Definition Acne is a common skin condition in which the skin pores become clogged. This causes pimples and inflamed infected abscesses, or collections of pus. Acne may occur on a person's face, neck, chest, and back. Eighty percent (80%) of all teenagers get acne.
What is going on in the body? Acne tends to develop in teenagers because of an interaction among hormones, skin oil and bacteria. During puberty, the sebaceous glands in the skin become more active. They produce excessive oil. In acne prone skin, the oil and dead skin cells clog the pores and form comedones, or clogged pores. These are more commonly known as blackheads, which are incompletely clogged pores capped with blackened dust or debris, or whiteheads, which are completely clogged pores. These comedones are the first sign of acne. A comedone may also break through the pore wall underneath the skin and release its contents. This causes a pimple or pustule. If this substance is released deep into the skin it will cause a cyst, which is a small, pus-filled bump beneath the skin.
What are the signs and symptoms of the condition? Symptoms of acne include:
blackheads
whiteheads
pimples
pustules
cysts
What are the causes and risks of the condition? Acne is caused by a hormonal change in the body.
What can be done to prevent the condition? It is important to keep the skin gently cleansed and pores unclogged. Creams and make-up can cause clogged pores. Look for non-comedogenic products, which are ones that don't block the pores.
How is the condition diagnosed? Acne is diagnosed when blackheads, whiteheads, pimples, pustules, and/or cysts are seen on the skin.
What are the long-term effects of the condition? Long-term acne can lead to permanent scarring. It can also decrease a person's self esteem and confidence.
What are the risks to others? There are no risks to others, as acne is not contagious.
What are the treatments for the condition? The most important thing in treating acne is to keep the skin gently cleansed and pores unclogged. Several topical creams are available by prescription to unclog pores, such as benzoyl peroxide (also available over-the-counter), tretinoin, adapalene, and azeleic acid. Antibiotics, such as tetracycline and erythromycin, are used both topically and orally to fight acne. Hormonal therapies, such as certain birth control pills, such as ethinyl oestradiol/norgestimate, can also help control acne. Isotretinoin, a powerful vitamin A derivative, is used for severe acne that has not responded to other treatment.
Removal of comedones can also help to treat acne. This needs to be done with a special instrument to minimise skin injury. Intralesional cortisone injections are also used in certain cases for the larger, painful cyst.
What are the side effects of the treatments? Excessively dry and red skin is the most common side effect of topical therapy. Oral antibiotics may cause nausea, diarrhoea, flatulence, dizziness, headaches, and sunburn sensitivity. Isotretinoin has multiple side effects such as:
skin dryness
muscle and joint aches and pains
mood disturbances
decreased night vision
increased sunburn sensitivity
Most importantly, it causes birth defects if a woman becomes pregnant while on the medication.
What happens after treatment for the condition? Most treatments need to be continued on an ongoing basis to be effective. One exception is isotretinoin, which is used for 16-20 weeks.
How is the condition monitored? All prescription treatments need to monitored regularly by a doctor. Topical treatments are monitored less frequently, while oral or injected medications require more frequent checks.
Author: Lynn West, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
