Acne is an extremely common condition that affects lots of people at some point in their lifetime. The severity of acne varies from person to person. But being such a visible condition, it can impact our mental health and quality of life.

To help better understand acne and ways in which we can learn to combat and live with the condition, we chat to Consultant Dermatologist, Dr Anjali Mahto from the British Skin Foundation.

What is acne?

Acne is the disorder of skin that is composed of an oil-producing gland, hair follicle and hair. Hormones is a common trigger that affects the size and activity of the oil producing glands. At the same time, dead skin cells are not shedding properly. As the skin cells become “sticky” they block pores and bacteria, creating an environment where the bacteria can multiply. It is this combination of factors that results in the formation of blackheads and whiteheads- acne.

Who is affected?

Boys and girls can equally be affected by acne during their adolescent years. There will be some who are more prone to acne because of a sensitivity to normal blood levels of certain hormones that causes the excess oil. Some people find that their symptoms improve as they get older and/or disappear entirely.

However, there are those, commonly women, who experience adult acne. Adult acne consists of two subtypes: persistent acne (acne that continues from teenage years and fails to clear) and late-onset acne (beginning after the age of 25). Women can be particularly sensitive to hormonal changes during the menstrual cycle and will find that their skin worsens during the pre-menstrual period.

Acne can run in families but most cases are sporadic and occur for unknown reasons.

Dr Mahto’s tips for combating and coping with acne

There is sadly no cure for acne. However, there are a number of things you can do to help treat, manage and even live with the condition:

  1. Do not suffer in silence. 

Seek support from a healthcare professional, ideally a qualified dermatologist.  These are the only people properly trained in managing skin problems. Everyone is different, so they can help identify the best course of treatment for you.

  1. Good skin care routine 

Look for cosmetics and sun creams that are suitable for acne-prone skin. “Non-comedogenic” i.e. products that will not block pores, a particularly beneficial.

It’s important that you cleanse your skin but taking care not to over cleanse or scrub viciously as this can worsen yours symptoms. Cleanse your skin with suitable products in the morning and evening. Look for mild, unperfumed and oil free cleansers.

  1. Regular use of a topical retinoid product

These are a class of compounds related to vitamin A that cause the skin’s outer layer to grow more quickly, stimulate collagen production, and exfoliate the top layers of skin cells.  This all helps to reduce the formation of comedones (blackheads or whiteheads) and other acne lesions.

Retinoid/vitamin A products can make your skin more sensitive to UV rays. So, it’s best to these cleansers and creams in the evening/before bed. Always ensure that you wear a sunscreen when using a retinol-based product.

  1. Regular facials

That involve steam extraction and manipulation of the skin to remove comedones and ease congestion will create an immediate sense of improvement to the skin in addition to reducing the number of future inflamed acne lesions.

It is advisable to have this carried out somewhere reputable with experienced therapists as if done incorrectly, there is a risk of damaging or scarring the skin and making acne worse.

  1. Chemical peels will improve mild to moderate acne

They involve application of a chemical to induce an accelerated form of exfoliation.  They can be used to treat active acne lesions, pigmentary change and superficial scars.  The two most common peeling agents include salicyclic acid and glycolic acid.

Salicylic acid is a beta hydroxy acid that is safe to use in all skin types.  It is anti-inflammatory and helps break down the outer layer of skin which makes it an ideal treatment for acne.  Even at low concentrations e.g. 3%, it can help speed up resolution of acne lesions and comedones.

Glycolic acid is an alpha hydroxy acid that also reduces comedones and inflammatory acne.  It also improves pigmentary changes in those that have darker skin types.

  1. On the spot treatments

For single, isolated stubborn large inflammatory acne lesions such as cysts, a dermatologist may occasionally use a small steroid injection directly into the spot.  This is a particularly useful form of treatment if a quick response is required e.g. preparing for an upcoming social event.  The cyst usually flattens within 48 hours.  There are potential side effects associated with this that your dermatologist will discuss with you.

  1. Light and laser treatments

Are an upcoming area in the management of acne.  There are a number of these available on the market that seem to have benefit in mild/moderate acne. Regenlite and photodynamic therapy are just two examples of the beneficial therapies available.

  1. Oral medications

Are appropriate if there is a problem with persistent and/or scarring acne. Or acne that is having a profound psychological impact on the individual.  Your dermatologist may recommend:

Antibiotics – e.g. Tetracycline, erythromycin, trimethoprim – that must be taken for a period of 3-6 months

Spironolactone – a medication that was initially developed for blood pressure and heart failure but also seems to work in female adult acne by local action on hormones in the skin

Isotretinoin is a vitamin A derivative usually reserved for severe, recalcitrant or acne that is leaving marks or scars on the skin.

We’d like to thank the British Skin Foundation for providing their expertise in creating this piece. We hope that it has helped you to identify the treatments that could be available to you in combating acne. If you’d like to see a dermatologist for advice specific for you, you’ll need to make an appointment with your GP for a referral to your local service provider. Alternatively, there are private clinics where you could obtain treatment.

It can be a rollercoaster of emotions when you’re living with acne. But you’re not alone. We came across Abbie’s experience of ‘how I got comfortable with my acne’ and hope you find it just as inspirational as we did:

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