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Acne: What is acne?

Acne is inflammation of the sebaceous (oil) glands of the skin. At first these glands become blocked (blackheads and whiteheads) and then inflammation can lead to red bumps (papules), yellowheads (pustules), and even deep, tender cysts.

Acne is a common disorder of adolescence. It appears usually on the face, but can extend onto the neck, chest and back.

What is the cause?

Acne is related to the increase in the levels of male hormones during puberty in both sexes. Although the increase in hormone levels is normal, some people seem more sensitive to it.

Bacteria on the skin grow in the blocked gland and release fatty acids, which are irritating and set up inflammation.

Who gets it?

Most young men aged 13 will get acne. It is worse in males aged 18. It is slightly less common in girls; for them it is worse around 14 years and around period time.

When will it settle down?

It usually settles by the age of 20, but may continue longer in severe cases.

Important facts about acne

• It is not usually affected by diet.
• It is not caused by oily hair or hair touching the forehead.
• It is not infectious from one person to another.
• Ordinary chemicals (including chlorine in swimming pools) do not make it worse.
• Blackheads are not dirt, and will not dissolve in hot, soapy water.
• It may flare up with excessive stress.

A word to parents

Your son or daughter hates acne and finds it embarrassing. It is not due to the way the skin is washed or what is eaten-it just happens.

It will not help if you are overanxious and nag your child; give support and encouragement instead, especially in following your doctor's instructions.

Treatment

This varies according to the severity and persistence of the problem and the person's skin type.

Diet

Avoid any foods that seem to aggravate your acne (such as chocolate or milk), but special diets are not advised. However, have a sensible, nutritious diet.

Soap and washing

Special soaps are unhelpful. Use a normal soap and wash gently and often-do not scrub.

Cosmetics

Avoid oily or creamy cosmetics and all moisturisers. Use cosmetics sparingly.

Hair washing and shampoos

These make no difference.

Blackhead removal

This is not recommended; avoid picking and squeezing.

Exercise

This is not of proven value.

Ultraviolet light

This can be very beneficial (includes sunlight and controlled artificial ultraviolet light). However, avoid extreme exposure to ultraviolet light. (This includes avoiding sunburn.)

Lotions and creams

Many preparations are useful. These include sulphur, salicylic acid, benzoyl peroxide and retinoic (tretinoin) lotions.

Antibiotics: Those taken by mouth are of proven value, especially long-term tetracyclines.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia

NEV advises

• see also Dermnet New Zealand -  http://dermnetnz.org/acne/index.html

• The Acne Resource Center, USA - http://www.acne-resource.org/