Acne

What it is

Acne, or pimples, is an inflammatory skin disease. The spots usually appear on the face, but the arms, back and chest can be affected too. It normally begins at puberty, between about 10 and 12, when the skin turns greasy, and often peaks between 13 and 19. It usually settles after that, though it can carry on into the early or mid twenties, and it sometimes returns in the mid thirties when hormones play a larger part.

What causes it

The oil glands in the skin are called sebaceous glands. At puberty the hormone testosterone makes them produce more sebum, the skin’s own oil. Dead cells, bacteria and sebum then form a plug at the mouth of the hair follicle. A plug at the surface shows as a black dot — a blackhead. A plug just under the skin shows as a white bump — a whitehead. When a plugged follicle bursts or becomes inflamed you get solid bumps, pus-filled spots and cysts.

Severe acne often runs in families. Greasy, oil-based cosmetics and heavy moisturisers block the pores, high-calorie food can make acne worse, and some medicines set it off. Many women get a crop of new spots a few days before a period.

How we treat it

Acne needs a proper treatment plan from a dermatologist. Several creams and several oral medicines are available, and your doctor will decide which suit you. Severe acne may need a long course of antibiotics over several months. For stubborn, severe acne your doctor may suggest a medicine called isotretinoin. Take the exact doses prescribed for the full length of time; it can take several weeks for the face to clear.

What you can do

Wash your face three or four times a day with soap and water. Shampoo your scalp two or three times a week. Avoid greasy cosmetics on the face. Do not squeeze pimples — squeezing makes severe scarring much more likely. Treating acne early lowers the risk of lasting scars.