Okay, buckle up everyone. This is a huge topic and acne is not just about the impact on our physical appearance so I hope I can address this sensitively, whilst getting the main points across.
Who gets acne?
A lot of patients will develop acne in their teen years, as during puberty various hormones, such as testosterone, surge. 95% of patients with acne are age 11-30. This typically improves over time, however, 3% of patients over age 35 present with acne which may need different treatment than teenage skin. Our genes can influence whether we will develop acne too. If our parents have experienced it, it is more likely that we will too. Smoking has been associated with adult acne so it is always worth trying to eliminate this.
What causes acne?
When there is a change in hormones such as puberty or menstration, or even genetic influences, this can affect how much sebum our skin produces. Sebum is a natural oil which lubricates our hair follicles. We need sebum for healthy follicle function, however, if an excess of sebum is produced, this can block the hair follicle. This, in combination with a build up of dead skin cells, can cause a breakout.
What DOES NOT cause acne?
Hygiene. Do not think that you have developed acne because you are not washing your skin well enough. There are harmless bacteria on the skin which can affect acne presentation, which we can treat, but it is not the cause of the problem. Far too often I see patients using scrubs, washes, creams, serums, and masks to try to exfoliate and clean their skin which creates more inflammation in the skin.
What types of spots do we get?
There are various types of spots we might develop depending on the type of acne present. If the harmless bacteria on our skin contaminates spots, they often turn to papules, pustules and nodules.
Blackheads – black or yellow spots. They are black in colour because they are open and the sebum oxidises and turns black. It is not because of dirt.
Whitehead – look similar to blackheads, but are usually firmer and do not ‘pop’. Whiteheads are when the congested follicle is close to the surface of the skin.
Papules – these are small red bumps that usually feel painful
Pustules – similar to papules but have yellow pus in the middle
Nodules – large hard spots that build up beneath the surface of the skin and can be painful
Cysts – These are large spots that look similar to boils but contain pus and are most likely to cause scarring
What can you do?
Firstly, never pick the spots. This increases the risk of forcing bacteria deeper into the pore which causes increased inflammation, irritation and scarring. Secondly, if your acne could be caused by a hormone imbalance and you have other concerns such as irregular periods, weight gain, then I would advise you discuss this with your GP to check any underlying health conditions. Treating the cause can help with treatment.
After a thorough consultation, we can identify if we are able to help you. Some of the treatments we are able to use are home skincare such as retinoids, benzoyl peroxide, and salicylic acids. We are also able to use some professional treatments such as chemical peels which target acne prone skin. There is no quick fix but with commitment we can try to improve the skins appearance and reduce long term affects. Treatment for acne usually requires medical grade skin care, not cosmetic, so seek advice from the correct practitioner.
In addition, it is important to seek advice if you are feeling low in mood because of the appearance of your skin. Having acne can really affect your confidence and it is crucial to talk to someone to find coping mechanisms.
If you are struggling, please contact us to find out how we can help and support you,