Acne Can be an Embarrassing Problem and Difficult to Treat
These guidelines are intended to give you a basic understanding of the way in which your body functions and, occasionally, malfunctions. It is also designed to help you to relieve some of the more common aches and pains by giving simple and practical notes on self-help. It is not, however, intended to replace your doctor. No amount of medical knowledge gleaned from reading books can replace the deep understanding that a qualified doctor gains from years of training and experience. So use this advice for interest and for reference and if any doubt, consult your doctor.
In the normal course of events, sebum, made in the sebaceous glands deep down in the skin, travels up the hair follicle to emerge through a fine pore on the surface. There, it emulsifies with sweat to fulfill its vital double role of lubricating and protecting the skin. Therefore, if the sebum hardens and becomes trapped just beneath the surface of the skin, or if the dead epidermal cells stick together and clog the opening of the pore, a small pimple or blackhead will appear.
If the blockage occurs deeper down, inflammation and primary bacterial infection combine to produce a much larger and angrier spot. Both are acne. The more severe inflammatory types of Acne are thought to be caused by the male hormone, androgen, circulating in the bloodstream and causing the sebaceous glands to secrete grease. Nothing is demonstrable “wrong” in a hormonal sense. Some people are simply more sensitive to the hormone than others. This sensitivity will depend on familial inheritance and skin type.
Although diet has no direct causal link with acne, an imbalanced diet can certainly aggravate it, so too can stress overzealous self-treatment, and squeezing. The first rule is to leave your skin alone. If you are a habitual picker or squeezer, cut the fingernails short and watch your skin improve. Wash your skin twice daily with an antiseptic or medicated soap, use topical creams and lotions sparingly, and remember that there’s absolutely no virtue in fanaticism. Dirt and oil on top of the skin have nothing to do with any but the smallest of pimples, it is the oil trapped beneath that is to blame.
If you’ve persistent or severe acne, or are distressed about the condition, see your doctor. Acne can be treated, often extremely effectively, with a course of antibiotics, prescribed over a period of months or even years. It works by counteracting the effects of the problem, not by curing it. It may be as many as three months before a noticeable improvement in the condition of the skin can be seen.
Topical acne treatments range from mild antiseptic lotions (astringents) to stronger, more abrasive chemical solutions that “strip” off the dead layer of skin cells to unblock the pore and free the sebum. Lotions containing benzoyl peroxide, salicylic acid, or retinoic acid (vitamin A) are probably the most effective. However, while they can be valuable in treating superficial non-inflammatory acne, they’ll not help more severe types and may even aggravate them.
In addition, if these lotions are used too often or applied over-enthusiastically, they may produce redness, dryness and excessive irritation Cis Retinoic acid (at present only available in the USA), taken orally as a course of tablets, works by cutting down sebaceous activity and can be very effective. Its disadvantage, however, is that it tends to dry up the skin. Common side effects are chapped lips and general flaking and dryness.
In the future, medical treatment of the more severe types of acne may involve regulating the hormone levels responsible for producing the condition, either by prescribing an anti-androgen, usually cyproterone acetate, or additional oestrogen, depending on the patient. While effective in combating and protecting again acne, the drug is at present being combined with oestrogen for a contraceptive effect. Risk factors on ovulation and pregnancy have still to be assessed.