Understanding Acne: What It Is and How to Treat It
Acne is a skin condition that causes spots and oily skin. It is most commonly seen in teenagers because it is linked to the hormonal changes that happen during puberty—hence its common (and rather dismissive) alternative name of ‘teenage spots’. It can, however, occur at more or less any stage in life.
The main cause of acne is changes in sebum levels. These can cause pores to block, and also have an effect on the bacteria living on your skin. This, in turn, causes inflammation. Acne treatments, therefore, tend to work on one or more of these areas: to unclog pores and clean the skin, to kill bacteria and/or to reduce inflammation.
When a spot is not a spot
The NHS website states that there are six main types of spots associated with acne. As well as the blackheads and whiteheads that we all know and love—small black or whitish lumps without any reddening of the skin—you may also get:
- Papules, or little red bumps that feel sore or tender;
- Pustules, which are slightly bigger red bumps with a white centre;
- Nodules, which are hard lumps under the skin; and
- Cysts, which are the biggest type of spot caused by acne, and are big pus-filled lumps that look a bit like boils. These are the spots that are most likely to cause scarring.
People with acne almost always get spots on their faces. They may also have spots on their backs and on their chests.
Living with acne
People with acne are generally advised to avoid washing their skin more than once or twice a day, to avoid irritating it. You should use a mild soap or cleanser, and warm water, because hot and cold water can irritate the skin. It’s helpful to avoid wearing make-up as much as possible, and make sure you clean it off every day. Water-based make-up is better, but still not ideal. Using fragrance-free bath and shower products may help to avoid irritating your acne.
You should never try to squeeze spots, however tempting. Yes, we know all aboutDr Pimple-Popper, but she’s a doctor, and she knows what she’s doing. Squeezing spots can actually drive the infection deeper, and can also leave permanent scars.
The treatment for acne depends on its severity. Pharmacists are probably the best source of initial advice on acne, especially when it is fairly mild. They can suggest suitable over-the-counter creams or gels to treat spots.
These often contain a product called benzoyl peroxide, which acts as an antiseptic to help reduce the number of bacteria on your skin. It is, therefore, most effective for whiteheads and blackheads. It can, however, irritate your skin, so it is best not to use too much.
If over-the-counter creams don’t control your acne, then you should speak to your GP. They can prescribe stronger creams, including topical retinoids, and topical antibiotics. Again, these can irritate your skin a bit, but sometimes that is worth it for the effect on your spots. However, if the side-effects are too much, go back to your doctor, because it may be better to try an alternative called azelaic acid. Your doctor will also be able to advise on combining treatments, for example, using an anti-inflammatory and an antibacterial product, or may refer you to a dermatologist.
People with very severe acne may be prescribed antibiotic tablets, which are often used along with other treatments. There is also one other treatment that can sometimes help in women and girls: the contraceptive pill. Acne is linked to hormonal changes, so regulating your hormones can sometimes help to reduce the symptoms.
It all takes time
Any treatment for acne takes a while to work. There are no miracle cures that will remove your spots overnight. Courses of treatment generally run for several weeks if not months, and it is worth sticking with a particular treatment for at least a month to see if it works. The contraceptive pill may take up to a year to show the full effects.
Some people might reasonably argue that the only real cure for acne is time—that, and the end of puberty. However, for those who are suffering—and particularly if it’s affecting how you feel about yourself—that’s not very helpful. If this is you, ask your doctor for help to get your acne under control. There is no need to suffer in silence, because there are plenty of effective treatments available.