Auckland DHB Dermatology Service
Public Service, Dermatology
Acne is a skin disorder that is characterised by pimples, blackheads, whiteheads, and, in bad cases, cysts (deeper lumps). Acne usually starts at puberty and is in response to our body’s production of hormones, called androgens. These hormones cause the sebaceous glands (oil-producing glands in the skin) to get bigger and produce more oil. The extra oil (sebum) mixes with dead skin cells and naturally occurring bacteria on the surface of the skin and blocks pores. Once a pore is blocked the bacteria multiply and cause inflammation, which produces the characteristic signs of acne.
Acne commonly occurs on the face, neck, back and chest. Acne can lead to permanent scarring.
Other causes of acne may include:
- heavy makeup
- harsh and repetitive cleansing
- picking and squeezing
- certain medications
- rarely diet.
Acne Vulgaris is the most common form of acne.
Adult Acne occurs in about 30% of people at some stage in their adult life. It is thought that adult acne also has some hormonal influences.
Acne Roseaca is similar to acne vulgaris, with oily skin and spots, but also has flushing or redness of the skin in the affected area. The flush may be set off by certain spicy food or alcohol.
Usually acne can be treated successfully, but results do not happen overnight and what can work for one person may not work for another. It may take several months to see initial results, and once it significantly clears treatment is still required to keep it from coming back.
Some medications for acne can only be prescribed by a dermatologist. When acne is treated early the results are very good and it also helps to reduce scarring.
Over-the-counter products are available to treat mild-to-moderate acne, but check with a pharmacist which product is the best for your type of acne. In moderate-to-severe acne, treatment usually requires the help of a dermatologist and often more than one type of treatment. Treatments may include:
- antibiotic creams
- topical (apply to your skin) retinoids
- oral (take by mouth) antibiotics: these reduce the number of bacteria present on the skin which leads to a decrease in inflammation
- oral contraceptives: these reduce the amount of oil produced by the sebaceous glands. However, possible side effects must be taken into consideration before starting treatment
- over-the-counter acne products.
Severe acne, with deep cysts, inflammation and scarring, should be treated by a dermatologist and in most cases can be successfully treated.
Treatment may include:
- surgery: the deep cysts are removed and drained
- corticosteroid injection: used to treat the inflammation, promote healing of an acne cyst and help prevent scarring
- isotretinoin: an oral medication prescribed by a dermatologist that effectively works on all factors that cause acne. It can also have some side effects so you will need to be continually monitored whilst on this medication
- oral antibiotics
- oral contraceptives.