What is Acne?

Acne refers to infection of the hair follicles and sebaceous (oil) glands by bacteria which live on the skin (Propionebacterium Acnes).  

Who gets acne?

Acne occurs at any age from puberty onwards. Contrary to popular belief, Acne is not just a teenage problem as it can occur in individuals as young as 9 and as old as 50 years.

Acne Myths

Despite what you hear, acne is not caused by chocolates, oily foods, fries, dirt or dandruff. People who get acne do not lack hygiene and acne is not contagious.

The Diet and Acne

There is no scientific proof that acne is affected by the diet.  Yet there are many individuals who complain that their acne worsens after they eat certain types of food.  If you are such an individual, it is probably best to avoid such foods, especially before important social events.

What causes Acne?

Acne is almost always hormonal. At puberty, there is an increase in the secretion of the hormone androgen. This causes increased output of sebum (oil) from the oil gland. Large volumes of oil flow out of the gland irritating the opening of the pores which thicken and become blocked. Oil is then trapped within the hair follicles. A whitehead (closed comedone) is then formed by the trapped oil. When exposed to air, the oil changes colour to a dark brown/ black resulting in the development of a blackhead (open comedone).

Bacteria on the skin are attracted to this trapped oil the way ants are attracted to sugar. The entry of bacteria sets off an inflammatory reaction resulting in red pimples (erythematous papules). When this reaction is severe, the body's white cells attack the bacteria and pus is produced. A yellow pimple (pustule) is then seen. Several red pimples may join up to form nodules while pustules join up to form cysts.

The annoying part of untreated acne is that it heals with scars.

Other causes of acne

Oil based Cosmetics

Medication

    Applied

    Taken internally

Greasy applications on the hair

The stages of Acne

•Closed comedones (Whiteheads)

•Open comedones (Blackheads)

•Papules (Red bumps)

•Pustules (Yellow pus filled bumps)

•Nodules

•Cysts

•Scars

Can cosmetics be used in an acne sufferer?

Of course. Not only can they be used but their use is encouraged to cover up the marks left behind during the healing phase of acne, provided these cosmetics are not oil based. Furthermore, acne is not worsened by facials and deep cleansing of the skin.

How is Acne treated?

Mild acne is treated with medicines which are applied. The medicines available may be divided into several broad categories:

Benzoyl Peroxide eg. Benzac, Benoxyl

Antibiotics eg Ilotycin, Dalacin T

Retinoic Acid eg Retin A, Isotrex Gel

Naphthoic Acid eg Differin Gel/ Cream

Azaleic Acid eg Skinoren

Moderate to severe acne uses a combination of medicines taken internally with applied medicines.

What internal medicines are available?

Antibiotics

        Tetracycline eg.

                   Lymecycline eg Tetralysal
                   Doxycycline eg Cyclidox, Doxycillin, Doryx, Dumoxin
                   Minomycin eg Minomycin, Minocin, Cyclimycin
                   Oxytetracycline, Roxy, O4cycline
                   (These must be taken 1/2 hour before meals and not with milk)

        Erythromycin eg Erymycin, Ilosone

        Cotrimoxazole eg Bacrtim, Purbac

Hormonal

Diane Generic equivalents:  Minerva (Schering), Ginette (Cipla Medpro)

Androcur Generic equivalent (Cipla ciproterone acetate - 50mg only)

Yasmin is a recently introduced oral contraceptive which has mild anti acne properties.  It can be used with androcur and makes a good substitute for Diane once the acne is clear.

Roaccutane

Diane and Androcur are used in females only. Roaccutane is used in severe nodulo-cystic acne or moderate acne not responding to two or three antibiotics and Diane.

It is important to remember that Acne is not a curable condition. However, with the medications available, excellent control can be achieved and permanent scarring can be avoided.

What's available for the scars?

Scar treatment is mainly surgical.  The following procedures are performed:

    punch excision

    punch elevation

    subcision

    microdermabrasion

    fractional laser treatment

 

For further information:

Go to the web site of the American Academy of Dermatology Acnenet.