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Acne develops when shifts in hormones occur, triggering an over production of oil and dead cells to build up within the skin follicle. The resulting blockage, or plug, obscures the pore opening and causes the follicle beneath to swell, allowing for an overgrowth of Propionibacterium acnes, or P. acnes, a type of bacteria which increases inflammation and results in blemishes.

Most typically associated with puberty, and in women around the time of menstruation, acne is also becoming increasingly common in adults, even those who have never previously suffered in puberty.

What are the symptoms?

There are two main types of acne blemish – blackheads, which are clogged follicles that remain open, and whiteheads or comedones, clogged follicles which are closed and under the skin. Certain types of acne also result in papules and pustules (small bumps), nodules and cysts.

Acne can vary from very mild symptoms to inflamed spots that may become filled with pus.

Most commonly affecting the face, chest and back, acne may also cause scarring which can differ in shape and pigmentation depending on the individual and the severity of their condition.

Scars are caused when the body produces extra collagen to try and counteract the damage caused by picking or squeezing the skin.

Who is affected?

Acne is mainly fuelled by male hormones, which usually peak during the teenage years. However, acne isn’t just a teenage condition. Many adults also suffer, with around 80% of adult acne cases affecting women. Experts believe this is due to fluctuating hormone levels during periods, pregnancy, medical conditions such as PCOS, or as a side effect of medication.

Essentially a normal physiological condition, certain factors may aggravate the acne including:

  • Hormonal fluctuation
  • Picking or squeezing blemishes
  • Certain clothing and headgear
  • Air pollution and weather conditions, including high humidity

Teenage acne is usually typified by pimples, blackheads or whiteheads on the face, especially the forehead, and occasionally, by deeper cysts on the chest and back.

In adults, acne is more likely to manifest lower down on the face, often around the mouth and jawline, with blemishes often being deeper in nature.

Common treatments

Acne cannot be cured, but it can be brought under control with the right treatment.

The main goal should be to reduce or clear blemishes through topical skincare or treatments designed to lessen sebum production, reduce bacterial growth, encourage shedding of skin cells and unclog pores.

Because some acne therapies can cause side effects, sufferers should also proceed with caution when trying a new treatment. Those with severe, persistent acne may also be referred to a dermatologist to help determine the right type of treatment.

Broadly speaking, there are two main types of acne treatment. Most over-the-counter treatments and prescription creams help by unplugging the follicles, while oral acne medications, like antibiotics or the contraceptive pill, work by interrupting the inflammatory process in different ways.

Because each and every case is different, there is no single wonder treatment. While some sufferers may respond well to a certain acne cream, others may require a combination approach to keep their symptoms under control.

There are many common treatment options for acne. Please speak to your GP for the best recommendation for you.

Skincare advice

In many cases, a sensible, simple skincare routine can help manage acne symptoms:

  • Avoid over-cleansing – washing too frequently may irritate the skin and exacerbate symptoms.
  • Use a mild cleanser with lukewarm water. Water that's too hot or cold can make acne worse.
  • Don't squeeze spots or attempt to extract blackheads yourself − this can lead to further inflammation and scarring.
  • Use non-comedogenic (non pore-blocking) water-based moisturisers and make up.
  • Be sure to cleanse the skin of all make up thoroughly before bed.
  • Washing hair regularly and wearing away from the face can also help.

For further information

The British Association of Dermatologists
4 Fitzroy Square, London W1T 5HQ
Tel: 0207 383 0266
Fax: 0207 388 5263

The Acne Support Group (ASG)
PO Box 9, Newquay, Cornwall TR9 6WG
Tel: 0870 870 2263