An overview of acne treatment

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Acne is one of the main reasons that patients attend dermatology clinics. Whilst many think of it as a disease of adolescents (85% of teenagers are affected), it is not uncommon in adults and 12% of adult women are affected by acne at one point or another. Acne is thought to be caused by a combination of increased sebum production, blockage of pores (the opening of hair follicles onto the skin surface) and the presence of a bacterium called P. acnes. Factors such as family history, hormones, diet and choice of skincare products can also play a role. There can be significant physical and psychological consequences of having untreated or poorly controlled acne. Examples include permanent scarring, poor self-image, depression and anxiety. As it is not a dangerous or life-threatening condition, however, the impact of these on acne sufferers is often underestimated by medical practitioners.

What You'll Need

  • For mild acne – salicylic acid or benzoyl peroxide washes or gels over the counter.
  • For moderate or severe acne – see your doctor for advice on prescriptions
  • Skincare and make-up – use a gentle cleanser and look for products that are labelled non-comedogenic as these will not exacerbate breakouts

What You'll Do

  • It is important to take action to control acne as soon as it appears. This helps to reduce the risk of permanent scarring in the longer term.
  • If your acne is mild you may like to try an over-the-counter acne preparation in the first instance. Look for products that contain ingredients such as benzoyl peroxide or salicylic acid.
  • If your acne is more widespread or severe, you may need prescription strength topical or oral treatment to gain control. These are often combined for best results. Examples of topical treatments include azelaic acid, antibiotics and retinoid creams or gels. Oral treatments include antibiotics or hormonal agents, such as the combined oral contraceptive pill e.g. Yasmin or Dianette.
  • An oral retinoid medication called isotretinoin may be given under the expert guidance of a dermatologist in the presence of cysts, deep-seated nodules, scarring or when other treatments have failed.
  • Topical treatments may dry or irritate the skin when you first start using them. This is a common reason for early discontinuation and can be reduced or prevented by tapering the application in very gradually. See my tip on introducing topical retinoids.
  • Expect to use your treatments for about three months before you see an improvement. Make sure that you understand how to use them correctly so you get the most out of them.
  • Avoid the temptation to pick or squeeze your spots as this tends to aggravate them and may cause scarring in itself.
  • Cleanse your skin and remove make-up with a gentle cleanser. Scrubbing too hard can irritate the skin and make your acne worse.
  • There are some really good foundations and concealers that can provide effective coverage and help reduce embarrassment. Look for products that are oil-free and labelled as being non-comedogenic. This means that they won’t block your pores and cause breakouts.
  • There is a small body of emerging evidence that foods with a high glycaemic index may contribute to acne. Whilst this evidence is not strong enough to make any specific dietary recommendations at this time, your overall health will benefit from a nutritious and balanced diet.
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