Acne

What is Acne?

Acne is just another word for spots or pimples. If the pores in your skin get blocked, natural oil in your skin can build up behind them. This causes spots.Photograph of an 18-year-old male with moderate severity acne vulgaris demonstrating classic features of whiteheads and oily skin distributed over the forehead

You might hear people say that pimples are caused by not washing enough. This isn’t true. And there’s no good evidence that eating fatty foods or chocolate causes acne.

What are the symptoms?

Acne usually appears on the face. But you can also have the spots on your neck, back, chest, or arms. The acne may be in the form of blackheads (small black marks) or whiteheads (white bumps). Spots can also become red and inflamed. Really bad spots can cause scars when they heal. But proper early treatment may help prevent this.

What treatments work?

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Less severe acne

Research suggests that the treatments most likely to be useful for mild pimples are creams containing substances called retinoids. Some of them can be got at the pharmacy without having to see a doctor first, but for some stronger kinds, you will need a prescription from your doctor.

Retinoids work by helping to unblock the skin pores. It doesn’t work immediately, and may take up to at least a few weeks before you see results.

Some people, especially the light-skinned ones, get side effects with retinoid creams that are similar to sunburn, such as red or peeling skin. But these are likely to resolve after some time. Retinoids can also make your skin more sensitive to sunlight, so you may want to stay out of bright sunlight as much as possible, and use sunscreen.

For people who have inflamed skin in addition to the spots (called inflammatory acne), doctors recommend in addition to the retinoid, the use of an antibiotic (either as a cream or as tablets) or benzoyl peroxide cream, or both. If you are using both a retinoid cream and benzoyl peroxide, these two treatments should not be used on the same area of skin at the same time.

Side effects of benzoyl peroxide may include red or peeling skin or a tingling feeling, and also makes the skin more sensitive to sunlight.

Doctors might recommend that some people with inflammatory acne also use a cream containing azelaic acid. This may reduce swelling and redness in the skin. You need a prescription from your doctor for this treatment. Some people get side effects from azelaic acid such as itching, a burning feeling, and red or scaly skin.

More severe acne

For some people with moderate to severe acne that is only mildly inflammatory, a stronger retinoid cream is the only prescribed treatment they need.

But most people with more severe inflammatory acne will need to take antibiotic tablets as well. Azelaic acid cream may also be recommended in addition, to help reduce swelling and redness.

Acne that is very severe or doesn’t improve with usual treatments

If you have very severe acne, or if other treatments haven’t helped, your doctor might prescribe isotretinoin tablets. They are a type of retinoid, and prevent your skin making as much oil as usual. This can reduce the number of spots you have.

But isotretinoin tablets can have serious side effects like severe headaches, bad night vision, or mood changes. If you get any of those, you should stop taking them straight away and report to your doctor. In some people isotretinoin can also cause dry skin, nosebleeds, aches and pains, and blood in urine.

Acne in women and girls caused by hormonal changes

Some women and girls get flare-ups of acne during their menstrual periods. Some hormonal conditions that affect women and girls can also cause pimples.

You may take some kinds of oral contraceptives to help deal with this type of pimples, or you can talk with your doctor and discuss what other treatments might suit you.

Other medicines called anti-androgenic drugs can also be used to treat hormonal acne.

These drugs help restore the balance of hormones in your body.

Hormonal changes in pregnancy may also cause acne to develop during this period. This type of acne usually clears up later in the pregnancy or after delivery.

Retinoids, are not safe for women to use during pregnancy. Some antibiotic creams and azelaic acid are considered safe. But you should talk to your doctor before using any treatments.

 

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What will happen to me?

Acne usually doesn’t stick around as you grow older, although it can last for several years especially if not properly taken care of. Some people need to keep using their treatments for months or even years before their acne goes away on its own.

If one treatment doesn’t help you, you may need to return to your doctor for a possible better alternative.