Acne is one of the most common skin conditions, affecting 95% of people aged 11-30 to some extent. Although it is often thought to be a teenage problem, acne can occur in people of any age. 25% of women and 12% of men in their 40s report having acne. June is global Acne Awareness Month and a perfect time to answer questions you may have and learn about treatments available.
You do not have to put up with acne and with the right knowledge and treatments, you can combat acne and experience clearer, healthier skin. We want to help educate about this often mis-understood condition and reduce the stigma and embarrassment that is associated.
Firstly, What Is Acne?
Acne is a skin condition that occurs when pores become clogged with oil (sebum) and dead skin cells. Sebaceous glands are tiny glands near the surface of the skin, which produce an oily substance -sebum. In acne the glands produce too much sebum, and the pore becomes blocked. Normally harmless bacteria that live on the skin surface can infect the blocked pore causing spots. Acne tends to affect the areas where large, hormonally responsive sebaceous glands are present. This is the face, neck, chest and back.
Knowing the various types of acne can help you to understand the condition better. Several types of acne spots occur, often at the same time. The treatment of these two different types of can spots can vary. All acne starts with a small blockage in a pore (microcomedone) that can develop into the different types of spots.
Inflammatory Acne
This is the type which most people think about when we talk about acne, it is usually the most noticeable type. Bacteria infiltrate the clogged pore causing inflammation in different forms:
- Papules are small, tender red bumps, while pustules are white or yellow and also known as pimples.
- Nodules are larger, painful bumps under the skin and cysts are fluctuant swellings also deeper in the skin.
Non-Inflammatory Acne
Non-inflammatory forms of acne are just as common. These forms of acne, known as whiteheads (closed comedones) and blackheads (open comedones), are typically less noticeable than their infected and swollen counterparts. Whiteheads occur when pores become clogged and closed, because the sebum cannot escape it maintains its white/yellow colour. Blackheads are caused by clogged pores that remain open, the sebum and dead skin cells take on a black colour when exposed to oxygen.
This type of acne can easily progress to inflammatory acne when the clogged pore becomes infected and inflamed.
What Causes Acne?
While many people incorrectly assume that acne is caused by dirty skin, the truth is that it is the result of a combination of factors. Although acne develops due to oversensitivity of the sebaceous glands to normal levels of hormones, contributing factors may include genetics, medications, lifestyle choices, and stress levels.
Acne affects many teenagers during puberty. Around 95% of teenagers will experience an increase in spots due to their changing hormones. Unfortunately, for some women, the struggle with acne will continue into their adult years, especially during pregnancy, when hormones continue to fluctuate. While we cannot control the hormonal changes that cause acne, we can take steps to reduce our risk of breakouts by making healthier choices and avoiding certain triggers.
Treating Acne: The Top Acne Treatments
Acne can be a frustrating skin condition to deal with, but there are various treatment options available. It’s important to consult with a dermatologist to determine which course of action will work best for your specific skin type and severity of acne. There are four main treatment routes you can explore: topical medications, oral medications, physical treatments, and the new laser for acne AviClear.
There are a variety of prescription creams, gels, and lotions available that can be applied regularly to help reduce the appearance of acne. However, it is important to understand that different types of acne require different types of active ingredients. It is essential to speak to a qualified dermatologist or medical professional before trying any topical treatment to ensure it is the right type of medication and is suitable for your skin. Dermatologist often combine topical treatments with other treatments.
Spironolactone
Spironolactone is a tablet which is used ‘off licence’ to treat women with acne. “Off licence” means that the treatment is not specifically indicated for these conditions in the UK government prescribing licence. However, it is still usually available on the NHS. Spironolactone is also used in the management of polycystic ovarian syndrome (PCOS) and is not usually given to men to treat skin problems.
Spironolactone works by blocking the action of androgens (male hormones) that are normally produced in all women in low levels. Some women have an increased sensitivity to these hormones, or sometimes higher levels which lead to skin problems. Spironolactone has been shown to be particularly useful in female adult acne.
Often used in conjunction with topical creams or lotions, antibiotics can help to reduce the severity of more problematic cases of acne. If your doctor thinks that antibiotics are a suitable option for your case, then you may be prescribed a course of tablets to take for around 3-6 months.
Microdermabrasion and Chemical Peels
Microdermabrasion works by removing the outer layer of skin by the use of tiny crystals, stimulating new cell growth and leaving your skin looking brighter and softer. It is a safe and effective procedure that is suitable for all skin types. At Southface Dermatology, we often combine microdermabrasion with a light chemical peel. This combined treatment is specifically designed to minimise acne breakouts by reducing blackheads, oiliness, and unblocking pores.
Isotretinoin
Isotretinoin is a retinoid drug which is part of the same family as Vitamin A. It may be known by brand names that include Roaccutane, Accutane (USA) and Reticutan. It reduces the production of sebum – an oily substance made by the skin. It also reduces the production of keratin – the outer layer of skin, which can block pores. As a medication that is only prescribed by dermatology specialists, it is highly effective in treating severe and stubborn forms of acne. By following a carefully tailored regimen under the guidance of a trusted dermatologist, patients can achieve significant results in clearing up their skin and regaining confidence in their appearance. If your doctor thinks that you are suitable for Isotretinoin treatment, they will explain carefully the potential side effects and requirements which need to be met, whilst taking the medication.
AviClear Laser Treatment
AviClear is a laser treatment that can effectively treat all acne severities. Its revolutionary
and award-winning technology is safe for all skin types and skin tones.
AviClear uses the power of light to target acne at the source. This laser treatment uses a
1726-nm wavelength to selectively target and down regulate the sebaceous glands. The
overproduction of sebum by the sebaceous glands is one of the leading causes of acne.
The AviClear treatment protocols recommend three, 30-minute treatment sessions spaced
one month apart to achieve optimal results. Like Isotretinoin, AviClear can result in long term clearance of acne.
How To Prevent Acne Breakouts
Acne breakouts can be frustrating and difficult to manage, but there are steps you can take to help prevent them. A targeted face wash or cleanser that helps to clear blocked pores can be beneficial, while oily moisturisers should be avoided. Use only makeup, sunscreen and skin products that are labelled “non-comedogenic” or “won’t clog pores.” These products don’t cause breakouts in most people. Even non-comedogenic makeup can clog the skin if slept in – always remove makeup before bed.
Visiting A Dermatologist For Acne
With their expert knowledge of skin and available treatments, a dermatologist can help you find a solution that is tailored to your specific needs. During a consultation they will consider your type of acne, your medical history , lifestyle and advise you on the best course of action to get the best results. So if you’re struggling with acne and feel like you’ve tried everything, consider reaching out to a professional dermatologist who can provide you with the guidance and expertise you need to finally achieve clear, healthy skin.
At Southface Dermatology our experienced dermatologists work with the latest guidance, research and technologies to provide safe, effective and long-lasting results. Your skin is in our safe hands.