Skin Problems - Acne
What is acne?
Most spots are acne, but not all spots are acne. There's a variety of causes, so it's important that you have the right diagnosis.
What are the causes of acne?
Acne spots are usually caused by hormone changes. They most commonly start in the teenage years. What happens is that the hormones that are normal at this stage in life, produce a change to the oil glands deeper in the skin around the hair follicles. This changes the oil gland, produces more oil and this can allow the growth of certain bacteria called kerino bacterium acnes or "the acne bacteria" that then in turn can produce the redness that we know is the acne spot. The blackhead, or the whitehead is actually the very first sign of acne and that's caused, again, by the hormones acting to block the opening of the sebaceous glands, so acne is a result of that. There are a variety of things that can make acne worse, including stress, including excess hormones from underlying problems in the body, including certain medicines that are taken, like some of the oral contraceptive pills. Some medicines that are used for epilepsy, for example. There is a wide range of medicines that can give acne as a result. Stress can make acne worse. There were some very interesting studies done tracking women students in the United States during the course of their years. Times of high stress, such as exams, correlated well with the acne being more severe. Some cosmetics and heavy makeups can make acne worse. So there are a variety of things that can make acne worse. One of the reasons that we're seeing much more acne in post-teenage women, and I will see acne in women in their thirties, forties, fifties, is probably because some of those women have a high stress lifestyle. That's almost certainly what's triggering their acne.
How can I get rid of acne?
It's difficult to totally get rid of acne. The best thing to say is that we can improve acne, and we can control acne. Acne will often go away spontaneously as your body adjusts to hormones. How can you control acne? We can use a variety of non-prescription medications. I have some in my own range that contains a variety of active anti-acne ingredients, and if you've got early mild acne, you may wish to go to the pharmacist and you may wish to get one of those non prescription acne products or a range of products - an acne cleanser and anti-acnegel,and an anti-acne toner. All of these can help. When the acne becomes more stubborn is when you need to go to your doctor, your dermatologist and get prescription products. The doctor will often start with topical prescription creams that contain a variety of things like benzoyl peroxide, antibiotics topically in gels, retinae or retinae related creams or gels. All of these need to be used in a careful way, otherwise you get too much drying. It's very important that you follow the instructions and the doctor or the dermatologist gives you those instructions. Don't leave the pharmacist until you've got those instructions. If you over use these things you can make your skin worse. The next range would be the oral antibiotic group of drugs. These can often be taken at very low dosage, preferably at night, with food so you minimize risks of things like indigestion, heartburn, sunlight sensitivity because they're cleared out of the body by the next day. These need to be used for several months under physician dermatology supervision. In addition, if the acne is slow to respond or indeed you want the acne to respond more quickly, we also have a group of treatments that my staff do, for example, at the clinic, where we treat with a combination of peels, special visible lights that kill the acne bacteria, microdermabrasion, and extraction of the early acne lesions. Those can be added to the other treatments. When all of that has failed, which is a small group,then we have to think of more powerful medicines which include drugs such as roacutane, which when used and prescribed by a dermatologist correctly is an incredibly useful drug. And in addition, some of the prescription contraceptive pills that actually block the effects of the hormones on the acne glands can be used. So we have a wide range of treatments now for acne, but it's important that you follow the treatment program carefully.
How can I get rid of acne scars?
Post acne scarring can be a real problem with some people. Classically it's on the face, often the cheeks and the temples, and depending on the type of scar, if it's a sunken hollow scar, I will use a combination of filling injections with fillers to improve the skins surface, and I will use a laser such as a fractal laser. If it's a red scar, I'll combine some of those treatments with the yellow dye laser that reduces redness. We can use a variety of different treatments for acne scars. Some of the other interesting things is that some of the creams that contain retenoids, both prescription and non prescription, can sometimes help the more superficial acne scars. But acne scars can be improved. I always like to say no scar can be completely removed, so it's a quest for improvement rather than removal.
How can I get rid of body acne?
Treatment of body acne really follows out of the face and you can refer back to what I've said about treatment of facial acne. Those are the types of treatment we use for the body.
Should I squeeze my spots?
It's not a good idea to squeeze spots, because that tends to force the inflammation and the bacteria deeper in the skin, which makes the spot worse. That's a common experience, but it's something that people keep forgetting. If you've got a really bad spot, then I will see patients and I will inject a special substance into the spot to remove it very quickly. But don't squeeze spots. If you've got an anti-acne gel that you've been prescribed, or a non-prescription gel, dab that on the spot more frequently, several times a day, but don't squeeze it.
Are spots on different parts of the body caused by different problems?
The most common other places to get spots is if you've got hair on the legs, on the arms, or on the back for example. This is more common in men, but it does occur in women. You can get infections in spots around those hair follicles and these are treated in a different way. Sometimes hair that grows back into the skin can also produce spots. They can be treated by, for example, hair removal laser, they can be treated by special body lotions, or by some antibiotics. In addition, there are a rarer cause of spots that you really need to consult with a dermatoligst about. If you've got unusual spots, large spots, spots that bleed, that may not be acne and they need to be looked at by a specialist dermatolgist.
Does toothpaste or banana get rid of spots?
Toothpaste and things like bananas, and papayas, things which contain very high concentrations of ingredients, can draw out the inflammation from a spot. In fact, it can be used. It is not the most effective of treatments, but if you've got nothing else it is certainly not going to give you any harm, and it is certainly safer than squeezing.
