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