skin, again if it is oil-free.
The treatments are:
- Topical treatments – eg creams and lotions – there are many available. Often they will make the skin red and sore initially, but you should expect this and it often improves with time.
- Antibiotic tablets – there are several different “acne-type” antibiotics, which should be prescribed for a minimum of 4 to 6 months to assess how your skin responds. They are usually prescribed together with a topical treatment.
- “Hyfrecation of macrocomedones” – this is a procedure which is performed by your consultant dermatologist, who will explain it more thoroughly. It helps to unblock and drain the blocked grease glands.
- Isotretinoin– this is a potent vitamin A treatment and is usually only prescribed by consultant dermatologists. It is often reserved for those with the severest acne, or for those who still have problematic acne after two courses of antibiotic tablets, lasting more than 4 months each.
There are several important side-effects of Isotretinoin, which your consultant dermatologist will explain to you, together with the need for blood tests. Any woman of child-bearing age who wishes to take isotretinoin must also use two methods of contraception in order to prevent pregnancy from occurring while on the treatment – and for two months after completing the course.
This is because Isotretinoin will damage the development of any unborn child, if it is taken during pregnancy.
