Acne

Acne is a common skin condition, and it often shows up on the face, back or chest. You may notice spots and oily skin, and sometimes deeper cysts. In some people the skin also feels hot or painful to touch.

Acne can cause different kinds of spots.

Blackheads are small bumps on the skin that look black or yellowish.

Whiteheads look a lot like blackheads, but they can feel firmer.

Papules are small red bumps on the skin, and they can feel tender or sore.

Pustules look a lot like papules in acne, but they have a white tip in the centre. That white tip is a build-up of pus.

In acne, nodules are large, hard lumps that build up beneath the surface of the skin. They can be painful.

Severe acne can cause nodules and cysts. These are large lumps filled with pus, and they can leave scars behind.

If you think you have acne, speak to your pharmacist. They can usually diagnose acne just by looking at your skin.

The pharmacist will check how many spots you have and how inflamed and painful they are. This helps them work out how severe your acne is, and that in turn helps in planning your treatment.

If you need further treatment, your pharmacist will tell you to see a doctor.

How acne is treated depends on how severe it is. Treatment may be creams that you put on your skin, or medicines that you take by mouth.

A pharmacist can treat acne. If that doesn't work, or if your acne is severe, they may advise you to see a doctor.

Acne can take several months to get better with treatment. So be patient and keep going with your treatment, even if your skin doesn't improve straight away.

Hormonal therapies often help women with acne. They work especially well if the acne:

• flares up around your period, or
• is linked to hormonal conditions like polycystic ovary syndrome

If you aren't already taking it, your doctor may suggest the combined oral contraceptive pill, even if you're not sexually active. The combined pill can often improve acne in women, but it may take up to a year before you see its full benefits.

If you have severe acne, your doctor may refer you to a dermatologist, who is an expert in treating skin conditions. This could happen, for example, if you have:

• a large number of papules and pustules on your face, chest and/or back
• painful nodules

Severe acne can be treated with a mix of antibiotic tablets and topical treatments, which you apply directly to your skin. If that doesn't work, a medicine called isotretinoin (Roaccutane) may be prescribed. Your doctors will talk with you about whether this treatment is suitable for you.

Sebaceous glands are tiny glands near the surface of your skin. They make an oily substance called sebum, which stops your hair and skin from drying out.

In acne, these glands make too much sebum. The extra sebum mixes with dead skin cells and blocks the hair follicles (the small holes that each hair grows out of). A blocked follicle can cause the first signs of acne, like whiteheads or blackheads.

Bacteria that live on the skin are usually harmless, but they can infect a blocked follicle. When that happens, you get papules, pustules, nodules or cysts.

Acne is common in women, and it can be a sign of a hormonal imbalance. That imbalance may be caused by:

• periods
• pregnancy
• polycystic ovary syndrome (PCOS)

Acne can have other causes too, including:

• testosterone: teenage acne can be caused by a rise in the hormone testosterone during puberty
• family history: you're more likely to get acne if your parents have had it
• some cosmetic products
• certain medicines
• wearing things that press on an affected area of skin, like a headband or backpack
• smoking

There's no evidence that poor hygiene or sexual activity play a role in acne.

Acne is very common in teenagers and younger adults.

Most people have acne on and off for several years, and then their symptoms start to improve as they get older. In some cases, though, acne can continue into adult life.

Acne can sometimes leave scars. Any type of spot can cause them, but scarring is more common when nodules and cysts burst and damage the skin around them.

You can also get scars if you pick or squeeze your spots, so don't do this.

If you have acne, a few things can help ease your symptoms.

• wash the affected area with a mild soap or cleanser and lukewarm water (very hot or cold water can make acne worse)
• use fragrance-free, water-based products on your skin
• avoid wearing lots of make-up
• remove make-up completely before going to bed

• don't wash the affected skin more than twice a day, because washing too often can irritate the skin and make acne symptoms worse
• don't try to "clean out" blackheads or squeeze spots, because it can make them worse and leave permanent scarring

Acne can sometimes affect your mental health and wellbeing. It may make you feel:

• anxious
• stressed
• low
• depressed

Speak to your doctor for further advice on managing your mental health and wellbeing.

The images on this page were sourced from dermnetnz.org.

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