We’ve all had days when we wake up to find our skin has broken out overnight and gifted us a huge, red, throbbing spot – perhaps, and most annoyingly, right before a job interview or a hot date. But some people are even more unlucky and have to endure repeated outbreaks, with symptoms ranging from masses of varying sized pimples to fewer, larger, pus-filled spots or even boil-like cysts.
Acne is a common, and sometimes chronic, skin condition that causes inflammation, redness, spots and pimples, mostly on the face, back, neck and chest. It often occurs during periods of hormonal change, typically at puberty, but can develop at any age. Most adults are free of the symptoms by their mid-twenties. While neither dangerous nor contagious, it is often painful, can leave scars and cause embarrassment and distress, affecting the sufferer’s confidence and mood.
When the sebaceous glands at the root of the hairs growing through the skin produce an excess of the skin’s natural oils (sebum) and mix with dead skin cells, the hair follicle can become blocked and infected.
Teenagers are particularly likely to suffer when hormone levels increase at puberty, and women are often affected at other times when hormone levels change, such as menstruation or pregnancy. Other factors that trigger acne are:
- genetics – it seems to run in families
- some medications
- oil-based cosmetics
Some simple skin care routines may help:
- Wash affected areas no more than twice daily, as too frequent washing can aggravate the symptoms.
- Use a mild soap or cleanser and avoid excessively hot or cold water.
- Avoid the temptation to squeeze or pop spots as that can lead to infection and scarring.
- Use water-based cosmetics, and sparingly, removing makeup completely before going to sleep.
- Keep hands and hair clean – and keep it off the face.
- Avoid excessive sweating and shower after exercise.
- Keep anything that comes in contact with the affected skin scrupulously clean.
- Avoid anxiety and stress, as these increase levels of certain hormones that can make matters worse.
Medications to treat mild conditions are widely available over the counter, catering for skin that is sensitive, dry or oily. These non-prescription treatments are often creams or gels containing benzoyl peroxide, which kills bacteria, speeds up skin replacement and slows down sebum production.
If over the counter medications haven’t worked, visit your GP. Doctors are sympathetic to the effects of recurring skin eruptions and may offer a combination of prescription medications to tackle it, such as:
- topical retinoids – derived from vitamin A, these clean pores by removing dead skin
- topical antibiotic creams or gels – these kill the bacteria that lead to follicle infection
- topical antimicrobials – prevent the growth or spread of bacteria
- azelaic acid – removes dead skin and kills bacteria
- antibiotic tablets
- the combined oral contraceptive pill (for women) to regulate hormone activity
- Co-cyprindiol – a hormonal treatment that reduces sebum production, used when antibiotics haven’t worked.
Severe cases that don’t respond to any of these treatments may have to be referred to a dermatologist (a specialist in skin conditions) who will consider stronger treatment options. These could include:
- Isotretinoin – a strong retinoid taken in tablet form, used for the treatment of severe conditions where other medications and treatments have failed. Not suitable for everyone, it must be used under supervision.
- Corticosteroid injection – reduces inflammation and accelerates healing.
There’s no quick fix for acne, and successful treatment can sometimes take several months, so it’s important to stick with any treatment program – even if it doesn’t seem to be working.