Acne

What is Acne?

Acne is a disease based on the grease glands in the skin (sebaceous glands) and their channels (ducts) through which the grease (sebum) passes to the surface. These glands occur mainly on the face, back and chest, which are therefore the main sites for acne.

Acne can affect people from ages 10 through 40 and up. Acne can take the form of congested pores, whiteheads, blackheads, pimples, pustules, or cysts (deep pimples).

What causes it?


During puberty, the production of male sex hormones (androgens) increases in both girls and boys. Androgens can stimulate the sebaceous glands to produce more sebum. The increased production of sebum can narrow the openings of the sebaceous gland, thus causing a build up of the sebum which cannot get out. In some people the sebaceous glands are more sensitive to androgens than others.

Pimples are often caused by Propionebacterium acnes, a common bacterium on the skin that feeds on sebum. This bacterium produces waste products and fatty acids that irritate the sebaceous glands and make them inflamed.

What are the symptoms?


The first symptoms are small, tender, red spots that later turn into pimples containing degraded fatty acids. The inflammation disappears over a few days or weeks, depending on the severity.

Ways to manage an acne breakout

  • Wash your face twice a day with a mild cleanser. Do not scrub your face
  • Do not squeeze or pick at the pimples as this can make them worse and cause scarring
  • Avoid exposing your skin to too much cold, heat and sunlight. Sunlight may improve your acne for a while, but it won't cure it. Too much exposure to sunlight can lead to burning and skin cancer
  • Use a water-based moisturiser. Greasy or oily creams and foundations block the pores and may cause pimples
  • No scientific research has shown that certain foods can cause acne, but if you notice that spots increase after you eat certain things, it makes sense to avoid them
  • Choose a sensible, varied diet, drink lots of water and exercise regularly. If you feel good, your skin will feel good too
  • Mild acne can be treated with over-the-counter medications. Ask your pharmacist for advice on products. Try them for at least six to eight weeks to find out if they are working - it takes time to get acne under control

When should the doctor be consulted?

  • If over-the-counter medications do not work after at least six to eight weeks of treatment
  • If acne causes psychological distress
  • If there are big, tender pimples
  • If the acne causes scars
  • If you have dark skin and dark patches form where the pimples used to be

What can the doctor do for acne?

The following prescription medicines are available

  • Topical preparations (applied to the skin) including benzoyl peroxide, azelaic acid, antibacterials, antibiotics and topical retinoids
  • Oral preparations including antibacterials, oral retinoids or hormone treatment