Acne Treatment - Acne Causes

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Acne
Introduction
Acne is an inflammatory skin disorder which affects the hair follicles which cover the face, arms, back and chest and the sebaceous glands in the skin. These glands produce an oily substance called sebum.

Acne usually comes on around puberty but may also start in adulthood.  About 85% of teenagers develop acne at some stage, 15% of which may be moderate to severe. 

Acne is an abnormal reaction in the skin to normal levels of the male hormone, testosterone, which causes the sebaceous glands to make more and more sebum.  The sebum together with dead skin cells, block the hair follicles.

At puberty, the hair, face, and upper trunk normally become greasy due to increased production of sebum.  Both men and women have testosterone circulating in the blood.

This abnormal response will eventually correct itself and get better without treatment. However in some cases this may take many years.

Severe acne may cause permanent scarring.  However, acne disappears from the majority of teenagers.
Causes

Acne, starting at puberty is the result of increased sensitivity to testosterone which is present in both boys and girls. Testosterone causes excessive sebum to be produced by the skin’s sebaceous glands.  Skin cells rapidly divide and can block the opening of hair follicles. 

The resulting build up of sebum behind the blockage produces acne. At puberty changes in skin acid levels encourage the growth of bacterium which can also become trapped in the hair follicles to produce pustules (small blisters containing pus) and raised pimples causing a deeper infection. 

There may be a genetic factor since acne can run in families. Acne may become worse in times of stress. In girls, outbreaks may be affected by the hormonal fluctuations that occur during the menstrual cycle.
Treatment

A medicated lotion or face wash that removes excess grease and cleans the skin may help to clear up mild acne.

Gels, creams or lotions containing benzoyl peroxide can be effective in mild acne because of its anti-bacterial action.  However, in some cases it may irritate and dry the skin.

Externally applied (topical) creams containing vitamin A may be suggested to loosen keratin that is sealing the hair follicles. A doctor may also prescribe topical antibiotics.

High oestrogen contraceptive pill may also help acne, but is not a recommended treatment for acne alone. Ultra violet light and exposure to natural sunlight may also be helpful.

Moderate acne is often successfully treated with a low-dose oral antibiotic, such as tetracycline or erythromycin. These reduce the number of bacteria, inflammation and sebum production. It sometimes takes up to 8 weeks for any noticeable improvement and the treatment is usually needed for at least six months.

If the acne is severe, a dermatologist may prescribe isotretinoin, a retinoid taken by mouth that acts to loosen keratin and reduce sebum secretion.

However, the use of isotretinoin taken during pregnancy can damage the growing baby so women using the drug should be using a reliable contraceptive.

If acne has already left noticeable scars, a cosmetic surgeon may discuss techniques such as dermabrasion. In this procedure, the top layer of skin is removed under a general anaesthetic which leaves a more even layer of skin.

 

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