everyone suffers from outbreaks of pimples at some point in life, making acne one of the
most common skin disorders. Acne is a skin affliction usually occurring in teenagers,
however quite a high percentage of adults do suffer some form of acne symptoms.
Acne is characterised by
inflammation of the sebaceous glands causing pimples, blackheads, white heads
inflammation. It occurs in both sexes, although teenage boys tend to have the most severe
cases. Women are more likely than men to have mild to moderate forms into their thirties
and beyond, and are somewhat more susceptible to rosacea.
Symptoms include a
mixture of pimples, blackheads, whiteheads occurring mainly on the face,
neck, upper back and chest but can sometimes occur on other areas of the
body as well.
- Blackheads are flat, dark spots in the pores
of skin which are blockages of excess oil and dead skin that have darkened after being
exposed to the air.
- In whiteheads, the blockage is not visible
but a small lump can be seen under the skin. This is the blockage of oil.
- Pimples can be described as persistent
inflamed red areas or swellings on the skin. These areas are often painful; they can
become pus-filled. They are due to a rupture of the blocked gland under the skin.
- If the blockage occurs slightly deeper, then
very large cysts can develop. These cysts appear as red or pale lumps which can be
inflamed and filled with fluid. This is a more severe form of acne.
- Red swellings or lumps, sometimes visibly
filled with pus, are pustules, which develop from blackheads or whiteheads.
- Acne also tends to be worse in people with
The cause of acne is not
fully understood. While poor hygiene, poor diet, and stress can aggravate acne, they
clearly do not cause it. Acne occurs because of a blockage in the opening of the oil
glands in the skin.
It starts when tiny hair
follicles become plugged with oily secretions from the skin's sebaceous glands.
Tiny hair follicles,
especially those on the face, neck, chest, and back, can become plugged with sebum and
keratin. As the follicles fill up and bacteria multiply, blackheads or whiteheads form on
the skin's surface, a condition called non-inflammatory acne.
If the follicle wall breaks
under pressure and sebum leaks into nearby tissue, pustules or inflammatory acne can
develop. If pustules become infected, matters are further complicated: The infection can
penetrate deep into the skin and create cysts, which can rupture and leave temporary or
Various factors appear to
make certain people prone to developing acne, it can be inherited, a stressful
lifestyle, and the use of oral contraceptives. Taking oral contraceptives may trigger acne
in some women but actually suppress it in others, depending on the type of pill taken.
Anabolic steroids taken by some bodybuilders can also lead to severe outbreaks.
However common acne
vulgaris usually occurs in adolescent years as this is when there are large increases in
hormone production from the sex organs and the Adrenal Glands.
During puberty, both boys
and girls produce high levels of androgens - male sex hormones that include testosterone.
Androgens can increase production of sebum, the substance that lubricates the skin and
helps it retain moisture. There is usually only enough sebum produced to keep the skin
supple and healthy.
Acne can afflict anyone who
is undergoing hormonal changes for whatever reason. The inflamed redness, pimples,
blackheads, whiteheads and in extreme cases, cysts are the result.
The most important
treatment is to keep the skin clean which allows the pores to breathe. Do not squeeze or
touch any infected or inflamed areas as acne can produce lifelong scars.
A clean face can only be of
help if the hair is also washed and away from the face. The overactive sebaceous glands
cause the hair to become oily and dandruff can develop which
can aggravate acne problems.
The occasional pimple or
two need no treatment. Over-the-counter cover-up creams and cosmetics, if used at all,
should be water based and hypoallergenic. These creams usually contain anti-bacterial
antiseptics to reduce skin bacteria and keratolytics which remove any plugs of sebum
blocking the follicles. These products can be very helpful for many patients.
Always follow the
instructions carefully. Mild degreasing products may also be beneficial.
If you use cosmetics ensure
that only water-based products are the favoured choices.
If these simple procedures
do not help the problem, it is sensible to consult a doctor who may prescribe certain
To treat mild acne, your
doctor may recommend a topical over-the-counter medication containing benzoyl peroxide or
prescribe the anti-acne drug tretinoin (retinoic acid), a vitamin A derivative. Before
applying the medication, wash the affected area with a mild oil- and scent-free soap.
When pus-filled pimples are
ready to break, applying a hot towel for a few minutes may encourage the process. Infected
pimples should be opened only by a nurse or doctor using surgical instruments and
following antiseptic practices. Squeezing pimples yourself may lead to further infection
and the possibility of permanent scars.
favours drug therapies that inhibit sebum and keratin production, limit bacterial growth,
or encourage shedding of skin cells to unclog pores.
Because many therapies can
have potent side effects, any patient with a skin problem should proceed with caution when
trying a new treatment. People with severe, persistent cases need the care of a
dermatologist. However, if this course of action is chosen antibiotics can be quite
Oral antibiotics are
usually left to treat the more severe cases of acne. They are of a lower dose that would
be prescribed for an infection. Some forms of bacteria inflame acne and this is where
antibiotics can help by removing these and settling the problem.
For moderate to severe
cases, a mainstay of treatment is tetracycline, an antibiotic that is usually taken
orally, sometimes in combination with topically applied tretinoin. Other useful
antibiotics are oral erythromycin and clindamycin.
Another development in acne
treatment is the use of medication called isotretinoin which is taken from Vitamin A. However it should only be considered in
extreme cases of acne where no other treatment has been of assistance and its use must be
strictly supervised by a medical practitioner. It must not be used during pregnancy or if
there is any likelihood that conception has taken place. At present this drug can only be
prescribed by a dermatologist. Chemical peeling and laser therapy are also avenues that
could be investigated.
Patients taking anti-acne
drugs should be alert to possible side effects and interactions. The drugs tretinoin and
benzoyl peroxide can leave skin reddened, dry, and sensitive to sunlight. Benzoyl peroxide
may inhibit the healing effects of tretinoin, so never apply them at the same time. Taking
antibiotics for more than a few weeks may leave women susceptible to yeast infections.
There are surgical
procedures available to eliminate the scars from acne and your medical practitioner will
be able to advise on this treatment.
Some alternative therapies
have proven to be very beneficial. In addition to these therapies it is advisable to keep
the skin and hair clean as in the conventional treatments mentioned above.
Use mild soaps designed
for skin health every day
Use a skin scrub based on
oatmeal, calendula, tea tree oil (which is a natural
anti-bacterial agent), thyme or cinnamon which gently removes the top layer of the
skin and open the pores. Use 2-3 times per week.
Avoid alcohol based skin
Herbal treatments aid in
reducing excess oil production, help the system cope with the overload of bacteria, helps
reduce inflammation and aids in healing
Expose your acne to some
sunlight in moderation, but be careful to avoid overexposure.
Diet is vitally important
and fatty or oily foods should be reduced.
Reduce stress by relaxing
with a cup of tea made from lavender or chamomile.
Chinese herbal medicine
for acne seeks to rid the skin of dampness and heat, which are believed to be contributing
Many herbs are used to
help heal the skin and soothe inflammation and itching. The herbs a trained naturopath or
herbalist may consider are Echinacea, calendula, tea
tree oil, and goldenseal.
Never use any herbal
medicines on newborns without consulting your doctor.
Most doctors now
believe that acne is not a food-related problem. Some alternative therapists, however,
make a change in diet the basis of treatment. While experts in both camps concede that
chocolate, fats, and other suspect foods don't cause acne, debate continues over whether
they can aggravate the condition. Most Health Professionals agree that fatty or oily foods
should be avoided and to eat plenty of fresh fruit and vegetables.
It is also important to
drink plenty of filtered water throughout the day. Try to combine fresh food with vitamin
supplements such as Vitamin A, B complex, Vitamin C and the minerals Zinc and potassium.
Also useful are Lecithin, Echinacea, Garlic and Evening
Primrose Oil. Always check the required doses.
When to Seek Further
If you notice your
condition worsening and the infection becomes severe with the formation of larger boils, cysts or abscesses
If the surrounding tissue
is bruised and damages as a result of squeezing the blackheads.
If your acne doesn't
respond in two to three months to over-the-counter remedies; you may need medical