Acne is a common skin condition that affects most people at some point. It causes spots to develop on the skin, usually on the face, back and chest. The severity can range from mild to severe.. Most people have acne on and off for several years before their symptoms start to improve as they get older. Acne usually disappears when a person is in their twenties. Hormonal changes related to pregnancy and menstrual periods can also cause or contribute to acne.

The spots can range from blackheads and whiteheads which can range from mild, to inflamed pus-filled pustules and cysts. It is caused when glands in the skin begin to produce excessive amounts of oil (sebum) which blocks small holes in the skin through which hairs grow, causing blackheads and whiteheads. As a rule, the more sebum that you make, the greasier your skin feels, and the worse acne is likely to be. Some people make more sebum than others.  In mild to moderate acne, pores become blocked due to the skin at the top of the pores becoming thicker, combined with dead skin cells that are shed into the pores. Sebum then collects under blocked pores.

In moderate-to-severe acne, trapped sebum is ideal for some types of bacterium to grow. If a large number develop in the trapped sebum, the immune system may react and cause inflammation. If inflammation develops, it causes the surrounding skin to become red, and the spots become larger and filled with pus.

Aside from scarring, the main effects of acne are psychological, such as reduced self-esteem and in very extreme cases, depression.

What treatments are available?

Although acne can’t be cured, it can be controlled with treatment. Several creams are available at pharmacies to treat acne. If your acne is severe and appears on your chest and back, it may need to be treated with antibiotics or stronger creams.   Your pharmacist or doctor will advise you based on the severity and type of your acne. Treatments can be topical (treatment that you apply to the skin), and/or tablets. Common topical treatments work by killing bacteria, reducing inflammation, and helping to unplug blocked pores. For more severe cases, topical antibiotic preparations may be required.

The combined contraceptive pill (the pill) may help some women if their acne seems to be partly related to their hormonal changes.

If topical treatments or antibiotics prove ineffective, your doctor may recommend a systemic drug which reduces the amount of sebum made by your sebaceous glands. These are normally used only after other treatments have been tried first. This is because there is a risk of serious side-effects.

It is normal to take up to four weeks for there to be any improvement that you can see. There is often a good response to treatment by six weeks. It can take up to four months (sometimes longer) for maximum response to a treatment. Once spots have cleared, acne commonly flares up again if treatment is stopped. For this reason, maintenance treatment is usually recommended.

Removal of scars

Scars caused by acne can sometimes be removed by abrasion (dermabrasion) or laser treatment. These treatments are carried out by a dermatologist or a plastic surgeon. Visit the webpage on laser treatments for further information.

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