Acne

Acne is one of the most common skin problems

Over 85% of people will suffer from acne between the ages of 12 and 24. Most cases are mild and can be managed simply with other the counter products. Acne is severe enough to seek medical help in 30% of people.

Acne can also affect adults and children. Men tend to have more severe acne, up to 15% of women develop adult onset acne that can persist for years. This can often have a hormonal basis.

Acne is a condition that affects the pilosebaceous units of the skin. There are a large number of them on the face. It often starts with a hormone surge at puberty. This causes increases greasiness on the skin ( seborrhoea), which in turn causes dead skin cells ( keratinocytes) to collect in the sebaceous gland channel. They form a plug ( comedone) which occludes the sebaceous unit.

These trapped skin cells are then colonised by a skin bacteria ( Proprionibacterium Acnes), causing inflamation and eventually rupture of the gland.

This causative process explains the types of lesions that occur in acne : comedones (open and closed), papules, pustules, nodules, cysts , and residual scarring.

Acne most typically affects the face, but it can also occur on the chest and back.

There are different types of acne, grading from mild to moderate to severe. Some types of acne are caused by external factors, like greasy cosmetics or steroids. Other patients may have different conditions that look similar to acne ( rosacea, perioral dermatitis). Some of the most severe forms of acne ( acne conglobata, acne fulminans) can make patients very ill, and cause significant life-long scarring.

Acne most typically affects the face, but it can also occur on the chest and back.

There are different types of acne, grading from mild to moderate to severe. Some types of acne are caused by external factors, like greasy cosmetics or steroids. Other patients may have different conditions that look similar to acne ( rosacea, perioral dermatitis). Some of the most severe forms of acne ( acne conglobata, acne fulminans) can make patients very ill, and cause significant life-long scarring.

Acne causes a lot of suffering and embarrassment, as it often affects young people at a time when they are psychologically vulnerable.

The good news is that there are lots of treatments to help acne and even eradicate it. It is important to start treatment promptly to prevent sequelae like scarring. Having said that, treatments for scarring are also available ( including micro needling, laser, peels and steroid injections).

Often oral antibiotics are used in acne. This can lead to the bacteria becoming resistant, and the antibiotics not working any more. It is important to use the right antibiotic in combination with topical treatments to prevent resistance.

A drug called isotretinoin ( a type of retinoid) has been used for acne for several years very successfully. This is a very strong medication with significant potential side effects, however it has the potential to cure acne for life (in about 70% of patients, their acne doesn’t recur).

It is important to tailor the treatment to the patient and the type of acne.

Make and appointment for an in-depth consultation and tailored treatment plan.

For more information on acne go to www.acnesupport.org.uk

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