Acne (otherwise known as 'acne vulgaris', from the ancient Greek word 'akme' meaning facial eruption) is a very common condition, particularly in teenagers and young adults. Statistics vary, but around 85% of all Australians will have acne at some point, with one 2013 estimate putting the number of sufferers worldwide at 660 million, making it one of the top ten most prevalent medical conditions. It is also an ancient condition, being prevalent from ancient Egyptian times.
Acne normally appears in teenage years at the onset of puberty (so girls tend to suffer earlier than boys) and lasts for eight to ten years before clearing up on its own. Around half of all sufferers will continue to have acne into their 20s and 30s and roughly 5% will suffer from severe acne.
What causes acne?
Hormones called androgens (testosterone is an androgen) start to be released in the human body at the outset of puberty, with boys having slightly more than girls. These hormones stimulate glands in the skin on the face and neck, as well as in skin on the chest, shoulders and back, to produce sebum - oil. What then happens is that bacteria that normally live on the surface of the skin (one of these bacteria called Propionibacterium is particularly implicated in acne) live off this oil and produce substances that irritate the skin and cause pores and hair follicles to be blocked, producing blackheads, whiteheads and pimples and cysts (affected areas that do not develop into whiteheads and contain pus and other tissue).
Although diet, smoking, exposure to sunlight or lack of clenaliness have been thought to be factors related to acne, it is generally believed that genetics is responsible for 80% of acne sufferers.
A relatively recent study (2007) has shown that there may be a link between the consumption of sugar (simple sugars) as sugar produces insulin in the body, which boosts both androgen production and something called 'growth factor 1' which may block skin glands.
Treatments for acne
Here are some general guidelines for dealing with acne on a day to day basis...
Products that are water based and oil free products help to avoid the blocking of pores. And always remove all makeup before going to bed.
Squeezing spots or pimples
Do not squeeze pimples and spots as this will make them worse and possible cause scarring.
Using cleansers specifically developed for acne-prone skin can help. Try washing the affected areas twice per day, but no more, as too much cleansing can cause dryness or irritation. Also avoid harsh or abrasive treatments which can make acne worse. Research has shown that, of all the products available for acne, those containing benzoyl peroxide, azelaic acid or sulphur are the most effective.
Try to keep hair washed and away from the face and neck, as oil in the hair may aggravate acne.
As reported above, it may be an idea to avoid foods with a high sugar content, or, if you find that acne outbreaks get worse after eating certain foods, try to minimise these foods.
For more severe outbreaks of acne, various medication may be prescribed, from antibiotic lotions and gels to a medication called isotretinoin (sold under brand names Roaccutane and Oratane) for very severe cases. This medication is limited to severe cases and can only be prescribed by as specialist dermatologist as it does have some side effects, including dryness of the lips and the skin and is not suitable for pregnant women.
There are a number of treatment available where severe acne has caused scarring including laser therapy, collagen injections and skin grafting.