Expert insight | Acne symptoms and solutions

With the second piece from our series of dermatology blogs, take sixty seconds to find out how to manage your condition and keep your skin looking its best.

What is acne?

Acne is an inflammatory condition that occurs when hair follicle oil glands enlarge and become blocked.  This causes white and black heads – spots.  Bacteria multiply more easily in this environment and the body responds causing inflammation – redness and pain.

Acne usually happens on the oiliest areas – the face, shoulders, chest and back.  The hormones of puberty stimulate the oil glands and once the process begins papules, pustules, nodules, and cysts can develop and rupture leading to scars.

Most teenagers get acne for several years, but it can persist well into adulthood and affects 5-10% of women by the time their 40.  It can be embarrassing and affect your confidence, your social life, and even your sex life so taking control can have some huge benefits.

What can I do to look after my skin?

• There’s little evidence for a link between acne and poor facial hygiene so washing repeatedly does nothing to help – twice a day with a mild cleanser is fine for most people.
• There is a weak association with high dairy or high sugar diet so avoiding these and increasing wholegrains, and fruit & veg may help. Reduce processed food consumption and cook fresh ingredients and swap refined carbohydrates (white bread, rice, pasta) for unrefined.
• Smoking worsens acne, and your skin will look terrible anyway!
• Stay out of the sun – tanning damages your skin and worsens acne and some acne treatments make your skin more sensitive to light.
• It’s important not to take gym supplements such as steroids, as these can induce or exacerbate acne.
• If you have irregular periods, trouble with your weight, and acne, you may have a condition called PCOS – ask a GP to discuss this and see if tests are needed.

How can I manage acne?

• Treat acne early – scarring is difficult to manage so getting a treatment that works and using it as early as possible is crucial.
• There are many different creams, gels, and tablets that reduce the amount of oil in the glands. Others target the bacteria and sometimes a combination is best.
• There are a variety of acne medications available over the counter containing ingredients such as Azealic or Salicylic acid. There’s limited evidence they work and they’re less effective than those available on prescription.
• The best prescribed creams contain something called a retinoid which reduces oil production. Creams containing benzoyl peroxidase are also very effective so combining these two is the best initial step.  There’s a product called Epiduo that contains both, so I usually recommend this.
• These creams can sting (don’t worry, this only happens when you first use them) and they dry the skin so it’s best to start by using only a little and then working your way up to applying them to the whole face.
• First clean the skin, and then apply a thin layer of your cream, avoiding the eyes and lips, to the whole face. Leave on for 15–30 minutes, and then wash off and apply moisturiser. Slowly increase the time the cream is left on the skin to build tolerance, ultimately aiming to leave it on overnight.
• Some of these medications shouldn’t be used if you’re pregnant or planning to conceive so ask your GP about this if needed.
• It will take several months before you see the effects so don’t give up too soon and try to be patient!

When to speak with your GP about acne

• If you have acne on the torso, antibiotics can be very effective. Most people don’t experience side-effects and notice a clear improvement after only a few months.  Antibiotics are on prescription only but can be used at the same time as using the prescribed creams.
• Another option is using a combined contraceptive – again, this is worth discussing with your GP and can be combined with the prescribed creams.
• Roaccutane is a medication taken orally for several months. It dries the skin and is highly effective – it clears acne in most people.  It can’t be taken without using contraception, and you need a blood test before you can start. If acne is scarring or hasn’t responded to creams and antibiotics, this is a good option.  Like all medications, there can be side effects so it’s worthwhile learning about these.