SKIN CONDITIONS
Acne
Acne is a common condition, mainly affecting the face with pustules, blackheads and cysts.
- Most common in teenagers and young adults
- Can lead to long-term scarring
- Treatments include topical and oral medications, laser and IPL
Acne is one of the most common skin conditions, affecting up to 85% of people at some point in their life.
It’s most common during teenage years and young adulthood (although it can occur at any age), and often resolves by 25 years of age.
Who gets acne?
Acne is most common in teenagers. Hormones play a large role, as androgens increase the size of sebaceous glands, which then produce more oil. Adult acne (i.e. over 25 years old) is less common, and appear to affect women more commonly.
Several factors can make acne worse:
- Stress.
- Smoking.
- Thick and oily make-up and skin products.
- Certain foods.
What causes pimples and blackheads?
Acne pimples and blackheads form when hair follicles get blocked. The oil-producing sebaceous glands secrete oil into the follicle, and it accumulates. In some cases, bacteria in the follicle multiply, causing inflammation. When the pore is clogged but open, the visible sebum (oil) darkens, causing the appearance of a blackhead. In some cases, deep pimples form cysts, which have a high risk of causing scars.
MBBS, MA (Virtual Comm), Grad Cert Hlth Info, Grad Dip Comp Inf Sci
What does acne look like?
Young man with acne of the cheek
Young woman with acne on her cheek, showing papules (pink bumps), pustules and generalised inflammation
Acne of the forehead, showing open comedones, also known as blackheads
Cystic acne affecting the jawline
Treatment of acne
The aims of treatment are to:
- Reduce the number of pimples and blackheads.
- Reduce the inflammation red lumps.
- Reduce general redness and pigmentation.
- Prevent scarring.
- Improve feelings of self-consciousness, depression and poor self-esteem.
Treatments include laser/BBL, topical retinoids, oral medication and photodynamic therapy.
Complications of acne
Untreated acne can cause long term scars. These may show as:
- Ice pick scars: small pinpoint holes in the skin.
- Rolling scars: depressions with rounded edges.
- Boxcar scars: depressions with distinct edges.
- Hypertrophic and keloid scars: overgrown, raised, firm lumps.
- Post-inflammatory pigmentation: areas and spots of increased pigmentation.
Psychological effects
Because acne affects the appearance of the skin, it can cause a reduction in self-esteem and cause feelings of self-consciousness. This can affect social interactions and may even harm educational and career prospects.
Acne is associated with depression which can cause feelings of sadness and worthlessness, social withdrawal, disordered sleep and appetite. People with severe depression may attempt self-harm.
Dermatologist-only acne treatments
People at high risk of scarring and depression or other serious psychological complications may require more aggressive acne treatment. This is an oral medication which in Australia must be prescribed by a dermatologist. In these cases, we can usually arrange an urgent dermatology referral.
Managing your acne
What you can do to help control acne symptoms
Repeated washing, exfoliating and astringent toners can make acne worse. Avoid applying oils or cosmetics to acne-prone areas and avoid abrasive treatments or squeezing and picking pimples. this can lead to scarring.
Hot and humid conditions such as saunas or working in poorly-ventilated kitchens can make acne worse.
Keep your skin care routine simple, and don’t overdo it. Let your skin “breathe”.
Wash acne-prone areas once daily with a gentle non-comedogenic cleanser. Use lukewarm (not hot or cold) water.
Diets with a high glycaemic index (i.e. high in sugar) often make acne worse. Reduce your intake of sugar, white bread, white rice, potatoes and other foods which raise blood sugar quickly.
In some cases, cow’s milk and other dairy products, including yoghurt and cheese, worsen acne symptoms. Consider reducing the amount of dairy in your diet.
Protein supplements containing whey are another dairy product shown to make acne worse in some people.
Treatments include mild salicylic acid preparations to unplug follicles, benzoyl peroxide cream or lotion and azelaic acid cream or lotion.
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