Ask the Expert: Acne

27 November 2019

What is acne?

In simple terms acne means spots. They can be red spots (papules), yellow pussy spots (pustules), whiteheads (pore is closed and debris are trapped) or blackheads (pore is open). If it’s severe, it can be having large spots (nodules) and cyst (large lumps under the skin).

What causes acne?

  • Face is rich in sebaceous glands. In patient with acne, the sebaceous glands produce more sebum (excess of oil).
  • Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. In patients with acne the sebaceous glands produce more sebum. This excess sebum causes the cells to stick to each other and they are not shed properly. This leads to clog pores and build of sebum.
  • Acne bacterium called Propionibacterium acnes lives on the skin. In acne prone patient it gets inside the blocked pore. This blocked pore, which is rich in sebum, is an ideal environment for bacteria to grow and multiply. This triggers inflammation and the formation of red or pus-filled spots. Deep inflammation causes large spots called nodules and cyst. This leads to acne scarring.

What areas are affected by acne?

In teenager acne tends to occur on T zone of the face - forehead, nose and chin. Acne can also occur on chest, back and shoulder. In adult females it occurs on lower face - jawline, chin and neck.

What age can I get acne?

Acne in young kids is uncommon. It may present as blackheads and pussy spots (pustules) on face. First time it can occur in teenage and it has also been seen in twenties and thirties. Women can get adult onset acne at a later stage in life.

Is acne hormonal?

Acne can be associated with hormonal changes. Women often get premenstrual flare up. Some tablets taken by body builders contain hormones and that causes acne.

Is acne caused by certain food?

The impact of diet on the course of acne vulgaris is still a very controversial subject. There is not enough medical evidence to say food makes acne worse.

How can acne be treated?

You have few options which depend on your age, extent and severity of acne and what treatment you have tried in the past.

Topical - creams and gel applied to your skin.

It can be antibiotic: Erythromycin, Clindamycin, benzyl peroxide or retinoid (Adapalene, Tretinoin). Often used for mild to moderate acne. Some creams/gel can irritate and make your skin red. If that happens, you should stop it and restart by gradually and build up treatment over days.

Oral antibiotics: Antibiotics are given by mouth for 3 to 6 months. When they are given for long they work as anti inflammatory and help acne.

Oral contraceptive pill: Can help some female patients who have hormonal imbalance.

Isotretinoin: Roaccutane is used for severe acne, acne with scarring and acne that fails to respond to other drugs.

Can I wear cosmetics if I have acne?

Yes, you can, but choose it carefully as cosmetics can cause acne. Less is better. If you need for covering the blemish then use powder based (mineral) or water based. Use non-comedogenic labelled make up. Remove makeup before sleeping. Don’t wear when not needed.

Dr Namita Jasani holds clinics at Spire London East Hospital on Friday morning. To book an appointment, please call 0208 709 7817.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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