Acne (otherwise called acne vulgaris) is a skin condition in which blockage of the glands near hair follicles occur leading to spots. The spots can be red and painful with a white head (called a closed comedome) or sometimes when mixing with the air becomes a blackehead (called an open comedome). Small spots with a white head are called pustules and these can sometimes enlarge to become bigger and painful where they are referred to as nodules or cysts.
Acne typically affects the face back and chest and usually first occurs around the age of puberty. It is not uncommon for acne to continue beyond teenage years.
The condition affects approximately 80% of people at some point between 11–30 years of age. Acne is sensitive to changes in the body’s hormones which cause a thickening to the lining of the pores of the skin causing blockage. As such, oral hormones can sometimes help to settle the condition in women.
When acne is more severe it can cause scarring or dark patches on the skin called hyperpigmentation.
Anxiety and poor self esteem are common when suffering from acne.
When we examine you, what are we looking for?
Mild acne: Face only
Moderate acne: Extensive coverage of the face and other surfaces
Severe: Nodules, cysts, scarring
We are also looking for features of more serious infection of suggestions of other underlying medical problems.
Given the relationship between acne and poor self esteem we often also screen for anxiety, depression and thoughts of self harm or suicide.
Treatment
Acne is not caused by poor hygiene, and there is no evidence it is improved by cleaning. In fact, excessive washing can aggravate acne.
Acne can be aggravated by heavy make up.
Diet has little or no effect on acne.
Picking at acne does not improve it and may cause scarring.
Acne is not infectious and cannot be passed on to other people.
Consider oral hormones in women (Combined oral contraceptive pill)
Topical (useful for localised spots)
Available without a prescription
Benzoyl peroxide
Available only with a prescription
Adapalene
Duac
Zineryt
Isotrexin
Oral antibiotics (useful for widespread spots, or nodules / pustules)
Available only with a prescription
Lymecycline
Erythromycin
Oxytetracycline
Oral Isotretinoin (for severe painful, scarring acne)
A referral to a dermatologist will be needed for this
Roaccutane
