Acne

Lots of teenagers experience acne. It’s a very common skin condition among 12 to 15 year olds. It affects the hair follicles in your skin, mainly on your face, chest and back.

Causes

Acne is caused by over-production of oil from the sebaceous glands combined with blockage of hair follicle openings. It’s not caused by greasy food or poor hygiene.

The sebaceous glands are influenced by sex hormones which alter during puberty. It’s not abnormal production of sex hormones that causes the problem, but the sebaceous glands responding to normal hormone levels.

Symptoms

The sebaceous glands attached to the hair follicle produce oil which passes through ducts to the surface of your skin. Too much oil encourages blockage of the openings of the ducts, which allows waste cells to accumulate, forming a plug.

If the plug stays below the surface, it is light in colour and is called a whitehead. If it enlarges or pops out, the tip is dark and forms a blackhead. Red and yellow spots occur when the skin is inflamed.

If you have black skin you may find that spots make your skin darker, and this pigmentation can last for many months.

As many as 85 per cent of 12 to 25 year olds suffer from acne spots, with boys and girls equally affected. Up to 15 per cent seek medical treatment for their condition. Modern treatment is very effective and can reduce the chance of scarring.

Diagnosis

Your doctor will be able to diagnose acne by examining your skin. The doctor may also refer you to see a skin specialist called a dermatologist.

Treatment

The first step if you have mild acne is a topical treatment that is applied directly to your skin. It is available from a chemist with no prescription (it’s an over the counter treatment). 

You need to apply medications to the affected areas according to the instructions, and continue as the acne improves, to keep it under control. Anti-bacterial face washes can also help to reduce the bacteria levels on the skin surface.

If there seems to be no improvement after a month of using over the counter treatment, or if your acne is severe, you will need to make an appointment to see your doctor.

The doctor may prescribe another form of topical treatment such as retinoic acid (a form of vitamin A) or a topical antibiotic lotion. Minor side effects include skin irritation with some dryness and redness. This happens because the treatment is designed to peel off some of the skin to unblock ducts and dissolve blackheads. Reducing the frequency of applications can reduce irritation. With continued use, these problems usually settle.

It can take time to clear even mild acne so persistence and patience is needed. Make sure you follow the instructions exactly. If treatment is not working a different brand may be more effective. Most teenagers will find a topical treatment that works for them.

With severe acne, your doctor may suggest oral antibiotics in addition to topical treatment. Antibiotics reduce inflammation and the number of skin bacteria. They generally need to be taken once or twice daily for three to six months or longer.

For the most severe cases, there is stronger medication derived from Vitamin A. This is very effective but can be prescribed only by a dermatologist as there are potentially serious side-effects that need careful monitoring.

Fresh air and exercise are always good for the skin. Many people with acne report that sunshine leads to an improvement in the skin.

Stress and certain foods, such as fast food and chocolate, seem to make acne worse although there is no scientific evidence to prove this. Some cosmetics may also provoke spots, especially those that contain oils, fatty acids and waxes.

It is best to leave spots alone. Squeezing a spot carries a risk of introducing infection and also scarring.

Looking ahead

If slight scarring does occur, topical treatments used long-term may be helpful.

With very severe scarring, carbon dioxide laser resurfacing may be considered, but only when there are no longer any active acne spots. This is a technique that is only available at certain specialist dermatological and plastic surgery centres in the UK.

Last review date: 
August 2014