What is acne?
Acne is what we commonly refer to as pimples.
What causes acne?
Acne occurs when:
- A hair follicle is clogged by thickening of the skin at the opening of hair follicles, oil from cosmetic products or tar
- There is increased oil excretion by the oil gland (sebaceous gland), which is a genetically determined and hormone dependent condition
- There is bacterial infection of the ducts (bacteria mainly responsible is Propionebacterium acnes)
Is acne caused by certain foods?
It is a myth that it is so.
Acne is not due to oily foods such as peanuts or chocolate. It is also not due to allergic rhinitis (resdung).
What does acne look like?
Acne can present as:
- White head or blackhead which is called comedones
- Red bumps with or without pus
- Nodules and cyst formation which may cause permanent scars
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What can make acne worse?
Things that can worsen acne are :
- Hormonal changes in girls during menstruation/period
- Make-up which is oil based
- Hair gel
- Picking on pimples
- Stress
- Pregnancy
- Medicine such as steroids, phenytoin ('Dilantin') or Lithium
Who gets acne?
It can affect anyone.
- It is usually worse among teenagers, especially boys
- Acne can also show up at any time in your life, even beyond 50 years of age
- If your parents have had significant acne, chances are you will have it too
What can I do when I have acne?
Mild acne can be treated by over-the-counter medication. It is usually sufficient to apply :
- Benzoyl peroxide 2.5%, 5%, 10% cream / gel at night or twice a day
- 2% - 6% Sulphur in calamine lotion
When should I seek medical advice?
If acne worsens you should see a doctor. Your doctor will use a combination of different creams such as topical retinoids, azelaic acid or topical antibiotics (clindamycin).
For moderate acne.
- Oral antibiotics are required and this needs to be taken for a period of four to six months
- Oral contraceptive is an effective treatment for girls but not for boys
For severe acne or nodulocystic acne your doctor should refer you to a dermatologist as Isotretinoin (Roaccutane) is an effective treatment. This can only be prescribed by a consultant dermatologist. Caution should be taken as :
- Isotretinoin has severe side-effects such as birth defects. Girls should not get pregnant whilst on isotretinoin and for at least one month after stopping the medication
- They should also be monitored for other side-effects of isotretinoin
Does acne cause scars?
Mild acne heals with pigmentation which will fade. It usually leaves no scar except if picking and squeezing were done.
Severe and nodulocystic acne leave permanent superficial and/or deep scars.
Some people are prone to keloid (thick scar) formation.
Can acne scars be treated?
After a few months the scars usually become less obvious.
Several methods that can be used to treat acne scars are :
- Chemical peeling for superficial scars using glycolic acid or trichloroacetic acid
- Laser resurfacing
- Filling material for broad-based scars using collagen injection or gelatin matrix implant
- Surgical repair
- Cosmetic camouflage can also be used to hide the scars
Can I prevent acne?
Yes. You can avoid or control acne by:
- Cleaning your face at least twice a day with gentle mild cleanser
- Avoiding oil based cosmetics. Choose 'non-comedogenic' cosmetics
- Eating healthily. Eating does affect your skin. Consume more vegetable and fruits
- Drinking a lot of plain water
- Exercising to improve blood flow and nutrition to the skin
- Reducing stress and practice relaxation methods
(See Treatment of acne)
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