What is acne?

Acne is caused by the blockage of the pores on your face with skin cells and oil which either results in ‘blackheads’ or if they get infected, pustules ( also known as pimples). Blockage is caused by sebum produced at the hair follicle. The production of sebum increases with increases in the level of the male hormones called androgens.

If the blocked pores become infected, this often causes redness, and in some cases scarring of the skin. It can affect the face, neck and chest and back.

In more severe acne the blocked pores form cysts or nodules deep under the skin which are usually painful and also can result in scarring of the skin and increased pigmentation.

Mostly, acne starts in teenage years when hormones are changing, but can start in adulthood either during pregnancy or during periods of stress

Acne can have significant psychological affects such as low self-esteem and lack of confidence and it is mostly chronic condition which means it can last for many years past puberty.

Are there other Causes of acne?

·      hormonal changes: puberty, pregnancy and polycystic ovarian syndrome. Increeases int eh male hormone called androgen can also occur in babies between age 3-6 months. There are also other rare causes of increased androgen levels that result in acne, so if you’ve never had acne before and develop it later in life then see your doctor to have your ovaries and adrenal function checked.

·      excess oil production from the skin

·      blocking pores from outside with makeup, oily creams and face masks!

·      Pollution

·      Change in the skin microbiome

·      Diet: possible link between drinking lower fat milk and acne, and also eating a diet high in refined carbohydrates.

·      Genetic link

·      Skin trauma from using harsh facial soaps or scrubs ( be gentle to your skin)

·      Rare Inflammatory conditions: SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome and PAPA (sterile pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome.

Can I treat acne myself initially?

If there is no scarring, deep nodules or redness then it is sensible to follow the basics below first for a couple of months:

Avoiding soap which is harsh, instead use a non-soap facial wash with luke warm water  this will help maintain the natural bacteria on your skin.

Exercise also helps so try and get your 30 minutes of moderate intensity exercise a day:

1.     it improves skin cell turn over and clears out blocked pores and

2.     it maintains normal body weight reducing insulin resistance which may be associated with acne.

Non-medical treatments for acne:

Wash your skin with a non-soap product and use warm water, don’t pick or squeeze spots as this can increase bacteria on the skin and cause more infection.

Exercise, eat well, loose weight if you need too, reduce stress

Medical treatments for acne

Treatment for mild- moderate acne which causes black heads and a few pustules/pimples little or no scarring.  

Retinoids should be used at night only and washed off in the morning with warm water. This is because retinoids make the skin on your face very sensitive to the sun’s rays which can cause skin damage and increase the risk of skin cancer

Remember that retinoids creams should be used long term for 1-2 years to avoid having recurrent acne after it initially settles down.

When trying a retinoid-based gels or cream for the first time leave it on for only one hour before washing off. Do this each night for one week before leaving it on overnight. It is a way of introducing your skin to the new product.

Antibiotic creams are best used combined with benzyl peroxide which makes the antibiotic cream work better and avoids your acne becoming resistant to the antibiotic.

Treatment for moderate to severe acne which causes scarring, inflammation, cyst/nodules under skin without pimples.

topical retinoids + topical antibiotic and topical benzyl peroxide plus either:

Oral antibiotics or

Oral contraceptive pill or

Oral retinoids.

If taking an oral antibiotic remember to take a probiotic with it.

If you are taking an oral retinoid you must also take the oral contraceptive pill so as not to become pregnant as oral retinoids will severely damage a growing fetus.

Some treatments work great and sometimes they can make your acne worse. If you think your acne is getting worse see you doctor straight away.

The above is not a substitute for consulting your doctor. We recommend you always seek professional advice and help from a medical doctor.

We would love hear of anything that you believe makes your acne worse or better!