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Top 11 frequently asked questions about acne

26/07/2021

Acne is one of the most common skin diseases. Chances are you’ve either heard of the disease, had it yourself or know someone who has been affected by it.

Dr Namita Jasani, Consultant Dermatologist at The Holly, answers some of the top frequently asked questions about acne.

1) What does acne look like?

Acne is predominantly seen on the face (in 99%), as well as the back (in 60%) and the chest (in 15%). It can occur as small red spots (papules), yellow spots (pustule) large and painful red spots (nodules,) or comedones – black and white heads.

2) What causes acne?

Acne is caused by clogging of pores and inflammation of pilosebaceous unit (which includes your hair follicle and sebaceous glands). Hormones – androgens – increase sebum production from sebaceous glands and this allows the Cutibacterium acne to feed and grow and cause inflammation.

3) Does family history matter?

Yes, if one of your parents had deep, painful acne you are more at risk of getting acne.

4) Can stress cause acne?

Stress doesn’t cause acne but it can intensify your acne.

5) What age can you get acne?

Acne can occur at any age but it is generally more common in adolescents and young adults. Acne symptoms commonly start showing between the ages of 10 and 13.

6) What is adult acne?

Some adults continue to get acne well into their 30s, 40s, and even 50s. It’s more common in women than in men. It affects the lower face mostly including the jawline and around the mouth and chin.

7) Does diet affect acne?

There’s still research being done on the impact than diet can have on acne. Several studies show that low glycemic index food will improve your acne as it prevents spikes in your blood sugar. More studies are needed to confirm that cow’s milk can make acne worse or not.

8) Can I use make-up if I have acne?

Yes, you can wear light make up – but it’s probably best to avoid it entirely if you possibly can. Choose your products carefully i.e. preferably use non-comedogenic make-up. Wash your face twice a day with gentle cleanser and after sweating. Always remove make-up before going to bed.

9) How can you help yourself?

If you have acne at the moment here are a few tips that may help:

  • Use non-comedogenic products or oil-free products including moisturiser and sunscreen
  • Use gentle cleanser to wash your face
  • Don’t pick or ‘pop’ your acne as it will leave scars.
  • Don’t scrub your face if it feels oily as it can worsen acne-prone sensitive skin
  • Wait 4 -6 weeks to see if acne treatment works. Be sure to spread the acne medication on all acne-prone skin, not just on spots.
  • See a dermatologist to treat your acne early

10) How to treat acne in skin of colour?

Treat acne and dark spots at the same time. Dark skin is at higher risk of forming pigmentary scar from acne spots. For mild acne use retinoid and benzyl peroxide. Do not use cocoa butter, shea butter or coconut oil on the face as it will block pores. Use non-comedogenic products, gentle cleanser with salicylic acid or glycolic acid.

11) How to treat acne?

Treatment of acne depends on the severity, type of acne and previous treatments.

For mild acne, topical treatment (applied to skin) may be enough.

Topical treatment includes benzyl peroxide, antibiotic cream- clindamycin or erythromycin gel/cream, and Retinoid gel.

For moderate acne or if acne fails to respond to topical treatment, then I would consider oral antibiotics for 3-6 months, and sometimes oral contraceptive pills are considered in female patients.

For patients with severe acne or acne failing to respond to standard treatment or scarring, then Isotretinoin would be considered. Isotretinoin is also known by the brand name Roaccutane in UK. It is a vitamin A derivative. Most patients find significant improvement of acne with this treatment. The course of treatment is between 4 to 6 months.

Isotretinoin works by decreasing the skin’s natural oil production – sebum secretion. It also:

  • shrinks sebaceous glands
  • affects production of keratin that causes clogged pores

A reduction in Propionibacterium acnes in the hair follicles occurs as a secondary result of decreased nutrients (decrease in sebum).

You can find out more about dermatology treatments and services at The Holly here.

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