Symptoms of acne
Acne most commonly develops on the:
- face – this affects almost everyone with acne
- back – this affects more than half of people with acne
- chest – this affects about 15% of people with acne
There are 6 main types of spot caused by acne:
- blackheads – small black or yellowish bumps that develop on the skin; they're not filled with dirt, but are black because the inner lining of the hair follicle produces colour
- whiteheads – have a similar appearance to blackheads, but may be firmer and will not empty when squeezed
- papules – small red bumps that may feel tender or sore
- pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus
- nodules – large hard lumps that build up beneath the surface of the skin and can be painful
- cysts – the most severe type of spot caused by acne; they're large pus-filled lumps that look similar to boils and carry the greatest risk of causing permanent scarring
Things you can try if you have acne
These self-help techniques may be useful:
- Do not wash affected areas of skin more than twice a day. Frequent washing can irritate the skin and make symptoms worse.
- Wash the affected area with a mild soap or cleanser and lukewarm water. Very hot or cold water can make acne worse.
- Do not try to "clean out" blackheads or squeeze spots. This can make them worse and cause permanent scarring.
- Avoid make-up, skincare and suncare products that are oil-based (sometimes labelled “comedogenic”). Use water-based non-comedogenic products, as they’re less likely to block the pores in your skin.
- Completely remove make-up before going to bed.
- If dry skin is a problem, use a fragrance-free water-based emollient.
- Regular exercise cannot improve your acne, but it can boost your mood and improve your self-esteem. Shower as soon as possible once you finish exercising as sweat can irritate your acne.
- Wash your hair regularly and try to avoid letting your hair fall across your face.
Although acne cannot be cured, it can be controlled with treatment.
If you develop mild acne, it's a good idea to speak to a pharmacist for advice.
Several creams, lotions and gels for treating spots are available to buy from pharmacies.
Products containing a low concentration of benzoyl peroxide may be recommended, but be careful as this can bleach clothing.
If your acne is severe or appears on your chest and back, it may need to be treated with antibiotics or stronger creams that are only available on prescription.
Why do I have acne?
Acne is most commonly linked to the changes in hormone levels during puberty, but can start at any age.
Certain hormones cause the grease-producing glands next to hair follicles in the skin to produce larger amounts of oil (abnormal sebum).
This abnormal sebum changes the activity of a usually harmless skin bacterium called P. acnes, which becomes more aggressive and causes inflammation and pus.
The hormones also thicken the inner lining of the hair follicle, causing blockage of the pores. Cleaning the skin does not help to remove this blockage.
Other possible causes
Acne is known to run in families. If both your mother and father had acne, it's likely that you'll also have acne.
Hormonal changes, such as those that occur during the menstrual cycle or pregnancy, can also lead to episodes of acne in women.
There's no evidence that diet, poor hygiene or sexual activity play a role in acne.
The main symptoms of acne are spots on your face, back and chest. Your skin may be oily, or it may be hot or painful to touch.
You can often treat acne with creams and gels bought from a pharmacy. If your acne is severe, a GP may prescribe stronger medicines or antibiotics.
Acne is often linked to changes in hormone levels during puberty, but can start at any age. It's also known to run in families.
Treatments from a GP
See a GP if your acne is moderate or severe, or medicine from your pharmacy has not worked, as you probably need prescription medicine.
Prescription medicines that can be used to treat acne include:
- topical retinoids
- topical antibiotics
- azelaic acid
- antibiotic tablets
- in women, the combined oral contraceptive pill
If you have severe acne, or prescription medicines are not working, your GP can refer you to an expert in treating skin conditions (dermatologist).
For example, if:
- you have a large number of papules and pustules on your chest and back, as well as your face
- you have painful nodules
- you have scarring, or are at risk of scarring
- your condition is making you feel very low or anxious
For mild to moderate or moderate to severe acne, you’ll usually be started on a combination of topical treatments, or antibiotic tablets combined with topical treatments.
Hormonal therapies or the combined oral contraceptive pill can also be effective in women who have acne.
But the progestogen-only pill or contraceptive implant can sometimes make acne worse.
Many of these treatments can take 2 to 3 months before they start to work.
It's important to be patient and persist with a recommended treatment, even if there's no immediate effect.
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